Prostate Cancer Flashcards
What is the most common cancer in men?
Prostate
second most common cause of cancer deaths in men
What are the risk factors for prostate cancer?
Age >50 African origin Family history Genetics (BRCA 1 & BRCA 2) Obesity
In which area of the prostate do prostate cancers most commonly arise?
Peripheral zone (75%)
transitional zone (20%) central zone (5%)
What are the two most common types of prostate cancer?
95% of prostate cancer = adenocarcinoma
Acinar adenocarcinoma
Ductal adenocarcinoma
What are the red flag symptoms for prostate cancer?
LUTS Back pain/bone pain Weight loss Erectile dysfunction Haematuria Lethargy
What are the Lower Urinary Tract Symptoms?
urgency frequency terminal dribbling hesitancy nocturia overactive bladder
What is Prostate Specific Antigen?
PSA = a protein produced by prostate epithelial cells to liquefy semen.
Small amounts of PSA leak into the blood, if there is altered architecture in the prostate then more will be released into the blood.
What are the possible causes of a raised PSA?
PROSTATE CANCER BPH Prostatitis Acute urinary retention TURP Urinary catheterisation Recent DRE Recent ejaculation Vigorous exercise
What are the criteria for a 2WW referral?
Abnormal DRE
PSA >3 in men aged 50-69
Red flag symptoms
How is PSA density calculated?
Total PSA/prostate volume
How might prostate cancer feel on a DRE?
Hard, irregular/craggy, lack of mobility, loss of central sulcus, may have a nodule in one lobe, induration, asymmetry of the gland.
What further investigations would you perform if suspecting prostate cancer?
Multiparametric MRI prostate
Transrectal ultrasound + biopsy or Transperianal biopsy
Radioisotope bone scan
CT CAP
Other than adenocarcinoma, what other types of cancer can form in the prostate?
Transitional Cell Carcinoma
Neuroendocrine (e.g. small cell carcinoma)
these are rare
What system is used to assess the histological grade of prostate cancers?
Gleason Score
What Gleason scores indicate low, intermediate and high grade adenocarcinomas?
Low: Gleason = 6
Intermediate: 7
High: 8-10
Which structures are at risk of direct invasion from prostate cancer?
Seminal vesicles
Bladder
Rectum