237/239 - Pathology of the Prostate, Prostate Cancer Flashcards Preview

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Flashcards in 237/239 - Pathology of the Prostate, Prostate Cancer Deck (23)
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1

According to the AUA, who should be screened for prostate cancer?

What is the appropriate interval?

People of average risk 55-69 years old

People with increased risk 40-55 years old

Every 2+ years "may be preferred" over annual

(This is a shared-decision making process)

 

 

 

  • Don't screen <40 years or average risk 40-55 years
  • Don't screen 70+, unless life expectancy >10 years

2

How do we enhance the accuracy of PSA testing?

Do advanced imaging (MRI) after elevated PSA

Helps determine whether biopsy is needed, and increases accuracy

(we know what to aim for)

3

What is the most common type of prostate cancer?

Adenocarcinoma

4

What is the mainstay of therapy for patinets with metastatic, castrate-sensitive prostate cancer?

Androgen deprivation therapy

 

  • Anti-androgens
  • GnRH antagonist or continuous agonist
  • Tesosterone synthesis inhibitor
  • Surgical castration

Maybe add bone protective therapy or chermohormonal therapy

5

Which cell type will be notably absent from a prostate adenocarcinoma?

Basal cells

6

Where in the prostate do most prostate cancers arise?

Peripheral zone

(Close to the capsule)

7

List 4 non-adenocarcinoma types of prostate cancer

  • Basal cell carcinoma
  • Ductal adenocarcinoma
  • Small cell carcinoma
  • Primary urothelial carcinoma of the prostate
    • Derived from urothelium of the prosatatic urethra
    • This is technically not a type of prostate cancer

 

 

8

What are the management options for organ-confined prostate cancer?

  • Prostatectomy (robot-assisted or orpen)
  • External beam radiotherapy
  • Brachytherapy
  • Cryoablation
  • High-intensity focused ultrasound
  • MRI-guided laser ablation

 

Basically, do not need to do chemotherapy, may not need to take out the whole prostate

9

List 7 risk factors for prostate cancer

  • Old age
  • Family hx
  • African American ethnicity
  • Vitamin D deficiency
  • Obesity
  • Chronic inflammation - IBD

Prostate cancer= cancer most commonly associated with aging 

10

What is the most common method of detection for prostate cancer?

Elevated serum PSA

11

How do we screen for prostate cancer?

PSA or digital rectal exam

 

PSA is not specific for prostate cancer

12

When prostate caner metastasizes to the bone, what changes will occur?

Increased osteoblastic activity

-> Thick trabecula

13

What is the most prevalent cancer diagnosis in men?

Prostate cancer

14

Is PSA a tumor marker?

No!

Will be elevated in prostate cancer

BUT can also be elevated in other conditions

 

Must confirm prostate cancer with tumor markers, pathologic microscipic features

15

What are the histologic features of prostate adenocarcinoma?

Small glands with an infiltrating pattern

Cells will have prominent nucleoli

 

No basal cells - they have been lost :(

 

Staining for basal cells will be negative

16

AMACR is a tumor marker that will be positive in which cancer cells?

Prostate

 

AMACR is an enzyme involved in beta-oxidation of branched-chain fatty acids

17

What is the treatment for prostate cancer that is "interemediate risk" or higher?

Radical prostatectomy

 

 

18

What is the frequency of hereditary prostate cancer?

15%

19

What is the precursor lesion for prostate cancer?

High-grade prostatic intra-epithelial neoplasia

 

A non-invasive neoplastic lesion, but we don't call it carcinoma in situ

20

Name a transmembrane glycoprotein that is expressed in 95% of all prostate cancer specimens

PSMa

21

Irritable bowel disease is associated with increased risk of which GU cancer?

Prostate cancer

22

What system is used to grade prostate cancer?

Gleason score

 

 

 

I would recommend using sources outside of this deck if you want to get cozy with the Gleason grading system

23

Which prostate cancer patients are candidates for surveillence?

Older men with low volume tumors that are Gleason 6 or less and low PSA