Prostate cancer

Question 1

Define Prostate cancer

Answer 1

Malignant tumour of glandular origin, usually in the exterior prostate (takes a long time for Sx)
A more mild form exist and it common-usually die with it (not from it), and a more aggressive form needs treatment

Question 2

Aetiology and risk factors of Prostate cancer

Answer 2

Low risk form can sit in bladder for years and not cause any issues
High grade/High risk-much higher chance of metastases and need treatment fast

Risk factors

Age, afro carribean, BRAC1 gene
FHx

Question 3

Epidiemology of Prostate cancer

Answer 3

Most common male cancer by far
Most old people have a mild form of it
want to treat the more aggressive form

Question 4

Signs and SX of Prostate cancer

Answer 4

usually no Sx-incidental PSA screening

can have LUTS-quite late presentation (Storage issues)
Urinary retention

Heamaturia

Bone pain, pain, weight loss, cord compression-usually metastases (most common spine)

Palpate bladder
DRE-not smooth, hard craggy and non symmetrical

Question 5

Investigations of Prostate cancer

Answer 5

PSA-anyone over 3
But can rise for tons of things (BPH, Urinary retention, infection, catheterisation, prostate cancer)
DRE doesn’t raise it

Gold standard-MRI scan-eep good for low risk vs high risk (doesn’t show low risk-if normal MRI-can have cancer, but low risk)

If high risk-Biopsy-only real diagnosis
Gleason score--
grading-3+3-low risk
anything higher
Staging TNM

Question 6

Management of Prostate cancer

Answer 6

Staging via MRI, bone scan

active surveillance-MRI anually, PSA every 3 month (low risk, for young
Surgery-radical prostatectomy-in organ
Radical radiotherapy-in organ, older pt
Watchful waiting (old)

will not treat–Hormones-conjuction with radiotherapy-shrinks cancer-
chemotherapy

surgery has been less popular because of sIde FX

Question 7

Complication of Prostate cancer

Answer 7

surgery-incontinence and erectile dysfunction

Metastases to spinal cord-compression-emergency, start steroids
Bone metastases

Radiation can cause lots of LUTS
Hormones-menopause like Sx

Question 8

Prognosis of Prostate cancer

Answer 8

Low risk-very good
T1/2-90% 10 year survival rate
even highest risk has 10y of 36%

Organ confined-very good
With metastases-18 month survival

active surveillance is often enough if low grade
In high grade-need agressive treatment