Prostate Cancer Flashcards
(46 cards)
What is the key enzyme involved in biosynthesis of testosterone?
CYP17A1
List the risk factors for prostate cancer. (3)
age > 60; african-american; family history
What are the two screening modalities used for prostate cancer?
Digital rectal exam (DRE) & prostate specific antigen (PSA)
What PSA level is highly suspicious for malignancy?
> 10 ng/mL
What PSA velocity is highly suspicious for malignancy?
> 0.75 ng/mL increase over the course of a year
At what age should men begin annual prostate screenings?
50
How do most patients with prostate cancer present?
asymptomatic
Where does prostate cancer metasasize to? (3)
bone (most common); lung; liver
A high gleason score signifies ______.
more poorly differentiated tumor with higher risk of recurrence
What are the treatment options for localized prostate cancer? (4)
observation; active surveillance; radiation therapy; prostatectomy
What does observation entail? Is the therapy palliative or curative?
monitor PSA and DRE every 6 months; palliative therapy
What does active surveillance entail? Is the therapy palliative or curative?
monitor PSA, DRE, & symptoms; curative therapy
What is external beam radiation?
radiation from the outside coming in
What is brachytherapy radiation?
a radiation implant that is placed near the prostate
In what patient population would you recommend radiation therapy?
patients with a high Gleason score (higher risk of recurrence)
What are the guidelines for ADT in patients getting radiation therapy?
start ADT prior to radiation therapy, then continue during and for 1-3 years after
What is the only definitive curative surgery for prostate cancer?
radical prostatectomy
When would you initiate ADT in M0-HSPC?
if PSA doubling time is less than 6 months
What surgical procedure can be done in M0-HSPC?
orchiectomy (removal of testes)
What are the LHRH agonists? (4)
leuprolide; goserelin; triptorelin; hiterelin
List the acute toxicities of LHRH antagonists. (5)
tumor flare; gynecomastia; hot flashes; erectile dysfunction; edema
List the two main chronic toxicities of LHRH antagonists.
osteoporosis; cardiovascular events
Definition: toxicity that occurs in metastatic patients where their symptoms worsen during initial treatment with LHRH agonist
tumor flare
What can be administered during the first week of LHRH agonist treatment to prevent tumor flare?
an anti-androgen
