Prostate, Penile and Testicular Disease

Question 1

Most prostate cancers are _____ arising in the ____ prostate

Answer 1

Adenocarcinomas, peripheral

Question 2

What is prostate cancer associated with (3)?

Answer 2

+ve family history
↑Testosterone
Cadmium batteries

Question 3

What are some of the signs and symptoms of prostate cancer?

Answer 3

Asymptomatic (majority)
Nocturia
Hesitancy
Poor stream
Terminal dribbling
Haematuria
Haematospermia
LUTS
Systemic (weight loss, anorexia)`

Question 4

What investigations can be done for prostate cancer?

Answer 4

PR (hard craggy prostate)
↑PSA
Transrectal US + biopsy
MRI
Bone scan (bony metastases)

Question 5

What system is used for grading prostate cancer and how does it work?

Answer 5

Gleason grading system
Combination of 2 numbers -> score for the most prominent pattern + score for the second most predominant pattern (each out of 5)

Question 6

Where can prostate cancer metastasise?

Answer 6

Pelvic lymph nodes

Skeleton (sclerotic lesions)

Question 7

What is the treatment/management of organ confined prostate cancer?

Answer 7

Watchful waiting (repeat PSA and PR)
Active surveillance
Radical prostatectomy
Radical radiotherapy (external beam, brachytherapy)

Question 8

What is the treatment/management of locally advanced prostate cancer?

Answer 8

Radiotherapy with neo-adjuvant hormonal therapy

Watchful waiting

Question 9

What is the treatment/management of metastatic prostate cancer?

Answer 9

Androgen deprivation therapy (LHRH agonist or antagonists, diethylstillboestrol = synthetic oestrogen)
Cytotoxic chemotherapy

Question 10

What 3 groups of patients are at increased risk of prostate cancer?

Answer 10

Older males (+50)
Black
+ve family history