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Basics of Focal Therapy Slidedeck > Prostate Anatomy and Physiology > Flashcards

Prostate Anatomy and Physiology Flashcards

(60 cards)

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1
Q

Walnut sized gland that produces seminal liquid

A

Prostate

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2
Q

Critical structure that controls continence

A

Sphincter

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3
Q

Critical Structure that control sexual function

A

Neurovascular bundle

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4
Q

Group of abnormal cells that grow more rapidly than normal cells and refuse to die

A

Cancer

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5
Q

Gland located behind the pubic zone and in front of the rectum

A

prostate

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6
Q

Gland surrounding the bottom bladder neck

A

prostate

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7
Q

Roughly how many new prostate cancer cases are dx each year

A

between 260,000 bd 270,000

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8
Q

How many deaths are caused by prostate cancer each year

A

34,5000

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9
Q

How many prostate biopsies are performed each year

A

1 million

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10
Q

How many american men are living with prostate cancer

A

3.1 million

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11
Q

Localized prostate cancer, not papable on DRE

A

T1

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12
Q

Localized prostate cancer palpable during DRE

A

T2

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13
Q

Locally advnaced prostate cancer with extracapsular extraction

A

T3

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14
Q

Locally advnaced prostate cancer, met to local structures

A

T4

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15
Q

Specific biological marker for the prostate

A

Prostate specific antigen test

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16
Q

what is the threshold PSA to raise concern

A

Greater than 4

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17
Q

Four reason, other than cancer, why a PSA level would be high

A
  1. UTI
  2. Prostate stimulation
  3. Vigourus exercise
  4. Medications
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18
Q

BX method performed by the majority of urologists in the United States

A

Transrectal

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19
Q

Value of a transperineal BX

A

limit hospital aquired infections

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20
Q

How many cores are sampled during a randomized BX

A

12

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21
Q

Grade Group with Gleason 6

A

1

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22
Q

Grade Group 3, Gleason score

A

7 4+3

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23
Q

Grade Group Gleason 4

A

8

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24
Q

What is Gleason score and GG is considered low/very low

A

6/1

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25
What is Gleason score and GG is considered Intermediate Favorable
7 (3+4)/2
26
What is Gleason score and GG is considered Intermediate favorable
7 (4+3) / 3
27
What Gleason score and GG is considered intermediate/unfavorable
7 (4+3) / GG 3
28
What Gleason score and GG is considered high risk
8/4
29
Evaluated by a pathologist and is assigned score based on cell arraingmenbt
Each BX core
30
Scale used to predict probability of cancer that is clinicall significant and is imaged using a combination of T2W, DWI, DCE imaging findings
PI-RADS Score
31
Helps detect extraprostatic extension and finds suspicious areas
PI-RADS v2.1 scoring
32
Limitations of random core BX
Cancer can be missed/under-estimated
33
Uses MRI to sample 2-3 additional core per target beyond the standard 12
Targeted BX
34
DX tool using software based fusion with MRI
Targeted BX
35
Low Risk D'Amico risk stratification
1. PSA less than 10 2. highest BX less than Gleason 6 AND 3. Clinical stage T2b
36
Intermediate D'Amico risk stratification
1. PSA between 10 - 20 2. Highest BX 7 OR 3. T2b
37
High D'Amico risk stratification
1/ PSA greater than 20 2. Highest BX Gleason 8 or higher OR 3. Stage T2c/T3
38
NCCN Risk Group Very Low
1. GG 1 2. PSA less than 10 3. fewer than 3 cores are positive with less than 50% cancer in both 4. PSA density less than .15
39
Calculated by PSA divided by prostate volume
PSA density
40
NCCN Risk Group Low
1. GG 1 2. PSA greater than 10
41
NCCN Risk Group Intermediate/Favorable
1. 1 IRF 2. GG 1 or 2 3. Less tha 50% of cores are positive
42
NCCN Risk Group Intermediate/Unfavorable
1. 2 or 3 IRF 2. GG 3 3. greater than 50% of BX cores are positive
43
NCCN Intermediate Risk Factors 3
1. T2b/T2c 2. GG 2/3 3. PSA between 10-20
44
NCCN Risk Group High
1. T3a OR 2. GG 4/5 OR 3. PSA greater than 20
45
NCCN Risk Group Very High
1. T3aor higher 2. Gleason pattern 5 OR 3. PSA greater than 20
46
Test performed on tissue sample and provides a statistical prediction on aggressivness
Genomic Testing
47
Decipher Score Range: Low
0 - .45
48
Decipher Score Range High
.6 and 1
49
Therapy that remove the entire prostate and some of the tissue around it, including the seminal vesicles
Radical Prostatectomy
50
Pros of Radical Prostate
1.gold standard for all intermediate/high risk 2. Highly effective, 80% cure rate 3. Core skill for all urologists
51
Cons of radical prostate
1. Risks associated with surgery 2. High morbidity 3. Depent on surgeon skill
52
According to literature, what is the reoccurance rate for Gleason 4+3
35%
53
Benefits of Radiation Therapy
1. Non-invasive 2. non-surgical 3. outpatient procedure
54
Cons of radio therapy
1. Long protocol, 6-8 weeks of daily therapy 2. 40% failure rate 3. High morbidity 4. Doesnt all for second line option, kills plains and freezes pelvis
55
Cons of cryotherapy
1. morbidity, esspecially sexual function 2. Percision, hard to control the extent of the iceball and going outside the ablated zone
56
life expectancy for prostate cancer today
20 years
57
LIfe expectancy for prostate cancer in 1990
7 years
58
Advances in imaging, screening and earlier DX have changed patient value equation from A to B
A. Efficacy at all costs B. Disease control with QoL
59
Advanced imaging, BX and genomic testing have changed the ability to WHAT prostate cancer
1. ability to localize the disease 2. Risk stratigy prostate cancer
60
Rational to adopt Focal Therapy for treatment
1. provides a balence between surveillance and radical 2. Relies on realtime, ACCURATE IMAGING 3. Needs CONTROLLED ENERGY

Basics of Focal Therapy Slidedeck (12 decks)

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