Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

3rd Year Semester 1 > prostate cancer > Flashcards

prostate cancer Flashcards

(61 cards)

Start Studying
1
Q

Zones of the Prostate

A

central zone :5%-10%
transitional :10-15
peripheral :80-85

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Signs and Symptoms of localised prostate

A

generally asymtomatic
usually diagnosed thru PSA or DRE screening based on risk factors

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Signs and Symptoms locally advanced tumours

A

urinary hesistancy
weakened stream
increased frequency, urgency nocturia
ED

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Signs and Symptoms of. Late stage tumours

A

bone pain eg lower back , hip , upper thigh

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

TURP
what does it stand for

A

transuretheral resection of prostate

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

how does TURP work

A

needle is inserted into urethra via penis

prostate tissue trimmed away to relieve urinary symptoms associated with Benign prostatic hyperplasia (BPH)

Tissue taken away to pathology , RT delayed for 4-6 wks

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

DRE (digital rectal exam)

A

prostate tumours are firm but surrounded by compressible tissue

difficult to palpate SVs: superior firm indiciates SV involvement

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

PSA

A

protein produced by prostate and found in blood , not cancer specific only organ specific

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Increased PSA indicates

A

Infection
prostatitis
BPH
cancer

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

what PSA is considered elevated

A

greater than 4ng/ml

PSA elevation does not correspond w tumour stage, but will influence risk group

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

raised age related PSA

A

under 50 ≥2µg/L
50-59 ≥3µg/L
60-69 ≥4µg/L
70+ ≥5µg/L

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Diagnostic Workup – Physical Examination

A

after PSA or DRE

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What does TRUS stand for

A

transrectal ultrasound scan

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Diagnostic Workup - TRUS

A

only 60% tumours are visible on TRUS
not great for screening, diagnosis or staging

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Limitations of TRUS

A

-calfications can result in poor image quality
-peripheral zone cane be difficult to see
-operator dependent (am. of pressure can decrease image quality)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Core Needle Biopsy

A

Systematic biopsy:
10-12 samples taken
base , mid and apex bilaterally
Guided by US

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Gleason score
1
2

A

-small uniform cell w minimal nuclear changes

-still separated by stroma but more closely arranged

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Gleason score
3
4

A

-varaition in glandular size and organisation w infiltration in stromal and neighbouring tissues

-atypical cells w extensive infiltration into surrounding tissues

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Gleason score 5

A

sheets of undifferentiated cancer cells

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

ISUP Grade group:
grade 1
2
3
4
5

A

GS ≤ 6
GS 3+4=7
GS 4+3=7
GS 4+4=8; 3+5=8; 5+3=8
GS 9-10

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Gleason Score
added up to be :
-2-6
-7
-8-10

A

-well differentiated , low grade
-moderately differentiated, intermediated. risk
-poorly differentiated , high grade

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

system for staging
system for grading

A

-TNM
-ISUP

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Further Imaging: based on PSA,DRE and GS

A

abdomen/pelvis CT w contrast
MRI
PSMA PET

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Abdo/Pelvic CT w/ contrast

A

-for lymphatic spread , which can also be determined thru dissection

-mpMRI is preferred over CT for abdominal/pelvic mets

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
MRI
better soft tissue delineation than pelvic CT asses extra capsular extension and SV involvement if biopsy comes back negative but still suspicion of cancer
26
PSMA PET (or Isotropic Bone Scan) reserved for patients with:
-high risk of skeletal mets -T3a -grade group 4or5 -PSA>20µg/L
27
when is PSMA PET used
all patients w symptoms of bony mets biochemical recurrence following prostatectomy in assessment of ADT every 6 -12 months
28
Most common sites of metastatic disease
bones brain lungs liver lymph nodes
29
Watchful Waiting: 1.tx intent: 2.follow up: 3.assessment/markers used: 4.life expectancy 5.aim: 6.for:
-1.palliative -2.patient specific -3.not predefined -4.less than 10 years -5.minimize toxicity -6.patients w all stages
30
treatment options :watchful waiting
TURP for urinary support hormone therapy
31
Watchful Waiting: what is it
-Deferred treatment until local or distant disease progression -if progression=observation continues until symptoms -prostate cancer slow growing tf safe option for those w/ limited life expectancy
32
active surveillence: 1.tx intent: 2.follow up: 3.assessment/markers used: 4.life expectancy 5.aim: 6.for:
-1.curative -2.predefined schedule -3.DRE,PSA, mpMRI -4.more than 10 yrs -5.minimize toxicity w/o comprimising survival -6.low-risk patients
33
Active Surveillance patient selection:
-life exp >10 years -ISUP group 1 -T1-T2
34
Treatment Options: Surgery
removal prostate , sv and surrounding tissue for clear margins
35
pelvic lymph node dissection (PLND)
may not improve oncology outcomes but gives important staging info
36
side effects of surgery
ED Incontinence
37
management of incontinence
-pelvic muscle re-education, bladder training -anticholinergic medications -artifical sphincter surgery
38
Hormone Therapy
Androgens or male hormones stimulate prostate cancer cells to grow Androgen deprivation therapy ADT supresses production of these hormones and shrink or slow the growth rate of prostate cancer
39
risk and ADT
low risk= ADT not recommends intermediate risk= consider 6 month of neo-adjuvant ADT especially at risk for SV involvement high risk=long term ADT : 3 years
40
what is used to compliment ADT
EBRT
41
How is Brachytherapy delivered? LDR
-permanent radioactive seeds are deposited at pre-defined position and left there for 1-7 days.
42
Brachytherapy: LDR Treatment delivery/Seed placement
mick applicator: single seed placement strand technique: preloaded needles and less chance of seed migration
43
Brachytherapy: HDR how does it work
temporary implant of catheters of IR-192 w different dwell times at each stopping point
44
How is Brachytherapy delivered? HDR
-sources are left to dwell in prostate -positions and dwell times are pre defined -just 10 to 20 minutes at a time
45
Brachytherapy: HDR benefits
improve target coverage improved sparing of normal structures improve potential to dose escalate sub volumes
46
Brachytherapy: HDR methods
single step procedure (ultrasound guided) two step procedure (ultrasound for implantation and CT/MRI for planning)
47
Brachytherapy: HDR steps involved
1.placement of catheters 2.imaging with catheters in place 3.target volume defintion 4.dosimetry/planning (dwell time optimisation) 5.QA 6.Treatment delivery
48
Brachytherapy: HDR planning verification
forward or inverse depending of software available catheter tip verification is done pre irradiation
49
Side Effects: Brachytherapy what side effects when they start how long they last
Urinary side effects: -frequency, urgency, pain and obstruction due to prostate swelling -6-12 weeks following seed insertion -2-12 months
50
adjuvant radiation therapy
performed 4 months after surgery and triggered by tumour size or surgical margin .....60-64Gy
51
salvage radiation therapy
perfomed when PSA levels increase during follow up
52
Treatment decisions should take into account:
-TNM classification -gleason score -baseline PSA -patient age , co-morbidity, life expectancy and QoL -wishes and circumstance of patient
53
RT: CT Simulation what is needed how is it achieved
empty rectum diet enema- microlax endo-rectal balloon- filling the rectum for consistency
54
RT: CT Simulation -slice thickness
2.5-3mm
55
RT: CT Simulation scan length
SUPERIOR: sacroiliac joint for prostate +/-SVs OR post prostatectomy L4/L5 for distal common iliac or proximal pre-sacral lymph nodes for high risk patients INFERIOR:fixed border taken from ischial tuberiosties eg 5cm inf
56
Advantages of MRI at Pre Treatment
- decreases of CTV which leads to:
57
Prostate CTV
entire prostate gland as defined on planning CT with aid of MRI
58
strengths of HDR
-implant large glands -implant extra capsular extension/SV -Accurate dose delivery -Focal subvolume boosts
59
limitations of HDR
-Fractionation -Requires HDR facility
60
strengths of LDR
-single step procedure -convenient -Well established technique with large amounts of historical data
61
limitations of LDR
-Volume limited -Limited cover of extra capsular extension/SV -Possible seed migration -Less flexible for boosts -Low radioprotection

3rd Year Semester 1 (58 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions