Prostate Cancer Flashcards
What is prostate cancer?
Malignant cancer in the peripheral zone of the prostate
What are the risk factors for prostate cancer? (3)
- Androgen sensitivity: high testosterone
- Family history
- Increasing age
Which layer of the prostate enlarges in prostate cancer?
Peripheral layer
What are the clinical presentations of a pt w prostate cancer? (3)
Non-specific: weight loss, fever, fatigue
LUTS obstruction: SHED
Bone pains
Bone pain and weight loss in a 70yo male with hesitancy and dysuria is suggestive of what?
METASTASIS to bone
How would you diagnose prostate cancer? (3)
DRE: hard, irregular, craggy/ nobly, enlarged
PSA: not specific
Transrectal ultrasound + biopsy
How would you test for metastasis? (2)
CT abdo, pelvis
MRI spine if spinal cord compression
How would you evaluate the prognosis of a prostate biopsy sample?
Gleason grading
On prostate biopsy small, uniform glands can be seen. What Gleason grading would you give?
Grade 1 (well-differentiated)
Microscopy of a prostate biopsy sample reveals irregular masses of neoplastic cells with few glands. What Gleason grading is this?
Grade 4 (poorly differentiated, anaplastic)
How would you manage localised prostate cancer? (3)
Active surveillance
Radical prostatectomy
Radical radiotherapy/ brachytherapy
What is the 1st line treatment for metastatic/ advanced prostate cancer? (3)
Androgen deprivation therapy = GnRH agonists
Goserelin, zoladex + anti-androgen therapy
