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MRCP -oncology > Prostate cancer: management > Flashcards

Prostate cancer: management Flashcards

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16
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Prostate cancer: management of localised prostate cancer (T1/T2)

A

depends on life expectancy and patient choice.

Options include:
conservative: active monitoring & watchful waiting

radical prostatectomy

radiotherapy: external beam and brachytherapy

17
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Localised advanced prostate cancer (T3/T4)

A

hormonal therapy

radical prostatectomy:

radiotherapy: external beam and brachytherapy

18
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side effects of external beam and brachytherapy

A

proctitis and are

also at increased risk of bladder, colon, and rectal cancer

19
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what are the hormonal therapy ?

A

ANTI ANDROGEN THERAPY :

1) synthetic GnRH agonist or antagonists

2) bicalutamide

3) cyproterone acetate

4) abiraterone

bilateral orchidectomy

20
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what are the synthetic GnRH agonist

A

GnRH agonists: e.g. Goserelin (Zoladex)

21
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Mechanism of GnRH agonists:

A

lower LH levels longer term by causing overstimulation, resulting in disruption of endogenous hormonal feedback systems. The testosterone level will therefore rise initially for around 2-3 weeks before falling to castration leves

22
Q

Side effects of Goserelin (Zoladex)?

A

rise in testosterone - ‘tumour flare’. The resultant stimulation of prostate cancer growth may result in bone pain, bladder obstruction and other symptoms

23
Q

How do we prevent the tumor flare ?

A

therapy is often covered with an anti-androgen / GnRH antagonists

24
Q

Examples of GnRH antagonists

A

degarelix

25
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Mechanism of action of bicalutamide

A

blocks the androgen receptor

non-steroidal anti-androgen

26
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Mechanism of action cyproterone acetate?

A

steroidal anti-androgen

prevents DHT binding from intracytoplasmic protein complexes
used less commonly since introduction of non-steroidal anti-androgens

27
Q

Mechanism of action of abiraterone

A

androgen synthesis inhibitor

28
Q

Abiraterone is particularly useful for ?

A

hormone-relapsed metastatic prostate cancer in patients who have no or mild symptoms after androgen deprivation therapy and before chemotherapy is indicated

29
Q

How does bilateral orchidectomy help

A

rapidly reduce testosterone levels

30
Q

Complication of radical prostatectomy

A

Erectile dysfunction

31
Q

what is indicated for treating metastatic castration resistant (hormone-relapsed) prostate cancer in adult ?

A

Abiraterone acetate

blocking cytochrome P450 17 alpha-hydroxylase

32
Q

Metastatic prostate cancer disease chemotherapy ?

A

docetaxel

MRCP -oncology (14 decks)

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