Prostate Cancer Flashcards
who is this most common in?
black men
aged 70-74
FH
cadmium batteries
most common type
adenocarcinomas
metastatic sites
pelvic lymph nodes
bone
presentation
most asymptomatic
haematuria/ haematospermia
bone pain, anorexia, weight loss
diagnosis
DRE (peripheral zone cancers)
PSA
TRUS biopsy
bone scan, MRI, CT
causes of raised PSA
cancer BPH prostatitis UTI retention catheterisation DRE/PR large prostate bike rider
what MUST be done before PSA?
counselling
why do bad prognosis cancers not release PSA usually?
do not resemble cell of origin so do not release PSA
when is TRUS biopsy indicated?
abnormal DRE
elevated PSA
risks in TRUS biopsy
bleeding
sepsis
vaso-vagal fainting
grading of prostate cancer
Gleason score
staging of prostate cancer
TNM
TNM of organ-confined disease
T1-2, NO, MO
locally advanced TNM
T3-4, NO, MO
metastatic TNM
N+, M+
management of organ confined disease
surveillance
radical surgery (prostatectomy)
radiotherapy (EBRT, brachytherapy
risks in prostatectomy
ED
incontinence
complications of radiotherapy
haematuria
GI
ED
incontinence
management of locally advanced
radiotherapy
hormonal therapy
watchful waiting
management of metastatic disease
androgen deprivation therapy
chemotherapy
diethylstilbesterol/steroids
androgen deprivation therapy
LHRH analogues
anti-androgens
bilateral orchidectomy
what is the growth of prostate called controlled by?
testosterone
dihydrotestosterone
so if deprived they undergo apoptosis
LHRH agonists complication
suppression of LH and FSH causing testosterone surge leading to spinal cord compression
how to prevent testosterone surge?
anti-androgen cover
examples of anti-androgens
steroidal (cyproterone acetate)
non-steroidal (nilutamide, flutamide and bicalutamide)
