Prostate Cancer Lecture Powerpoint

Question 1

Recall the anatomy of the prostate

Answer 1

Situated beneath the bladder and perforated by a portion of the urethra, up against the anterior wall of the rectum, has muscular function to seal off bladder during ejaculation and glandular function to produce alkaline fluid (adds to semen volume) and release PSA

Question 2

PSA

Answer 2

Prostate specific antigen, used as a screening tool to detect BPH, prostatitis, and prostate cancer

Question 3

The prostate’s secretion is ___ dependent

Answer 3

DHT (androgen)

Question 4

The majority of prostate cancer occurs in what zone? What are 95% of cell types?

Answer 4

Peripheral zone, adenocarcinomas

Question 5

Definitive diagnosis for prostate cancer is through…

Answer 5

…biopsy

Question 6

Prostate cancer epdiemiological factors

Answer 6

-Most common cancer in males excluding melanoma, majority found in patients over age 65, rates twice as high in African Americans, BCRA1 and 2 genes

Question 7

Prostate cancer signs and symptoms (4)

Answer 7

• Weak and interrupted urine flow
• burning urine
• low back, hip, or thigh pain (metastasis for bone)
• difficulty getting or maintaining erection

Question 8

Most common site for prostate cancer to metastasize to

Answer 8

Bone

Question 9

Screening guidelines for early detection of prostate cancer by American cancer society

Answer 9

• Balance of benefit and harm related to use of PSA is uncertain
• men with 10+ year life expectancy should make informed decision starting at age 50
• men at risk discuss screening at age 45

Question 10

2 tools for prostate cancer screening

Answer 10

• DRE

- PSA

Question 11

PSA level ranges

Answer 11

2.5-4 consider referral based on risk factors
4-10 biopsy usually recommended
>10 uniformly recommended

Question 12

Gleason score (prostate cancer)

Answer 12

Grading system of 2 most predominant tumor patterns graded on scale of 1-5 then added to score either 2-6 well differentiated, 7 moderated (need bone scan), 8-10 poorly differentiated (aggressive cancer)

Question 13

T1-4 staging for prostate cancers

Answer 13

T1 and 2 are confined to prostate, 3 and 4 have invaded or metastasized

Question 14

Overwhelming majority of patients with prostate cancer in local or regional stages have a 5 year survival of almost __%

Answer 14

100

Question 15

Prostate cancer treatment options (4)

Answer 15

• active surveillance
• radical prostatectomy (will cause dysfunctions like ED)
• brachytherapy (radiation)
• hormonal therapy (orchiectomy, GNRH analogues, estrogens)

Question 16

No major organization fully endorses routine testing for what type of cancer? What age group is screening most likely to benefit?

Answer 16

Prostate, 50-70 years old