Prostate Cancer Flashcards
what are the most common cancers in the UK?
breast, prostate, lung, colorectal
what is the most common cancer in men in the UK?
Prostate
when is prostate cancer usually diagnosed?
85% diagnosed older than 65
present with localised disease
what are the risk factors for prostate cancer?
Age
Ethnicity (African americals, Caucasians, low in Asians)
Diet-red meat
Family history
Genetic mutations: BRCA2 (5 times higher risk)
what can cause PSA to be elevated transiently?
Prostatis After endoscopic urethral manipulation Prostatic biopsy Ejaculation Urinary retention
what has little effect on PSA
what is the half life of PSA?
rectal examination has little effect on PSA
Half life of 2.2 to 3.2 days, decline to original in 4-8 weeks
what are the issues with potential screening for prostate cancer?
Controversial
Unnecessary anxiety
Treatment related to complications
Low risk cancers which may not need treatment
what are the signs and symptoms of prostate cancer?
Presence of symptoms attributable to growth of prostate cancer into urethra or into bladder neck
Obstruction- urinary hesitancy, decreased force of urine stream, intermittency
Irritation-urinary frequency, nocturia, urgency, urge incontinence
what symptoms of prostate cancer arise when there is obstruction of the ejaculatory ducts?
haemtospermia, decrease in ejaculate volume
what symptoms of prostate cancer occur when there is an extension to the neurovascular bundle?
erectile dysfunction
describe the presentation of metastatic prostate cancer?
Bone pain Anaemia Leg oedema Leg weakness Fracture Weight loss
what is the role of bone scans in diagnosing prostate cancer?
Bone scans show hotspots of where it is metabolically active showing areas of cancer spread. Sensitive for any metabolic activity but not specific for cancer.
describe the potential for examination and investigation in patients with prostate cancer?
Rectal examination PSA Transrectal ultrasound guided biopsy (TRUS) MRI/CT scan Bone scan (gleason >7, PSA>10) Routine FBC and BCP
describe the risk stratification for prostate cancer?
Risk stratification
Low risk: T2a, gleason6, PSA<10. Cancer in prostate
Intermediate risk: t2b, gleason7, PSA10-20
High risk: t3a and higher, gleason>8, PSA>20 – metastasis to distal organs
describe the gleason scoring system for prostate cancer?
Scores of 6 or less describe cancer cells that look similar to normal cells and suggest that the cancer is likely to grow slowly.
A score of 7 suggests and intermediate risk for aggressive cancer. Scoring a 7 means that the primary score (largest section of the tumor) scored a 3 or 4. Tumors with a primary score of 3 and a secondary score of 4 have a fairly good outlook, whereas cancers with a primary Gleason Score of 4 and a secondary score of 3, are more likely to grow and spread.
Scores of 8 or higher describe cancers that are likely to spread more rapidly, these cancers are often referred to as poorly differentiated or high grade.
