Prostate Cancer Prevention & Tx - Westra Flashcards
What are the risk factors associated with Prostate Cancer?
Race (African American males are 65% more likely to develop prostate cancer than whites.)
Family History (Pt with a first-degree relative who has had prostate cancer is 2.4 times more likely to be diagnosed with the disease than is a man with no affected relatives.)
Age (65-74)
Diet (folic acid, dairy, and calcium)
Occupational/Chemical Exposure => ***Dioxin (agent orange)
Hormonal Factors => ***Men with high plasma testosterone levels are at increased risk
What are the prevention strategies for Prostate Cancer?
Diet - Folate in foods
Medications - Chemoprevention with finasteride and dutasteride
Define PSA.
Blood test used to measure a protein made by prostate cells
10 ng/ml high
What are the clinical symptoms of Prostate Cancer?
Difficulty starting to urinate
Less force to the stream of urine
Dribbling after urinating
Frequent urination
Hematuria
Pain or burning while urinating
Pain with ejaculation
Knee, Hip, or back pain not resolving
What are potential treatments for Prostate Cancer?
Active Surveillance
Surgery
Cryosurgery
External Beam Radiation
Interstitial Brachytherapy
Hormonal Therapy
Chemotherapy
What is the incidence of Prostate Cancer?
Estimated 220,800 new cases and 27,540 cancer-related deaths in 2015
Most common male cancer
Most common age group at diagnosis 65-74
What race/ethnicity has the highest incidence of prostate cancer?
Black 214.5/100,000 men*
African American males are 65% more likely to develop prostate cancer than whites.
(compared to White 130.4/100,000 men and All Races 137.9/100,000 men)
What are the four tests/studies that help detect prostate cancer?
PSA
Digital Rectal Exam
Transrectal Ultrasound
Biopsy
What do the PSA Velocity and PSA Density measure?
PSA Velocity=measures how quickly PSA level rises over period of time. A change of >0.75 ng/ml rise in one year is significant
PSA Density=reflects relationship between PSA level and size of gland measured by transrectal ultrasound (TRUS)
Who would be a good candidate for Active Surveillance treatment of Prostate Cancer?
Less aggressive tumors
> 70 years with co-existent illnesses
Potential treatment side effects
Palliative therapy – Radiation for metastatic bone pain
Who would be a good candidate for surgery in the treatment of Prostate Cancer? Options?
SURGERY USUALLY FOR PTS
What is cryosurgery?
Destroys Prostate Cancer by freezing the prostate tissue with cryoprobes
What tx strategy would you consider for a 55 yr old male with PSA of 6, normal DRE, positive family hx, and a prostate biopsy positive for adenocarcinoma?
Radical prostatectomy
(best tolerated by
What tx strategy would you consider for a 78 yr old male with PSA of 15, nodular prostate and positive prostate biopsy?
Radiation Therapy
surgery would be risky, esp. if multiple co-morbidities
What tx strategy would you recommend for a 74 year old male with oxygen-dependent COPD, PSA of 8, and enlarged prostate?
Active Surveillance
co-morbidities eliminate aggressive tx
