prostate cancer JD Flashcards
what are the signs and symptoms of prostate cancer?
*Difficulty starting urination
*Weak or interrupted flow of urine
*The need to urinate more frequently, especially at night
*Difficulty emptying the bladder completely
*Pain of burning during urination
*Pain in the back, hips, chest (ribs) or pelvis that
doesn’t go away
*Weakness of numbness in the legs or feet
*Erectile dysfunction
*Painful ejaculation
what are the risk factors associated with prostate cancer?
*Age (most cases are diagnosed in people
over 50)
*More common in men of African-Carribean
or African descent
*Family history – having a brother or father
who developed prostate cancer under the
age of 60 increases a person’s risk
*Obesity
*Exercise
what are the two ways in which to detect prostate cancer?
- Digital rectal exam
- Prostate-specific antigen (PSA) test: measures the level of PSA in the blood. PSA is made by the prostate. It is produced by normal and cancerous prostate cells.
how is diagnostics made?
if PSA or DRE is abnormal – diagnostic tests are
undertaken:
1. MRI scan
2. Transrectal ultrasound
3. Transperineal biopsy
what is gleason score?
this is determined when the biopsy is
looked at under the microscope. If there is a cancer, the score looks at how likely it is to spread. Score
ranges from 2-10.
when is localised prostate cancer low, medium and high risk?
Low risk
*Slow growing tumour
*PSA less than 10ng/mL
*Gleason score less than 7
*Medium risk
*PSA 10 – 20ng/mL
*Gleason score is 7
*High risk
*PSA above 20ng/mL
*Gleason score of 8, 9 or 10
how should you monitor low risk localised prostate cancer?
*Active surveillance
*PSA every 3-6 months
*DRE every 6-12 months
when would you move from active surveillence to radiacl treatment?
*Disease progression
*Considering patient preference, co-morbidity
and life expectancy
how would you treat medium to high risk localised prostate cancer?
*Radical prostatectomy
*Radical external beam radiotherapy
*Radiotherapy and hormonal treatment
Brachytherapy
what is external beam radiotherapy? how does it work?
*Most common treatment for UK men
*Destruction of cancer cells using focussed X-ray
radiation delivered from outside the body
when is external beam radiotherapy used?
Often used together with hormonal therapy or after surgery
what are the short and long term problems associated with external beam radiotherapy?
*Short term:
*Urinary problems – frequency, urgency, retention
*Bowel problems– diarrhoea, wind, bleeding
*Fatigue
*Skin damage
*Long term:
*Ongoing urinary and bowel issues
*Erectile dysfunction
*Infertility
*Lymphoedema
*Second cancers
what is brachytherapy?
*Delivers radiotherapy to the prostate from a
local internal source
*Uses permanently implanted seeds (low dose
rate) or temporary implanted wires directly into
the prostate (high dose rate)
when would you not used brachytherapy?
Not alone for high risk patients
*May be given in combination with hormonal
treatment or external beam radiotherapy
where does bradhytherapy deliver the radiation to?
Delivers radiation directly into the prostate
*Healthy tissue less likely to be damaged
