Prostate Cancer

Question 1

When should the PSA test be discussed with Pt?

Answer 1

Present with associated symptoms

If they talk about FHx or PSA

Question 2

How may someone present with prostate cancer?

Answer 2

Urinary symptoms
Bone pain
Post PSA check/biopsy
Incidental finding during TURP for urinary/ retention symptoms
Abnormal finding at DRE for another reason ie change in bowel habit

Question 3

What are some factors influencing treatment decisions in CaP?

Answer 3

Age
DRE
PSA level
Biopsies
MRI scan and bone scan

Question 4

What is meant by prostatism?

Answer 4

Lower urinary tract symptoms associated with bladder outflow obstruction.

Nocturia, frequency, urgency, hesitancy, a poor stream and post-micturtion dribling.

Question 5

Give 3 risk factors for prostate cancer

Answer 5

Increasing age
Family history (BRCA2)
Ethnicity - black> white> Asian

Question 6

What are some other causes of raised PSA?

Answer 6

BPH
Infection (can not rely on it within 6 weeks of a urinalysis infection)
Inflammation 
Urinary retention
Large prostate

Question 7

If picked up on DRE or serum PSA what should be the next step?

Answer 7

TRUS

Question 8

What is unlikely if PSA is less than 10?

Answer 8

Bone metastasis

Question 9

What is used in medical castration of the prostate?

Answer 9

LHRH agonists

Question 10

Give a drug used in palliative care of metastatic prostate cancer

Answer 10

Zoledronic acid (bisphosphonate)

Question 11

Give a surgical procedure used in localised prostate cancer treatment.

Answer 11

Robotic radical prostatectomy