Prostate cancer Flashcards Preview

Y4 Oncology > Prostate cancer > Flashcards

Flashcards in Prostate cancer Deck (39)
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1
Q

what are the three zones of the prostate?

A

central
transitional
peripheral

2
Q

in what zone do most prostate cancers occur?

A

peripheral (70%)

3
Q

what staging does prostate cancer use?

A

TNM

4
Q

how many T stages of prostate cancer is there?

A
4:
1
2a/b/c
3a/b
4
5
Q

what is stage T1 of prostate cancer ?

A

normal DRE but + on biopsy

6
Q

what is stage T2a of prostate cancer ?

A

palpated on DRE and in 1/2 of one lobe

7
Q

what is stage T2b of prostate cancer ?

A

palpated on DRE and in >1/2 of one lobe

8
Q

what is stage T2c of prostate cancer ?

A

palpated on DRE and in both lobes

9
Q

what is stage T3a of prostate cancer ?

A

through the prostate capsule

10
Q

what is stage T3b of prostate cancer ?

A

invaded the seminal vesicles

11
Q

what is stage T4 of prostate cancer ?

A

metastatic

12
Q

what chemical is used as a non specific marker for prostate cancer?

A

PSA (prostate specific antigen)

13
Q

what is the action of PSA?

A

luminal cells release PSA to help liquefy the semen after ejaculation

14
Q

what hormones does the luminal cells rely on?

A

testesterone
androstenedione
dehydroepiandrosterone
dihydrotestosterone

15
Q

what are normal PSA levels for <60yrs, 60-70yrs and >70yrs ?

A
<60yrs = <3
60-70yrs = <4
>70yrs = <5
16
Q

what factors increase PSA levels?

A
age
BPH 
prostatitis 
UTI 
biopsy 
catherisation 
prostate cancer
17
Q

what factors decrease PSA levels?

A

ejactulation
prostatectomy
hormonal therapy (5alpha reductase inhibitors)

18
Q

what is the name of the histology grading of prostate cancer?

A

gleason grading

19
Q

state some storage symptoms ?

A

frequency
nocturia
urgency
urge incontience

20
Q

state some voiding symptoms ?

A
poor urinary flow 
hesitancy 
straining 
intermittency 
incomplete emptying
21
Q

what two investigations could be done for prostate urianry symptoms?

A

international prostate symptoms score (IPSS)

uroflowmetry

22
Q

what should the Qmax be below for uroflowmetry to suggest obstruction?

A

<10ml/sec

23
Q

what active treatment is available for prostate cancer?

A
active surveillance 
wait and watch 
radical prostatectomy 
radical RT 
brachytherapy
24
Q

what is a benefit of active surveillance and wait and watch

A

avoid toxity side effects of treatments

25
Q

what is a con of active surveillance ?

A

psychological difficulties

risk of significant progression

26
Q

what is a con of wait and watch?

A

potential complications (spinal cord compression)

suitable for older males with low grade tumours

27
Q

what is a disadvantage of radical RT?

A

risk of rectal damage
risk of obstructive symptoms
risk of impotence

28
Q

what is a disadvantage of radical prostatectomy ?

A

risk of impotence

not suitable for patients with co morbidities

29
Q

what is a disadvantage of bradytherapy?

A

risk of worsening obstructive symptoms

radiation protection issues for family

30
Q

what palliative treatments are available ?

A

hormonal therapy
chemo
biologics
bisphosphonates

RT
TURP

31
Q

as well as PSA what other marker may suggest prostate cancer?

A

Acid phosphatases

32
Q

what genes are associated with FHx prostate cancer?

A

BRCA1/2

HPC1 and PCAP on Chr 1

33
Q

is prostate cancer incidence increasing or decreasing ?

A

increasing

34
Q

what race is most affected by prostate cancer?

A

afro caribbeans

35
Q

what symptoms may locally advanced prostate cancer have?

A

haematuria

obstruction

36
Q

what investigations can be done for prostate cancer?

A
DRE
PSA, FBC
TRUS and biopsy 
MRI pelvis 
isotope bone scan
37
Q

how many samples are usually taken for prostate biopsy?

A

8

38
Q

what gleason score is the cut off for low and high risk cancer?

A
<7 = low risk 
7 = intermediate risk 
>7 = high risk
39
Q

what are some arguments against prostate cancer screening?

A

diagnostic test (TRUS) is invasive
no impact on prostate cancer mortality
impact on cancer services
curative therapies carry significant morbidity