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Medicine, oncology > Prostate cancer > Flashcards

Prostate cancer Flashcards

1
Q

How common?

A

2nd in men

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2
Q

What is a large problem with prostate diagnostics?

A

Overdiasnosis and overtreatment!!

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3
Q

How much higher risk do a man with 1 first degree relative have for prostate ca?

A

Risk x 2

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4
Q

Early symptoms?

A

Asymptomatic.

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5
Q

Advanced symptoms?

A

Bladder outlet obstruction
Hematuria
UTIs

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6
Q

MC metastasis?

A

BONE

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7
Q

Symptoms of metastatic disease?

A

Bone pain
Fractures
Spinal cord compression

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8
Q

Is PSA recommended for screening to decrease mortaliti=

A

NO! Beneftis of screening are outweighed by harm of overtreatment

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9
Q

Screening age for man with average risk?

A

50 years

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10
Q

Screening age for man with high risk?

A

40-45 years

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11
Q

Stop screening at age?

A

69

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12
Q

At what PSA level should you do biopsy?

A

> 7ng/ml

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13
Q

What is diagnosis based on?

A

HIstopathology

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14
Q

How many cores should be taken in biopsy?

A

min 12!

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15
Q

Explain Gleason’ grade?

A

Grade 1 + 2 is well differentiated
Grade 3 is moderately differentiated
Grade 4 + 5 is poorly differentiated

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16
Q

Gleason grade I?

A

Small, uniform glands

17
Q

Gleason grade II?

A

More between glands

18
Q

Gleason grade III?

A

Distintly, infiltrative margins

19
Q

Gleason grade IV?

A

Irregular masses of neoplastic glands

20
Q

Gleason grade V?

A

Only occasional gland formation

21
Q

Which gleason grade is most serious:

  • 4 + 3
  • 3 + 4
A

4 + 3!

22
Q

MC histology of prostate ca?

A

Adenocarcinoma (95%)

23
Q

Staging?

A

TNM

24
Q

How do we calculate risk stratification?

A 
T
PSA level
Gleason score
Comorbidities
Age
25
Q

Management of low risk, localized ca?

A

ACTIVE SURVEILLANCE (may do radical prostatectomy, radiotx)

26
Q

What is active surveillance?

A

Measure serum PSA every 3rd month

Repeat prostate biopsy

27
Q

Side effects of radiotx and prostatectimy?

A

Radiotx: Urinary symptoms, erectile dysfunction

Prostatectomy: Incontinence, erectile dysfunction

28
Q

Management of high risk, localized ca?

A

Radiotherapy

Prostatectomy

29
Q

FIRST line management of metastatic disease?

A

HORMONAL tx!

  • androgen suppression (castration, LHRH agonist)
  • hormonal manipulation (adding/withdrawing Flutamid)
30
Q

Tx of castrate-resistant ca (hormonal ineffective)?

A

CHEMOTHERAPY = TAXELS (docetaxel, cabacitaxel)

31
Q

Tx of bone metastases?

A

Radiotherapy!!!
Denosumab (inhibits osteoclasts)
Surgery
Bisphosponates

Medicine, oncology (15 decks)

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