Prostate Cancer and Prostatitis Flashcards
who gets prostate cancer?
black men
70-74
FH (BRCA2)
most common type of prostate cancer?
adenocarcinoma
what causes most prostate cancers to grow?
testosterone
presentation of prostate cancer
haematuria haematospermia bone pain anorexia weight loss
diagnosis of prostate cancer
DRE PSA TRUS biopsy (transrectal ultrasound guided) MRI nuclear medicine bone scan
why is a DRE good in prostate cancer?
most prostate cancers arise from peripheral zones
what causes PSA to be elevated?
BPH prostatitis UTI retention DRE
what must be done before a PSA is taken on a blood test?
must have counselling
what is normal PSA?
<3.5
TRUS biopsy adverse effects
bleeding
sepsis
vaso-vagal fainting
needs multiple samples
what is the scoring system used in prostate cancer?
Gleason’s scoring
what is Gleason’s scoring?
histology from two parts of the tumour to give a prognostic index (scored 2-10)
management of organ confined disease
surveillance with PSA level monitoring
radical surgery
radiotherapy (EBRT, brachytherapy - iodine)
locally advanced disease management of prostate cancer
radiotherapy
hormonal therapy
surgery (castration)
metastatic disease management of prostate cancer
androgen deprivation therapy
steroids
chemotherapy
radiotherapy for painful bone mets
examples of hormonal therapies
testosterone antagonists (bicalutamide) GnRH agonists (goserelin and leuprorelin) bilateral orchidectomy
adverse of hormonal therapy
hot flushes sexual dysfunction gynaecomastia fatigue OP
adverse of EBRT?
risks proctitis when directed at the prostate
risk in prostate cancer
testosterone surge
needs anti-androgen cover
what is prostatitis?
infection of the prostate
four types of prostatitis
- acute infection
- chronic infection
- chronic pelvic pain syndrome
- asymptomatic inflammatory prostatitis/ incidental finding
presentation of prostatitis
pelvic pain fever myalgia nausea LUTS sexual dysfunction pain with bowel movements
diagnosis of prostatitis
DRE may feel a tender, boggy prostate
MSU= microscopy and culture
management of prostatitis
3-4 fluoroquinolone (ciprofloxacin/ ofloxacin)
TURP if abscess
management of category 3 prostatitis
NSAIDs
long-term antibiotics
