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E CAN ext. > Prostate Cancer > Flashcards

Prostate Cancer Flashcards

1
Q

How common is prostate cancer, compared to other cancers?

A

Most common male cancer

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2
Q

How deadly is prostate cancer, compared to other cancers?

A

3rd most common cause of male cancer death

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3
Q

What % of men over 80 have prostate cancer?

A

80%

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4
Q

What ethnicity has the highest prevalence of prostate cancer?

A

Black people

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5
Q

What kind of cancer is prostate cancer?

A

Adenocarcinoma

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6
Q

Where does prostate cancer affect?

A

The peripheral zone of the prostate

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7
Q

Is prostate cancer always symptomatic?

A

No, it is usually asymptomatic

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8
Q

What are the urinary symptoms of prostate cancer?

A 
Nocturia
Frequency
Hesitancy
Poor stream 
Terminal dripping
Obstruction
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9
Q

What are the systemic symptoms of prostate cancer?

A

Weight loss

Fatigue

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10
Q

What are the metastatic symptoms of prostate cancer?

A

Bone pain

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11
Q

What is found on DRE in prostate cancer?

A

Hard, irregular prostate on PR

Loss of midline sulcus

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12
Q

Where does prostate cancer spread locally?

A

Seminal vesicles
Bladder
Rectum

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13
Q

Which lymph nodes does prostate cancer spread to?

A

Para-aortic nodes

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14
Q

What does prostate cancer cause if it spreads haematologically?

A

Sclerotic bony lesions

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15
Q

What bloods are done in prostate cancer?

A

PSA
U&E
Acid and alk phos
Calcium

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16
Q

What imaging is done in prostate cancer?

A

XR chest and spine
Transrectal US and biopsy
Bone scan
Staging MRI

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17
Q

How can the detection of affected nodes be improved in MRI staging scan for prostate cancer?

A

Contrast enhancing magnetic nanoparticles

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18
Q

What is PSA?

A

A proteolytic enzyme used in liquefaction of ejaculate

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19
Q

What can cause an increase is PSA?

A 
Prostate cancer
Age
PR
TURP
Prostatitis
20
Q

What % of small cancers have a normal PSA result?

A

30%

21
Q

How is Gleason grade calculated?

A

Score the two worst affected areas

22
Q

How is Gleason trade interpreted?

A

The sum is inversely proportional to prognosis

23
Q

What is Tis in prostate cancer?

A

Carcinoma in situ

24
Q

What is T1 in prostate cancer?

A

Incidental finding on TURP or increased PSA

25
Q

What is T2 in prostate cancer?

A

Intracapsular tumour with deformation of prostate

26
Q

What is T3 in prostate cancer?

A

Extra-prostatic extension

27
Q

What is T4 in prostate cancer?

A

Fixed to pelvis and invading neighbouring structures

28
Q

What is N1-4 in prostate cancer?

A

Lymph node involvement

29
Q

What is M1 in prostate cancer?

A

Distant mets

30
Q

What is the importance of prognostic factors in prostate cancer?

A

Help determine whether to pursue radical Rx

31
Q

What are the prognostic factors in prostate cancer?

A

Age
Pre-Rx PSA
Tumour stage
Tumour grade

32
Q

What is the problem with the management fo prostate cancer?

A

It is difficult to know which tumours are indolent and will not cause mortality before something else, and radical therapy is assocaited with significant mortality

33
Q

What is involved in the conservative management of prostate cancer?

A

Close monitoring with DRE and PSA

34
Q

What are the options in the radical therapy of prostate cancer?

A

Radical prostatectomy

Brachytherapy

35
Q

What is used alongside radical prostatectomy if the cancer is node +ve?

A

Goserelin

36
Q

How is a radical prostatectomy performed?

A

Laparoscopically with a robot

37
Q

What is the limitation of the survival increase with radical prostatectomy for prostate cancer?

A

It only improves survival vs active monitoring if <75 years

38
Q

What happens in brachytherapy for prostate cancer?

A

Implantation of palladium seeds

39
Q

What are the side effects of radical therapy for prostate cancer?

A

Erectile dysfunction
Urinary incontinence
Death

40
Q

Where is medical therapy for prostate cancer used?

A

Metastatic or node +ve disease

41
Q

What is involved in the medical therapy of prostate cancer?

A

LHRH analogues

Anti-androgens

42
Q

Give an example of an LHRH analogue?

A

Goserelin

43
Q

How do LHRH analogues work in prostate cancer?

A

They inhibit pituitary gonadotrophins, decreasing testosterone

44
Q

Give two examples of anti-androgens

A

Cyproterone acetate

Flutamide

45
Q

What can be used in the symptomatic management of prostate cancer?

A

TURP for obstruction
Analgesia
Radiotherapy for bone mets/cord compression

46
Q

Why is population based screening for prostate cancer using PSA not recommended in UK?

A

PSA not accurate tumour marker
Trials show small or no mortality benefit
Must balance mortality benefit with harm caused by over-diagnosis and over treatment of indolent cancers

E CAN ext. (47 decks)

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