Prostate Cancer Flashcards
(21 cards)
What is the most common cancer in men?
Prostate cancer
Prostate cancer is characterized by varying degrees of aggression, with many cases being slow-growing.
How does advanced prostate cancer commonly spread?
To lymph nodes and bones
This spreading is a key feature of advanced stages of prostate cancer.
What does it mean that prostate cancer is almost always androgen-dependent?
It relies on androgens (e.g. testosterone) to grow
Understanding this dependency is crucial for treatment strategies.
List five risk factors for prostate cancer.
- Increasing age
- Family history
- Black African or Caribbean origin
- Tall stature
- Anabolic steroids
What are common clinical features of prostate cancer?
- Asymptomatic
- Lower urinary tract symptoms (hesitancy, frequency, weak flow, terminal dribbling, nocturia)
- Haematuria
- Erectile dysfunction
- Symptoms of advanced disease (weight loss, bone pain, cauda equina syndrome)
What produces prostate specific antigen (PSA)?
Epithelial cells of the prostate
PSA is specific to the prostate, and elevated levels can indicate prostate cancer.
What is a limitation of PSA testing?
High rate of false positives and false negatives
This unreliability can complicate early detection efforts.
Name at least three causes of raised PSA levels.
- Prostate cancer
- BPH
- Prostatitis
- UTIs
- Vigorous exercise (notably cycling)
- Recent ejaculation or prostate stimulation
What does a benign prostate feel like during examination?
Smooth, symmetrical, slightly soft with a maintained central sulcus
This contrasts with findings in infected or cancerous prostates.
What are the indications of a cancerous prostate during examination?
Firm or hard, asymmetrical, craggy/irregular with loss of central sulcus
These characteristics help differentiate cancerous from benign conditions.
What is the first-line investigation for suspected localized prostate cancer?
Multiparametric MRI
This method provides detailed imaging to assess the presence of cancer.
How is the Likert scale used in the context of prostate cancer assessment?
It rates suspicion of cancer from 1 (very low suspicion) to 5 (definite cancer)
This scale assists in determining further diagnostic steps.
What is the purpose of a prostate biopsy?
To establish diagnosis
Biopsy is indicated if Likert score is ≥3 with clinical suspicion.
What are two options for prostate biopsy?
- Transrectal ultrasound guided biopsy
- Transperineal biopsy
What does the Gleason grading system help determine?
The most appropriate treatment for prostate cancer
It is based on the histology of prostate biopsies.
What does a higher Gleason score indicate?
More poorly differentiated cells and worse prognosis
The Gleason score is composed of two numbers added together.
What management strategies are available for prostate cancer?
- Surveillance and watchful waiting
- External beam radiotherapy
- Brachytherapy
- Hormone therapy
- Surgery
What is a complication of external beam radiotherapy?
Proctitis
Proctitis is inflammation of the rectum, leading to various symptoms.
What does brachytherapy involve?
Implanting radioactive metal ‘seeds’ into the prostate
This method can cause inflammation in nearby organs.
What are some side effects of hormone therapy for prostate cancer?
- Hot flush
- Sexual dysfunction
- Gynaecomastia
- Fatigue
- Osteoporosis
What is a major complication of radical prostatectomy?
Erectile dysfunction and urinary incontinence
These complications highlight the risks associated with surgical intervention.
