Exam 2 - Prostate Cancer Weddle

Question 1

prostate cancer is the ____ most common cause of cancer related death in men

a. 1st
b. 2nd
c. 3rd

Answer 1

b. 2nd

Question 2

Most risk factors associated with prostate cancer
are related to increased exposure to __________

Answer 2

testosterone

Question 3

T or F: risk of PC is more common in Asians than African-Americans

Answer 3

F (more common in African-Americans)

Question 4

metastasis to the ______ is the most common natural progression of PC?

a. lung
b. liver
c. bone

Answer 4

c. bone

Question 5

which Gleason Scores are slow-growing and well-differentiated?

a. 2-4
b. 5-7
b. 8-10

Answer 5

a. 2-4

Question 6

which Gleason Scores are aggressive and poorly differentiated?

a. 2-4
b. 5-7
b. 8-10

Answer 6

b. 8-10

Question 7

normal PSA range

Answer 7

0-4 ng/mL

Question 8

PSA of > _____ ng/mL is highly suspicious for malignancy

a. 0
b. 4
c. 10

Answer 8

c. 10

Question 9

what do HSPC and CRPC stand for?

Answer 9

HSPC = hormone sensitive prostate cancer
CRPC = castrate resistant prostate cancer

Question 10

for the localized tx of prostate cancer, observation involves monitoring the course of disease with the expectation to deliver _________ therapy for development of sx or a change in exam or PSA that suggests sx are imminent

Answer 10

palliative

Question 11

localized tx of PC: in active surveillance, if cancer progressing, will initiate potentially ________ therapy

a. curative
b. palliative

Answer 11

a. curative

Question 12

which of the following is a disadvantage of active surveillance of PC?

a. ~2/3rds of pts eligible for surveillance will avoid therapy
b. avoids possible SE
c. QOL less affected
d. periodic follow up and tests necessary

Answer 12

d. periodic follow up and tests necessary

Question 13

tx overview for localized tx of PC (3 of them)

Answer 13

-active surveillance
-radiation therapy
-surgery

Question 14

radiation therapy for localized tx of PC (2)

Answer 14

external beam vs brachytherapy

Question 15

for locally advance/high risk pts for PC, what is used in combo with EBRT (external beam radiation therapy)?

Answer 15

ADT (androgen deprivation therapy)

Question 16

radical prostatectomy + PLND is a ________ therapy

a. palliative
b. curative

Answer 16

b. curative

Question 17

the goal of ADT is to induce castrate levels of __________

Answer 17

testosterone

Question 18

ADT involves what two things?

Answer 18

LHRH agonist +/- anti-androgen or orchiectomy

Question 19

which drug class blocks androgen receptors and inhibits androgen uptake and binding in target tissues?

Answer 19

antiandrogens (part of ADT)

Question 20

examples of LHRH agonists

Answer 20

leuprolide; -relins

Question 21

look at toxicities of LHRH agonists (slide 25)

Answer 21

ok

Question 22

which drug, compared to LHRH agonists, has less CV events?

Answer 22

relugolix

Question 23

examples of anti-androgens (just the ending)

Answer 23

-lutamides

Question 24

which anti-androgen has the longest half-life?

a. flutamide
b. bicalutamide
c. nilutamide

Answer 24

b. bicalutamide

(longest half-life; once daily dosing)

Question 25

first line therapy for metastatic PC: -goal is to suppress testosterone production < ____ ng/dL -need to determine whether this is a _____ recurrence or overt metastatic disease -determine PSA ________ time

Answer 25

< 50 ng/dL PSA doubling

Question 26

for m0HSPC, if pSA doubling time < 6 months: a. can give ADT b. can observe

Answer 26

a. can give ADT

Question 27

what is an orchiectomy?

Answer 27

removal of testes

Question 28

which drug class has risk of disease flare in the first weeks of therapy due to initial release of testosterone?

Answer 28

LHRH agonists (resolves in 2 weeks)

Question 29

m0CRPC tx

Answer 29

ADT (leuprolide probably) and add enzalutamide, apalutamide, or darolutamide (least SE)

Question 30

T or F: abiraterone is used in the M0 setting

Answer 30

F

Question 31

low volume m1HSPC tx (2 things)

Answer 31

-ADT -add one of the 3: abiraterone + prednisone enzalutamide apalutamide

Question 32

why is abiraterone given with prednisone?

Answer 32

to help prevent renal insufficiency

Question 33

high volume m1HSPC tx differs from low volume because of what?

Answer 33

in high volume we add chemo (docetaxel) + ADT

Question 34

look at m1CRPC tx, there are many things we can add to ADT (slide 53)

Answer 34

alrighty

Question 35

m1CRPC first and second line tx includes ?

Answer 35

1st line: docetaxel + prednisone 2nd line: cabazitaxel + prednisone

Question 36

drug with FDA approval for dMMR/MSI-H cancers a. pemetrexed b. apalutmide c. mitoxantrone d. pembrolizumab

Answer 36

d. pembrolizumab

Question 37

what isotope is used for bone metastases?

Answer 37

radium 223 dichloride

Question 38

drug used for PSMA positive mCRPC

Answer 38

Pluvicto (Lu-177)

Question 39

what exam is used for prostate cancer screening? a. DRE b. PSA c. MRI d. CT scan

Answer 39

a. DRE (digital rectal exam)

Question 40

for men aged 50 or older, PSA level 2.5 or higher, how often should they be screened for PC? a. every 6 months b. every year c. every 5 years d. every 10 years

Answer 40

b. every year

Question 41

for men aged 50 or older, PSA < 2.5, how often should they be screened for PC?

Answer 41

every 2 years

Question 42

drug for prostate cancer prevention

Answer 42

finasteride