Prostate cancer

Question 1

Define prostate cancer

Answer 1

Primary malignant neoplasm of the prostate gland

Question 2

Aetiology of prostate cancer

Answer 2

Unknown

Question 3

Risk factors for prostate cancer

5

Answer 3

Age
Afro-Caribbean
FH
Dietary factors 
Occupational exposure to cadmium

Question 4

Presenting symptoms of prostate cancer

general + 2

Answer 4

Often asymptomatic
Lower urinary tract obstruction
Metastatic spread

Question 5

Presenting symptoms of prostate cancer - lower urinary tract obstruction
(5)

Answer 5

Frequency
Hesitancy
Poor stream
Terminal dribbling
Nocturia

Question 6

Presenting symptoms of prostate cancer - metastatic spread

4

Answer 6

Bone pain
Cord compression
Systemic symptoms - malaise, anorexia, weight loss
Paraneoplastic syndromes (e.g. hypercalcaemia)

Question 7

Signs of prostate cancer on physical examination

2

Answer 7

Asymmetrical hard nodular prostate

Loss of midline sulcus

Question 8

Investigations for prostate cancer

6 + 1 + 1 +1

Answer 8

Bloods
FBC
U&Es
PSA (not v specific)
Acid phosphatase
LFTs
Bone profile

CT/MRI scan
Assess extent of local invasion & lymph node involvement

Transrectal US & needle biopsy

Isotope bone scan
Check for bone metastases