Prostate cancer Flashcards
What is the most common histological type?
adenocarcinoma
What is the usual nature of the growth of prostate ca?
slow
What are the RFs for prostate cancer?
- older
- obesity
- afro-caribbean
- FHx
What are the sx?
localised often asymptomatic
- bladder outlet obstruction - hesitancy, urinary retention
- haematuria, haematospermia
- Pain: back, perineal, testicular
- Erectile dysfunction, anorexia, WL
What may be found on DRE?
asymmetrical hard nodular enlargement w loss of median sulcus
Where does prostate cancer tend to metastasise to?
bones (pain)
LN
What produces PSA
normal and malignant prostate epithelial cells
When should PSA be considered?
LUTS
Impotence
Visible haematuria
Unexplained sx that could be due to advanced prostate cancer
What ages can men request PSA
over 50
When shouldn’t men be offered PSA
if they’re asymptomatic
What are the causes of a raised PSA
BPH Prostatitis + UTI Ejaculation Vigorous exercise Urinary retention
What PSA should prompt 2 week referral in what age?
≥3 ng/ml and 50-69yrs
What is the normal range of PSA ?
0-4 but varies w age and race
What tests would you do in suspected prostate cancer?
- PSA
- DRE
- transrectal US + biopsy
- MRI/CT bone for staging
What is Gleason grading and scoring? How does it work?
Uses biopsy to determine how likely it is for the tumour to spread outside the prostate
Gleason Score ranges from 1-5 and describes how much the cancer from a biopsy looks like healthy tissue (lower score) or abnormal tissue (higher score). Most cancers score a grade of 3 or higher.
Since prostate tumors are often made up of cancerous cells that have different grades, two grades are assigned for each patient. A primary grade is given to describe the cells that make up the largest area of the tumor and a secondary grade is given to describe the cells of the next largest area.
