Prostate Cancer

Question 1

What is the prevalence of prostate cancer in the West.

Answer 1

40% of males born in the Western world will develop prostatic cancer.

Question 2

What percentage of men in the West with prostate cancer will be diagnosed with prostate cancer.

Answer 2

10%.

Question 3

What percentage of men in the West with prostate cancer will die from the disease.

Answer 3

3%.

Question 4

What part of the world has a low incidence of prostate cancer.

Answer 4

Asia.

Question 5

What ethnic group has a higher incidence of prostate cancer.

Answer 5

African-American men.

Question 6

What are the risk factors for developing prostate cancer. (2)

Answer 6

Aging.

Positive family history.

Question 7

What are your chances of developing prostate cancer if you have 1 first degree relative with prostate cancer.

Answer 7

Twice as likely.

Question 8

What are your chances of developing prostate cancer if you have 2 first degree relative with prostate cancer.

Answer 8

Five times more likely.

Question 9

What are the symptoms of prostate cancer. (3)

Answer 9

Voiding symptoms (hesitancy, poor stream, terminal dribbling). 
Storage symptoms (nocturia). 
Haematuria/spermia.

Question 10

How is prostate cancer usually diagnosed in asymptomatic men.

Answer 10

PSA screening.

Question 11

What are the physical signs of prostate cancer. (8)

Answer 11

Hard nodular prostate on PR exam (stony hard).
Occasionally incidental diagnosis after TURP.
Can present as advanced disease with:
Acute renal failure from ureteric obstruction.
Bone pain.
Pathological fracture.
Spinal cord compression.
Malaise.
Weight loss.

Question 12

How is prostate cancer staged.

Answer 12

TNM

Question 13

What is a T1 prostate cancer.

Answer 13

Impalpable and not visible on imaging.

Question 14

What is a T2 prostate cancer.

Answer 14

Tumour confined within the prostate.

Question 15

What is a T3 prostate cancer.

Answer 15

Tumour extends outside of the prostate capsule.

Question 16

What is a T4 prostate cancer.

Answer 16

Tumour invades adjacent structures.

Question 17

What are the adjacent structures that can be invaded in prostate cancer. (ie T4). (3)

Answer 17

Bladder.
Pelvic wall.
Levator ani.

Question 18

What percentage of male cancers is prostatic cancer accountable for.

Answer 18

7%

Question 19

Histologically, what are most prostatic tumours.

Answer 19

Adenocarcinomas.

Question 20

What are the symptoms of metastatic spread of prostate cancer. (4)

Answer 20

Back pain.
Weight loss.
Anaemia.
Obstruction of the ureters.

Question 21

What is the basis of the Gleason scoring system for grading prostatic cancer.

Answer 21

Histological appearance.

Question 22

What is the average age of presentation of prostatic caner.

Answer 22

70

Question 23

Bony metastases of prostatic cancers are usually to the______ and ________

Answer 23

Lumbar spine.

Pelvis.

Question 24

Where within the prostate do most cancers develop.

Answer 24

Within the peripheral zone.

Question 25

Is there a genetic predisposition to developing prostate cancer.

Answer 25

Yes, a family history of prostate cancer greatly increases a man’s chances of developing the disease.

Question 26

On PR exam of a man with prostatic cancer, what features of the prostate may be lost.

Answer 26

Median sulcus.

Question 27

What percentage of prostatic tumours are impalpable.

Answer 27

Up to 45%

Question 28

By how much is your risk of developing prostate cancer increased with a positive family history.

Answer 28

2-3 times more likely.

Question 29

In what percentage of small prostatic cancers is PSA normal.

Answer 29

30% of small cancers.