Prostate Cancer

Question 1

Definition

Answer 1

Primary malignant neoplasm of the prostate gland

Question 2

Aetiology

Answer 2

Unknown

Question 3

Risk factors

Answer 3

o Age
o Afro-Caribbean
o Family history
o Dietary factors
o Occupational exposure to cadmium

Question 4

Epidemiology

Answer 4

· COMMON

· 2nd most common cause of male cancer deaths

Question 5

Presenting symptoms (lower urinary tract obstruction)

Answer 5

o Frequency
o Hesitancy
o Poor stream
o Terminal dribbling
o Nocturia

Question 6

Presenting symptoms (metastatic spread)

Answer 6

o Bone pain

o Cord compression
o Systemic symptoms: malaise, anorexia, weight loss
o Paraneoplastic syndromes (e.g. hypercalcaemia)

Question 7

Signs on physical examination

Answer 7

· Asymmetrical hard nodular prostate

· Loss of midline sulcus

Question 8

Investigations (bloods)

Answer 8

o FBC

o U&Es

o PSA
· NOTE: not a very specific test for prostate cancer

o Acid phosphatase

o LFTs

o Bone profile

Question 9

Investigations (other)

Answer 9

· CT/MRI Scan
o Assesses extent of local invasion and lymph node involvement

· Transrectal Ultrasound and Needle Biopsy

· Isotope Bone Scan - check for bone metastases