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Endo/Repro: Week 6 > Westra: Prevention and Treatment of Carcinoma > Flashcards

Westra: Prevention and Treatment of Carcinoma Flashcards

1
Q

MC cancer in men

A

prostate cancer

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2
Q

MC age group at dx for prostate caancer

A

65-74

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3
Q

ethnic group w/ highest incidence and death rate

A

AA

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4
Q

only RFs incorporated into current screening recommendations

A

African American

family hx

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5
Q

male relatives of bresat cancer pts BRCA 1/2

man w/ 1st degree relative w/ prostate cancer 2x

A

increases risk of prostate cancer

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6
Q

folic acid, dairy and Ca relation to PC

A

increases risk possibly

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7
Q

high plasma testosterone levels

A

increase risk of PC

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8
Q

dioxin

A

exposed on the ground in Vietnam

increases risk of PC

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9
Q

may decrease risk of prostate cancer

A

lycopene

folate

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10
Q

finasteride and dutasteride

A

decrease INCIDENCE of prostate cancer

decrease size w/ BPH

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11
Q

pt w/ PC will most likley have what sxs

A

Asymptomatic or sx of lower UT obstruction

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12
Q

hip/back pain
difficulty/frequent urination
hematuria

A

PC

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13
Q

Detection fo PC

A

PSA
digital rectal exam
transrectal US
biopsy

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14
Q

normal PSA

A

<4

*usually total

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15
Q

PSA 4-10

A

borderline

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16
Q

PSA >10

A

high

*higher hte PSA the more likley the presence of PC

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17
Q

PSA velocity

A

measures how quickly PSA rises over period of time

change of >75 rise in one year is SIGNIFICANT

18
Q

most prostate cancer begs in posterior part of gland in what zone?

A

peripheral zone

19
Q

if digital rectal exam is abnormal?

A

trans-rectal US

20
Q

important tool to assess size of prostate and identify areas that need to be biopsied

A

transrectal US

21
Q

what is the screening controversy around PSA

A

unclear whether the PSA blood test saves lives or whether it exposes men to unnecessary physical and emotional anguish

22
Q

USPSTF recommends

A

AGAINST PSA screening in healhty asymptomatic men regardless of RF

23
Q

when can you start screening African american males?

A

age 40-45

24
Q

ACS recomends taht you should screen

A

age 50 for average risk and lifetime survival of 10 years

40-45 for high risk men

25
Q

when to take a biopsy

A

abnormality palpated by DRE
elevated PSA on age adjusted reference range
PSA velocity >.75
previous neagative biopsy but increasing PSA

26
Q

what are most prostate cancers?

A

adenocarcinomas

27
Q 
55 y/o M
nocturia
normal DRE
PSA 6
subsequent biopsy+
for adenocarcinoma
A

radical prostatectomy

He’s 55!

radiation woried about rectal problems and diarrhea

a little young for orchiectomy

28
Q 
78 y/o M
increased freq/hesitancy
nodular DRE
PSA 15
Pos biopsy
A

RADIATION Therapy

he’s doing to well for active surveillance
Don’t want bone mets

29
Q 
74 y/o M
severe O2 dep COPD
hesitancy
enlarged prostate on DRE
PSA 8
declined biopsy
A

active surveillance

if he is really worried you can talk about radiation

wound need to do biopsy first

30
Q

94 y/o
firm nodular prostate
urinary retention
PSA 100

A

bilateral orchiectomy and transurethral resection

decreased testosterone and let him go to the bathroom

31
Q

less aggressive tumors
>70 w/ co existent illnesses
potential tx SE
palliative therapy

A

active surveillance

32
Q

radical prostatectomy

A

removal of prostate and seminal vesicles

50-65 w/out comorbidities

only occurs if cancer has not spread outside prostate gland

33
Q

SE of radical prostatectomy

A

impotence

urinary incontinence

34
Q

transurethral resection

A

removes cancerous section of PG

35
Q

destroys prostate cancer by freezing the prostate tissue w/ cryoprobes

A

cryosurgery

36
Q

complications of cryosurgery

A

bladder outlet injury
urinary incontinence
impotence

37
Q

radiation therapy for pts not candidate for radical prostaectomy

A

Extrernal beam radation for T3 and T4

> 70
damage rectum, impotency, urinary incontinence

38
Q

tx for locally advanced prostate cancer

A

hormonal therapy

LHRH agonists> decrease amt of testosterone in hte body

39
Q

tx for progressive disease or recurrent after tx, metastatic disease

A

docetaxel + prednisone

Cabazitaxel

40
Q

best way to monitor for recurrent cancer

A

PSA

Endo/Repro: Week 6 (8 decks)

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