Prostate cancer Flashcards
Where is prostate cancer normally located?
70% in peripheral zone
What is the histology of prostate cancer?
95%= adenocarcinoma
What are the risk factors for prostate cancer?
> 65
FH
Afro-Caribbean
What are the early features of prostate cancer?
Often asymptomatic
Some urinary symptoms
What are the features of local or locally advanced prostate cancer?
Obstructive= poor stream, hesitancy, incomplete emptying, terminal dribbling Irritative= frequency, urgency Haematuria haemospermia Pain Lethargy, weight loss, cachexia
What is the diagnostic triad for prostate cancer?
Digital rectal exam
PSA
Prostate biopsy
How does prostate cancer feel on DRE?
Hard, craggy, nodular
What is a normal PSA value?
50-59= <3 60-69= <4 >70= <5
What are non cancerous causes of a raised PSA?
UTI Prostatitis BPH Ejaculation in past 48 hours Vigorous exercise in last 48 hours DRE Instrumentation e.g. catheter Urinary retention
What kind of biopsy is done for prostate cancer?
Transrectal US guided
What imaging can be done for prostate cancer?
MRI if suspect of locally advanced disease
What score is used to grade prostate cancer?
Gleason score
What is the Gleason score?
2 scores of 1 to 5 describing the 2 most dominant types of cells
10= worst prognosis
2= best prognosis
What are the principles of management of local disease?
Dependent on life expectancy, grade of disease, patient choice
What are the management options for localised prostate cancer?
Watchful waiting and active surveillance
Radical prostatectomy
RAdiotherapy
