Prostate Cancer Flashcards
What do you use to grade prostate cancer?
Gleason score - find biggest tumour to do this
What is the most common type of prostate cancer?
Adenocarcinoma
What are risk factors for prostate cancer?
- Obesity
- Afro-Caribbean
- Genetic (BRCA1/2)
- FH
- Age > 50
If prostate cancer causes symptoms, what are they?
LUTS
- Nocturia
- Poor stream
- Hesitancy
- Dysuria
- Increased frequency
- Systemic symptoms - weight loss, lethargy
What is the main symptom of metastatic prostate cancer?
Bone pain e.g. lumbar back pain - spinal mets/external compression
What is a treatment-related complication of prostate cancer?
Post-operative sexual dysfunction
What is the first line investigation for prostate cancer?
DRE
What blood test might you do for prostate cancer?
Serum PSA (raised - non-specific) > 4
How do you diagnose prostate cancer?
Transrectal US + biopsy (TRUS biopsy) - transrectal US-guided needle biopsy
What other investigations might you do for prostate cancer?
- Bone scan ± X ray - mets
- Pelvic MRI
- Staging - CT/MRI AP
What is the curative treatment for prostate cancer?
- Active surveillance
- Surgery (radical prostatectomy)
- Radical radiotherapy
- ± hormone therapy
What is palliative treatment for prostate cancer?
- Watchful waiting
- Hormone therapy
What hormone therapy can you give in (palliative) prostate cancer?
Androgen deprivation
- LHRH agonists/antagonists
- Anti-androgens
Why do you treat palliative prostate cancer with androgen deprivation?
Androgens promote growth of prostate cells (cancer + normal) so want to slow this down
What would you find on DRE/PR exam in prostate cancer?
Asymmetrical nodular mass (craggy mass)
anal tone
What type of lymphadenopathy does prostate cancer cause?
Non-tender inguinal lymphadenopathy
What medication is used to treat BPH?
Tamsulosin
What is the most common cancer diagnosed in men in the UK?
Prostate cancer
What are some complications of treatment for prostate cancer?
- Radiation-induced urinary symptoms
- Surgery-induced urinary symptoms and altered sexual function
- Hormone-induced (gynaecomastia, hot flushes, ED)
What are signs suggestive of mets in prostate cancer?
- Lumbar back pain
- Non-tender inguinal lymphadenopathy
What can you not do before having PSA measured?
No ejaculation 24h before checking PSA (can be raised)
What other blood tests can you do in prostate cancer?
- Testosterone
- LFTs
- FBC
- Renal function - if low don’t use contrast
How do you manage localised prostate cancer?
- Active surveillance (PSA every 3-4 months + PR exam at 12 months + MRI at 12-18 months)
- Radical prostatectomy (robotic)
- Radical radiotherapy/external beam radiotherapy
- Brachytherapy
- Androgen-deprivation therapy (LHRHa)
- Watchful waiting
