Prostate cancer Flashcards
Describe the epidemiology of prostate cancer. (2)
Very common in old men - all men over 80 have it. 2nd commonest cause of cancer death.
Describe the risk factors for prostate cancer. (4)
Increased age
Family history - BRCA2 or 1st degree relative under 60 with it.
Black > white > Asian.
Describe the screening that occurs in the UK for prostate cancer. (6)
Not recommended with no symptoms. If someone has urinary symptoms or FH then OFFER a PSA - don’t do on everyone because of:
Over-diagnosis - you have no symptoms
Over-treatment - bad side effects of treatment
Other causes - infection, inflammation, BPH, urinary retention.
Normal PSA does not equal no cancer.
Describe the presentation of prostate cancer. (5)
Urinary symptoms, bone pain (always mets to bone but sclerotic - hypocalcaemia), DRE for change in bowel habit, incidental finding in TURP.
Describe the diagnosis of prostate cancer. (2)
TRUS - transracial ultrasound guided biopsy.
Transperineal biopsy.
Describe the factors that affect treatments of prostate cancer. (4)
Age, staging PSA levels (higher = more aggressive = more mets), grade (Gleason grading system), bone mets seen.
Describe the treatments of prostate cancer. (8)
Localised: surveillance, robotic prostectomy, radiotherapy.
Locally advanced: surveillance, normal therapy, radiotherapy.
Metastatic: hormone with chemotherapy to reduce testosterone - castration - LH releasing hormone agonists.
Palliative: radiotherapy, bisphosphates, chemotherapy.
Describe the differences in positioning between BPH and CaP.
CaP usually occurs in the peripheral zone - palpable on DRE.
BPH usually occurs in the transition zone.