Prostate cancer Flashcards
what is the definition of prostate cancer?
A malignant tumour of glandular origin, situated in the prostate.
what is the epidemiology of prostate cancer?
Prostate cancer is the second leading cause of cancer mortality in men in the US.
It is most commonly reported in men aged over 50 years.
what is the aetiology of prostate cancer?
The exact aetiology of prostate cancer is unknown. However, a number of aetiological factors have been suggested.
High fat diet, genetics, black ethnicity, hormonal influence
what are the risk factors for prostate cancer?
Over 50 Black Northwest europe, caribbean, australian, new zealand, north america and southern african Family history High fat diet
what is the pathophysiology of prostate cancer?
High-grade prostatic intraepithelial neoplasia, characterised by cellular proliferation within pre-existing ducts and glands with cytological changes that mimic neoplasm.
Prostate cancer tends to spread along the capsular surface of the gland and may invade the seminal vesicles, peri-prostatic tissue, and eventually the bladder neck. Subsequent spread can be to the perineural spaces, lymphatics, and blood vessels, which results in haematogenous metastases.
what are the key presentations for prostate cancer?
Presence of risk factors
Elevated prostate specific antigen (PSA)
what are the signs of prostate cancer?
Presence of risk factors
Elevated prostate specific antigen (PSA)
Palpable lymph nodes
what are the symptoms of prostate cancer?
Nocturia Urinary hesitancy and frequency Dysuria Haematuria Weight loss Lethargy Bone pain
what are the first line and gold standard investigations for prostate cancer?
Prostate-specific antigen and digital rectal examination are key diagnostic tools used in screening.
Serum prostate specific antigen - >4 micrograms/L (>4 nanograms/mL)
Testosterone - normal
LFTs - normal
FBC - normal, not in metastatic disease
Renal function - normal, locally advanced causing obstruction causes abnormal
prostate biopsy - may detect malignant cells in one or more biopsy specimens (assigned to Grade Group 1 to 5)
what are the differential diagnoses for prostate cancer?
Benign prostatic hyperplasia, chronic pancreatitis
how is prostate cancer managed?
Management may be expectant or definitive (curative).
Low risk:
Observation, High-dose rate brachytherapy involves the transperineal placement of treatment catheters through which an individual radioactive source is robotically placed temporarily at various dwell positions to achieve a conformal dose of radiation to the prostate., external beam radiotherapy, radical prostatectomy and lymph node dissection
High risk:
Observation, androgen deprivation therapy (leuprorelin), external beam radiotherapy, abiraterone (abiraterone acetate), radical prostatectomy and pelvic lymph node dissection
how is prostate cancer monitored?
In a patient who has been treated definitively, a prostate-specific antigen (PSA) should be checked every 6 to 12 months for 5 years and annually thereafter and a digital rectal examination should be performed annually looking for signs of local or distant recurrence. Some physicians pursue more vigorous monitoring, with complete re-staging of the patient by blood and imaging at each annual interval for the first 5 years following definitive treatment.
what are the complications of prostate cancer?
Radiation induced dysuria, urinary infrequency and urinary incontinence
what is the prognosis of prostate cancer?
In the US, the overall 5-year survival rate is approximately 100% for local- and regional-stage prostate cancer, and approximately 31% for distant-stage prostate cancer.
