Prostate Cancer Flashcards
T/F: men castrated before puberty do not develop cancer
True
T/F: prostate cancer does not respond to hormonal deprivation
False, it does respond to hormonal deprivation
At what stage do you start to see obstructive sx of prostate cancer?
Late stages
What are the 2 main dx used to detect prostate cancer?
DRE
PSA
What 3 instances would you do a DRE in?
- prostate issues
2, blood in stool
- rectal cancer
DRE: General principles:
Any ______ nodule needs to be considered for biopsy
Any _____________ nodule needs to be correlated with the PSA
hard
questionable
What position must the pt be in when performing the DRE?
kneeling position
DRE is useful for approximating the __________
size of the prostate gland
Which part of the prostate can we access during a DRE?
Why is this so useful to us?
peripheral zone
this is the zone where prostate cancer is most common
The following are physiological properties of what?
Serine protease
Produced by epithelial cells lining the
aciniand ducts of the prostate gland
Secreted in the seminal fluid, very little
should enter the general circulation
Liquefaction of the seminal coagulum
PSA
The median increase in serum PSA
after routine DRE is clinically insignificant/significant?
INSIGNIFICANT
What is PSA velocity and why is it significant?
change in PSA concentration over a period of time
may detect early prostate cancer before detection through other methods
What is PSA density and why is it significant?
serum PSA concentration/prostate volume (divided by)
May be helpful in differentiating prostate cancer from BPH
T/F: PSA is prostate specific not prostate cancer specific
TRUE
T/F: PSA following DRE is accurate and reliable
True
T/F: PSA can detect cancers not identified by DRE
TRUE
Dx of Prostate Cancer
Transrectal Ultrasonography / Biopsy
What major sign will you see in a transrectal US that is indicative of prostate CA?
hyperechoic area on prostate
T/F: Prostate Cancer is usually an incidental finding
True
What are the sx of prostate CA metastasis?
Bone pain
weight loss
fatigue
dyspnea
fatigue
What are the 3 diagnostics used for evaulation of metastatic Prostate CA?
Nuclear Medicine Bone Scan
CT Abdomen + Pelvis
PET
5 possibleTx of Prostate CA
Surgical
Radiation
Hormonal manipulation
observation/active surveillance
When would you perform a radical prostatectomy?
if lesions are clinically confined to the prostate
What are the 3 complications of radical prostatectomy?
bladder neck contractures
impotence
incontinence
(BII)
What are the 2 types of radiation for prostate CA?
External beam
seed implantation
“A beam plants a seed”
What hormone can you manipulate to treat prostate cancer?
testosterone
T/F: testosterone deprivation regresses prostate CA
True
2 Meds used for hormonal manipulation
LH-RH analogs
antiandrogens
2 LH-RH Analogs
leuprolide
goserelin
MC side effect of LH-RH analogs
hot flashes
Which drug is used for bone metastases sites?
Radium-223
What is the biggest risk factor for prostate cancer?
family hx
