SM_239b: Prostate and Prostate Cancer Flashcards
Prostate has ____, ____, and ____ zones
Prostate has peripheral, central, and transition zones
Most prostate cancer originates in the ___ zone
Most prostate cancer originates in the peripheral zone
Describe risk factors for prostate cancer
Prostate cancer risk factors
- Age: 65+
- Heredity: 15% of prostate cancer
- Ethnicity: African American men
- Inflammation: prostatis / STI, IBD
- Diet: fat
- Obesity
Men with metastatic prostate cancer may have ____
Men with metastatic prostate cancer may have germline mutations in DNA repair genes
PSA screening ___ prostate cancer detection
PSA screening increases prostate cancer detection
- Without screening: men ≥ 75 years have an increase in high grade disease and metastatic disease, men < 75 years have an increase in high grade disease and metastatic disease
- Screening reduces mortality
____, ____, and ____ are biases associated with prostate cancer screening
Detection bias, lead-time bias, and length bias are biases associated with prostate cancer screening
Prostate health index consists of ____, ____, and ____
Prostate health index consists of free PSA, total PSA, p2PSA
____ is the PSA isoform most important in screening for prostate cancer
[-2]proPSA is the PSA isoform most important in screening for prostate cancer
Higher PI-RADS increases likelihood of ____
Higher PI-RADS increases likelihood of prostate cancer
___ is secreted by luminal cells of the prostate
Prostate specific antigen is secreted by luminal cells of the prostate
High grade prostatic intraepithelial neoplasia is ____
High grade prostatic intraepithelial neoplasia is neoplastic cells growing within pre-existing glands (ducts and acini)
- Non-invasive neoplastic lesion
- Precursor lesion of prostate cancer
____, ____, and ____ are key histological features of prostate adenocarcinoma
Infiltrating patterns, small glands, and prominent nucleoli are key histological features of prostate adenocarcinoma
Describe Gleason score and grading for prostate cancer
Gleason score and grading for prostate cancer
- Group I: ≤ 6, good prognosis
- Group II: 3+4=7
- Group III: 4+3=7
- Group IV: 4+4=8
- Group V: 9-10
Describe staging of prostate cancer
Staging of prostate cancer
- T1: microscopic tumor confined to prostate gland, palpated gland feels normal
- T2: palpable tumor confined to prostate gland
- T3: tumor that has begun to expand beyond the prostate
- T4: tumor that is fixed and has pushed well beyond the prostate into adjacent structures
18F-DCFPyL imaging for prostate cancer detects ____
18F-DCFPyL imaging for prostate cancer detects prostate membrane specific antigen
Describe prostate cancer management options
Prostate cancer management options
- Active surveillance
- Radical prostatectomy
- External beam radiotherapy
- Brachytherapy
- Cryoablation
- High-intensity focused ultrasound
- MRI-guided focal laser ablation
____ can be used to manage prostate cancer patients with very low or low progression risk
Careful monitoring can be used to manage prostate cancer patients with very low or low progression risk
___ is surgery to remove prostate ± pelvic lymph nodes
Radical prostatectomy is surgery to remove prostate ± pelvic lymph nodes
- Removes prostate, salvage radiotherapy is an option for recurrence, no bowel complications
As pathologic stage increases, survival ____
As pathologic stage increases, survival decreases
Radiation therapy has benefits of ____, ____, ____, ____, and ____
Radiation therapy has benefits of
- No surgery
- Little risk of urinary incontinence
- Well suited for older patients and those not medically suitable for surgery
- Useful for locally advanced disease
- Effective post-radical prostatectomy adjuvant therapy
Prostate brachytherapy is ___
Prostate brachytherapy is implantation of radiation directly into prostate
Prostate cryoablation is ___
Prostate cryoablation is using cold temperatures to kill prostate cancer cells
Describe managent of metastatic prostate cancer
Metastatic prostate cancer management
- Androgen-deprivation
- Chemotherapy
- Chemohormonal therapy
- Immunotherapy
- Bone-directed therapy
- PARP inhibitors
Hormonal control of metastatic prostate cancer can be accomplished with ____
Hormonal control of metastatic prostate cancer can be accomplished with androgen deprivation therapy
Enzalutamide is an ____
Enzalutamide is an androgen receptor inhibitor
- Prostate cancer
Abiraterone is an ____
Abiraterone is an androgen biosynthesis inhibitor
- Prostate cancer
If mutation causes androgen binding domain of androgen receptor to be lost, androgen receptor is ____
If mutation causes androgen binding domain of androgen receptor to be lost, androgen receptor is constitutively active
In progression of prostate cells to malignancy, there is a progressive increase in ___
In progression of prostate cells to malignancy, there is a progressive increase in androgen receptor variants
____ chemotherapy is used for metastatic prostate cancer
Taxane chemotherapy is used for metastatic prostate cancer
- Disrupt microtibular network in cells
- Bind to tubulin
- Promote assembly and inhibit disassembly
- Stabilization of microtubules
- Inhibition of mitotic and interphase cellular functions
____ is an immunotherapy for metastatic prostate cancer
Sipuleucel-T is an immunotherapy for metastatic prostate cancer
- For patients with lower disease burden and better performance status
___ and ___ are bone directed therapies for metastatic prostate cancer to bone
Denosumab and Radium-223 are bone directed therapies for metastatic prostate cancer to bone
___ targets DNA repair deficiencies in metastatic prostate cancer
Olaparib targets DNA repair deficiencies in metastatic prostate cancer
Injury to ____ during robotic assisted laparoscopic prostatectomy for organ-confined prostate cancer is responsible for postoperative erectile dysfunction
Injury to pelvic splanchnic nerves during robotic assisted laparoscopic prostatectomy for organ-confined prostate cancer is responsible for postoperative erectile dysfunction
____ should be administered first in a prostate cancer patient with symptomatic bone metastases
Antiandrogen should be administered first in a prostate cancer patient with symptomatic bone metastases
