PROSTATE CANCER Flashcards
Prostate cancer is common in men
over 50
95% of prostate cancer is
ADENOCARCINOMA
most common cancer diagnosed in men
prostate cancer
____ leading cause of cancer deaths is prostate cancer
2nd
____ most common male malignancy world wide
4th
level standard for prostate cancer testing
PSA and DRE
20-40% of men with prostate cancer will have
normal PSA level
PSA density is
ratio of PSA to prostate volume
PSA variants
PSA density
PSA velocity
Free/total PSA ratio
indications for initial biopsy (4)
Abnormal DRE, TRU, PSA, mets
first biopsy takes how many samples
10-12 + suspicous area
repeat biopsy done when
negative but PSA more than 10, atypical cell, small so might have missed, and active surveillance
repeat biopsy # of samples
13 to 15
most cancer found where
peripheral
position for guided biopsy
left lateral decub
how far does biopsy needle go in
2-3 cm
side effects of biopsy
blood in urine, stool and sperm for days
discoloured ejaculate for months
singnificant side effects of biopsy
sepsis, large hematoma, urinary retention, significant rectal bleeding
why is cancer difficult to detect in the inner gland
heterogenous and BPH nodules
hardest tumor to detect
anterior midline tumor
classic cancer appearance
hypoechoic nodule
_____-_____% of cancer not detectable
30-50%
__% of cancer is isoechoic
30%
alternative cancer appearance
can replace entire peripheral zone making peripheral zone more hypoechoic than inner
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what is staging
extent of the disease
two types of staging
clinical and pathological
clinical staging important for
deciding patient management
cTX
can not be assessed
cT0
no evidence of tumor
CT1
Not palpable and not visible
cT2
Palpable and visible
cT3a
extended to periprostatic soft tissue
cT3b
extended to seminal vesicles
T4
TUMOR INVADED OTHER STRUCTURES
pathological staging considered
more accurate prognosis
pathologiclas staging requires (3)
evaluation of prostate, sv and lymph nodes
pT2
organ confined
pT3
extraprostatic extension
pT4
invasion of rectum, levator muscle ad or pelvic wall
