Prostate Cancer

Question 1

Prostate T Staging

Answer 1

Tx Primary tumour cannot be assessed
T0 No evidence of primary tumour
T1* Clinically inapparent tumour not palpable or visible by imaging
T1a* Tumour incidental histological finding in 5% or less of tissue resected
T1b* Tumour incidental histological finding in more than 5% of tissue resected
T1c* Tumour identified by needle biopsy (e.g. because of elevated PSA)**
T2 Tumour confined within prostate
T2a Tumour involves one half of one lobe or less
T2b Tumour involves more than half of one lobe, but not both lobes
T2c Tumour involves both lobes
T3 Tumour extends through the prostate capsule***
T3a Extraprostatic extension (unilateral or bilateral) including microscopic bladder neck involvement
T3b Tumour invades seminal vesicle(s)
T4 Tumour is fixed or invades adjacent structures other than seminal vesicles external sphincter, rectum, levator muscles or pelvic wall

Question 2

Prostate N Staging

Answer 2

NX Regional lymph nodes cannot be assessed
N0 No regional lymph node metastasis
N1 Regional lymph node metastasis

Question 3

Prostate M Staging

Answer 3

M0 	No distant metastasis 
M1 	Distant metastasis 
M1a  	Non-regional lymph node(s)  
M1b 	Bone(s) 
M1c  	Other site(s)

Question 4

Prostate Stage 1 Grouping

Answer 4

Stage I T1, T2a N0 M0

Question 5

Prostate Stage 2 Grouping

Answer 5

Stage II T2b, T2c N0 M0

Question 6

Prostate Stage 3 Grouping

Answer 6

Stage III T3, T4 N0 M0

Question 7

Prostate Stage 4 Grouping

Answer 7

Stage IV Any T
Any T N1
Any N M0
M1

Question 8

Prostate Stage 1 Mortality

Answer 8

100% 5Year Survival

Question 9

Prostate Stage 2 Mortality

Answer 9

100% 5 Year Survival

Question 10

Prostate Stage 3 Mortality

Answer 10

95% 5 year Survival

Question 11

Prostate Stage 4 Mortality

Answer 11

50% 5 Year Survival

Question 12

Prostate Low Risk PSA

Answer 12

<10

Question 13

Prostate Intermediate Risk PSA

Answer 13

10-20

Question 14

Prostate High Risk PSA

Answer 14

> 20

Question 15

Prostate Low Risk Gleeson

Answer 15

3+3=6

Question 16

Prostate Intermediate Risk Gleeson

Answer 16

3+4/4+3=7

Question 17

Prostate High Risk Gleeson

Answer 17

> 7

Question 18

Prostate Low Risk T Stage

Answer 18

=

Question 19

Prostate Intermediate Risk T Stage

Answer 19

=

Question 20

Prostate High Risk T Stage

Answer 20

=>T3

Question 21

Prostate IPSS mildly symptomatic

Answer 21

0-7 Mildly symptomatic; 8-19 moderately symptomatic; 20-35 severely symptomatic.

Question 22

Prostate IPSS Moderately symptomatic

Answer 22

0-7 Mildly symptomatic; 8-19 moderately symptomatic; 20-35 severely symptomatic.

Question 23

Prostate IPSS severely symptomatic

Answer 23

0-7 Mildly symptomatic; 8-19 moderately symptomatic; 20-35 severely symptomatic.

Question 24

Prostate Normal Urine flow rate

Answer 24

Uroflowmetry is the measurement of voided urine (in milliliters) per unit of time (in seconds). The important elements of the test are voided volume (which should be >150 mL), maximum flow rate (Qmax), and the curve of the flow (which should be bell shaped). In men, a Qmax >15 mL/s is considered normal, whereas a Qmax <10 mL/s is considered abnormal.

Question 25

Prostate Max size for Brachytherapy

Answer 25

60cc

Question 26

Criteria for Active Surveillance

Answer 26

Low to intermediate risk

Question 27

Followup schedule for AS

Answer 27

PSA estimation (including doubling time (DT)) and DRE every 3-6 months.
Early MRI and rebiopsy after 12 months (TRUSS-guided or template).

Active surveillance - progression to treatment:
PSA DT of 2 years or less
Evidence of disease progression on PSA, DRE or rebiopsy