Prostate cancer

Question 1

What is the most common histological type of prostate cancer?

Answer 1

adenocarcinoma

Question 2

What are RFs?

Answer 2

increased age
obesity
afro-caribbean
FHx

Question 3

What are possible sx?

Answer 3

1. LUTS - obstruction so voiding problems
2. Haematuria, haematospermia
3. Pain - back, perineal, testicular
4. ED, weight loss, anorexia

Question 4

What is found on DRE?

Answer 4

asymmetrical hard nodular enlargement w loss of median sulcus

Question 5

where does it commonly metastasis to?

Answer 5

bones - causing pain

Question 6

What investigations can be done?

Answer 6

1. PSA
2. DRE
3. Transurectal USS + biopsy
4. MRI/CT + bone scan for staging
5. Gleason scoring

Question 7

What is Gleason scoring?What scores signify low, intermediate, high risk

Answer 7

grades tumour by biopsy
Low: ≤6
Intermediate: 7
High: 8-10

Question 8

What is the management of low risk localised prostate cancer?

Answer 8

Active surveillance or:

• radical prostatectomy
• radiotherapy: external beam and brachytherapy

Question 9

What are management options for localised advanced prostate cancer?

Answer 9

Hormone therapy ]
Radical prostatectomy
Radiotherapy: EB + B

Question 10

What are important risks of radiotherapy rx for prostate cancer?

Answer 10

increased risk of bladder, colon and rectal cancer

Question 11

what is a common complication of radical prostatectomy

Answer 11

erectile dysfunction

Question 12

What is rx of metastatic prostate canceR?

Answer 12

1. synthetic GnRH agonist e.g. Goserelin, cover initially w anti-androgen to prevent rise in testosterone
2. Anti androgen - cyproterone acetate