Prostate Cancer

Question 1

What are risk factors for prostate cancer?

Answer 1

Afro-Caribbean, FH, Age, anabolic steroids

Question 2

How does prostate cancer present?

Answer 2

LUTS, weight loss, fatigue, night sweats, bone pain

Question 3

What are first line tests?

Answer 3

DRE and PSA

Question 4

What is the gold standard investigation?

Answer 4

Transrectal USS and biopsy

Question 5

What are negatives about the PSA test?

Answer 5

Test isn’t very accurate, false positives mean needless testing that can cause SEs, only 1/3 with a high PSA will have cancer, may be worried needlessly, if cancer is found you can’t be sure it will impinge on your health

Question 6

What are the main differential diagnoses?

Answer 6

BPH, chronic prostatitis

Question 7

How would you manage local prostate cancer?

Answer 7

Prostatectomy or active surveillance

Question 8

How would you manage metastatic prostate cancer?

Answer 8

Chemotherapy, radiotherapy, bilateral orchidectomy, goserelin

Question 9

What complications can arise?

Answer 9

Erectile dysfunction, mets to bone, brain, liver, lung

Question 10

What staging system is used?

Answer 10

TNM system

Question 11

What grading system is used?

Answer 11

Gleason grade

Question 12

How do you calculate the Gleason grade?

Answer 12

Analyse histology from 2 different areas and add their scores together

Question 13

What does a grade of 8-10 mean?

Answer 13

Aggressive

Question 14

What does a grade of 5-7 mean?

Answer 14

Intermediate

Question 15

What does a grade of 2-4 mean?

Answer 15

Indolent