Westra's prostate cancer; 4.1 Flashcards
What is the most common male cancer?
Prostate cancer (1:6 lifetime risk in US)
Which race is at greatest risk of both developing and dying from prostate cancer?
Africans
Is there a genetic component to prostate cancer?
Yes…first degree relative with prostate cancer→ 2x as likely and relative with breast cancer also increases risk
What gene is equated with prostate cancer?
Hereditary Prostate Cancer 1 (HPC1)…on chromosome 1q24-25
What age group is mostly to present with prostate cancer?
65-74 (avg. age is 66)
What can be eaten that INCREASES the likelihood of developing prostate cancer?
High amounts of folic acid (synthetic folate)
also increased dairy/calcium…but that isn’t important
What chemicals can men be exposed to at work that increase the likelihood of developing prostate cancer?
Polyaromatic hydrocarbons
Acetic acid and acetic anhydrate
Dioxin
What can be eaten/taken that DECREASES the likelihood of developing prostate cancer?
Natural folate (diet) Finasteride/dutasteride (chemoprevention)
What is considered a “normal” PSA level?
<4ng/mL
What is considered a high PSA level?
> 10ng/mL
What is PSA velocity?
PSA change over time
What is a significant PSA velocity?
> 0.75ng/mL
What is PSA density?
PSA level relative to size of gland
How is PSA density measured?
Transurethral ultrasound (TRUS)
What is the Gleason score of a grade II prostate cancer?
5-7
What stages of prostate cancer are clinically localized?
T1 and T2
What is done with a radical prostatectomy?
Removal of prostate and seminal vesicles
retropubic/perineal approach
What is done with a transurethral resection?
Removal of cancerous section of prostate gland
Cryosurgery is exactly what it sounds like…but besides the typical side effects of impotence and urinary incontinence, what else can go wrong?
Bladder outlet injury
Rectal injury
What are two types of radiation therapy used for prostate cancer?
External beam radiation
Interstitial brachytherapy
What is the end goal of hormonal therapy for prostate cancer?
Decrease androgen stimulation of prostate cancer cells
Where is the site of action of estrogens in prostate cancer therapy?
Estrogens act on the hypothalamus
What is an orchiectomy?
Removal of testicles
Where is the site of action of anti-androgens for prostate cancer?
Anti-androgens act directly on the prostate
Where is the site of action of LHRH agonists for prostate cancer?
LHRH agonists act in the pituitary
When is chemotherapy used?
Progressive or recurrent disease
Impotence is a common side effect to many of the prostate cancer treatment options. How is impotence treated?
Phosphodiesterase type 5 inhibitors
Hot flushes happen with androgen deprivation therapy…how should this side effect be treated?
Paroxetine or gabapentin
How is a local prostate cancer surveyed?
DRE annually
PSA every 6-12months for 5yrs…then annually
How is advanced (N1, M1) surveyed?
DRE and PSA every 3-6months
