Prostate cancer Flashcards
In what ethnicities is prostate cancer more common?
African and Afro-carribean backgrounds.
What genes have been linked with an increased risk of prostate cancer?
BRCA 2 and pTEN
What histiologcial type are 95% of prostate cancers?
Adenocarcinoma, most commonly arising from the peripheral parts of the gland
What percentage of patients with prostate cancer present with metastatic disease?
20%
What scan is best to visualise the anatomy of the prostate and internal pelvis?
MRI
What staging system is used in prostate cancer?
TNM
What grading system is used in prostate cancer and how does it work?
Gleason system - scores tumours (from 2 to 10) on the basis of histiological patterns in the two most dominant areas of the tumour, (e.g. Gleason 4 + 3 means main area is 4 with the second area 3). Minimum total score 6, maximum score of 10
When might observation rather than active treatment be indicated for management of prostate cancer?
In patients with asymptomatic disease, confined to the prostate. Particularly where other conditions limit the length of survival that is expected
When is radical surgery indicated for management of prostate cancer?
Patients with localised disease (T2 disease or less) can be treated by radical prostatectomy with curative intent
What side effects should men receiving prostatectomy be warned about?
Can lead to temporary or lasting impotence and incontinence.
When is radiotherapy indicated in management of prostate cancer?
Radical radiotherapy may be used as an alternative to surgery in T1 and T2 tumours, where PSA is low, suggesting no occult metastases. It is also more appropriate for the control of more advanced local disease. Adjuvant radiotherapy may also be given following radical surgery if there is concern for residual disease.
Why should definitive radiotherapy be delayed until at least six weeks following trans-urethral resection?
To prevent stricture formation
What methods of radiotherapy are available for prostate cancer treatment?
External beam irradiation
OR
by the interstitial implantation of radioisotopes (brachytherapy)
OR by a combination of these.
What side effects can arise following radiotherapy of the prostate?
Dysuria, rectal bleeding, diarrhoea, impotence and incontinence.
When might hormonal therapy be indicated for the management of prostate cancer?
For treating advanced disease or in conjunction with radiotherapy for the treatment of localised disease.
