Prostate cancer wiki

Question 1

Most prostate cancers grow at what speed?

Answer 1

Slow, some are fast.

Question 2

PC tends to metastasise to

Answer 2

bones and lymph nodes

Question 3

What are the symptoms of PC?

Answer 3

Initially could cause no symptoms, later stages:
Difficulty urinating,
Blood in the urine,
Pain in the pelvis, back or when urinating.

Sometimes mistaken as benign prostatic hyperplasia (BPH).

Question 4

What are the factors that increase the risk of prostate cancer?

Answer 4

Older age
Family history of the disease
Race

99% in those over age of 50.

African americans more than white americans.

Diet high in processed meat, red meat, or milk products or low in certain vegetables.

An associated with gonorrhea has been found - dont know why.

Question 5

PC risk is associated with which STI?

Answer 5

Gonorrhea.

Question 6

PSA

Answer 6

Prostate specific antigen resting increases cancer detection but does not decrease mortality.

Question 7

Why would a patient with PC be receiving bisphosphonates?

Answer 7

spread to bones.

Question 8

PC is classified as what type of cancer?

Answer 8

Adenocarcinoma, glandular cancer, that begins when normal semen-secreting prostate gladn cells mutate into cancer cells.

Question 9

Why do prostate cancer cells have excess energy?

Answer 9

The prostate is a zinc-accumulating, citrate-producing organ. The protein ZIP1 is responsible for the active transport of zinc into prostate cells.

Zinc -> citrate, important component of semen. This process is energy intensive.

PC cells are generally devoid of zinc, this allows PC cells tosave energy and utilise the new abundance of energy to grow and spread.

This absence of zinc is thought to occur via silencing of the gene that produces the transporter protein ZIP1.

ZIP1 is now called a TSG product for the SLC39A1.

Question 10

Zinc is anti-proliferative and induces apoptosis in abnormal cells, how?

Answer 10

It inhibits the NF-kB pathways.

Unfortunately, oral ingestion of zinc is ineffective since high concentrations of zinc into prostate cells is not possible without the active transporter, ZIP1.

Question 11

p53 mutations are seen mostly at what stage of PC?

Answer 11

More frequently seen in metastatic settings - later in the pathology of PC.

Question 12

“Up to 70% of men with PC have lost one copy of the ____ gene at the time of diagnosis”

Answer 12

PTEN

Question 13

How does the PSMA (Prostate specific membrane antigen) stimulate the development of PC?

Answer 13

Increases the folate levels for the cancer cells to use to survive and grow, hydrolysing glutamated folates.

Question 14

Macrophage inhibitory cytokine - 1 (MIC-1) plays what role in PC cell growth?

Answer 14

MIC-1 stimulates the focal adhesion kinase (FAK) signalling pathway which leads to prostate cancer cell growth and survival.

Question 15

What is the only test that can fully confirm the diagnosis of PC?

Answer 15

Biopsy.

Question 16

What are the different diagnostic tools for use in PC?

Answer 16

Digital rectal examination (DRE)

Cytoscopy - use thin, flexible camera tube inserted down the urethra.

Prostate imaging - US, MRI.

Biopsy - only tool to fully confirm it.

Gleason scoring - tissue samples are examined under a microscope to determine whether cancer cells are present.

Tumour markers - PSA, small cell carcinoma (1% cases) can be diagnosed using the PSA levels.

Question 17

The oncoprotein BCL-2 is associated with the development of what?

Answer 17

Androgen-independent prostate cancer.

Question 18

What impact may finasteride and dutasteride have on overall PC risk?

Answer 18

May reduce - insufficient evidence either way really. Could lead to increased chance of more serious cases.

Question 19

What are the main side effects of PC treatments?

Answer 19

ED

Urinary incontenence etc.

Question 20

Treatment of aggresive PC may involve what?

Answer 20

1. Surgery (radial prostatectomy)
2. Radiation therapy, including brachytherapy (prostate brachytherapy) and external beam radiation therapy, high-intensity focused ultrasound (HIFU).
3. Chemotherapy, oral chemotherapeutic drugs
4. Cryosurgery
5. Hormonal therapy

Question 21

What is Sipuleucel-T?

Answer 21

A cancer vaccine has been found to result in a benefit (a four-month increase in survival) for men with metastatic prostate cancer.

Actually an immunostimulant.

Question 22

Most hormone dependent cancers become resistant to treatment after how long?

Answer 22

one to three years and resume growth despite hormonal therapy.

Question 23

First-line treatment for Castration-resistant prostate cancer (hormone treatment resistant)

Answer 23

Docetaxel with median survival benefit of 2 to 3 months.

Question 24

As well as PSA, what other detection test can be used for PC?

Answer 24

PCA3 mRNA is expressed almost exclusively by prostate cancer cells and has been shown to be highly over-expressed in prostate cancer cells.

Test result is reported as a specimen ratio of PCA3 mRNA to PSA mRNA.