Prostate Cancer Flashcards
Where does prostate cancer primarily occurs where?
Peripheral zone
What is the commonest cancer in men?
Prostate cancer
What are the risk factors for prostate cancer?
Age
FH – BRCA2 gene mutation
Black > white > asian
How is prostate cancer investigated?
Blood test = PSA
PR exam = DRE
What are the issues for PSA screening?
Over-diagnosis
Over-treatment
Cost-effectiveness
Other causes of raised PSA = infect, inflam, large prostate, urinary retention
QoL
Why is PSA not reliable?
Cant rely on PSA within 6 weeks of urinary infection
Having normal PSA does not mean you do not have prostate cancer
Can have normal PSA but abnormal prostate on DRE
How does prostate cancer present?
Bone pain – can spread to the bone
Urinary symptoms
Found on DRE
How is prostate cancer diagnosed?
DRE
Serum PSA
TRUS (transrectal US) – guided biopsy of prostate
TURP – transurethral resection of prostate
What factors influence the treatment of prostate cancer?
Age
DRE – localised, advanced
PSA levels
Biopsies – grade
MRI and bone scan
Outline the treatment options for prostate cancer
Surveillance
Robotic radical prostatectomy
Radiotherapy – external beam, brachytherapy
Hormones
Discuss bone mets in prostate cancer
Sclerotic (osteoblastic)
Hot spots on bone scan
Highly unlikely if PSA <10
How is metastatic prostate cancer treated?
Hormones = surgical castration, medial castration (LHRH agonist, present all the time, pituitary makes less LH = less testosterone)
Palliation = chemo, radiotherapy
