Prostate Cancer Flashcards Preview

Hugh's MD2 Core Conditions and Presentations > Prostate Cancer > Flashcards

Flashcards in Prostate Cancer Deck (16):
1

What is are the principles of luteinizing hormone releasing hormone (LHRH) agonist therapy?

GnRH stimulation of LH hormone release is usually pulsatile so constant stimulation reduces LH hormone release therefore testosterone. 

The initial dosing must be accompanied with an anti-adrogenic agent (bicalutamide) to counteract the initial burst in testosterone

2

What is the treatment of choice for metastatic prostate cancer?

Docetaxel (anti-mitotic chemotherapy)

3

What is active surveillance? When is it used?

6monthly PSA and DRE

12monthly biopsy

 

For a GLEASON 6 prostate cancer in a patient who is able to tolerate the treatment if required

4

What is the difference between active surveillance and watch full waiting?

In active surveillance the intent is for cure and the screening is more rigorous as the patient is more likely to be able to tolerate the required therapy

 

In watchful waiting the intention is to paliate therefore the screening is less rigorous. The patient is unlikely to tolerate the required therapy 

5

What are the differentials for an elevated PSA?

Prostate cancer

Prostatitis

BPH

6

What are the options of androgen depreviation therapy?

Luteinizing hormone releasing hormone agonists (goserelin)

7

Outline the Gleason scoring system and the implications of scores?

1-10

6 is low risk

7 is medium risk

8-10 is high risk

8

What are the pro's and con's of PSA screening?

Pro's

- It's a safe, reliable test

- Early treatment is effective at lowering mortality and has low side effects

 

Con's

- Overtreatment and over diagnosis

- 2/3 positive tests won't be prostate cancer

9

What does BPH stand for?

Benign prostatic hyperplasia

10

How many men are diagnosed and die of prostate cancer every year in Australia?

20 000

3500

11

What are investigations available to stage prostate cancers?

MRI

CT

Bone scan

12

How is the diagnosis of prostate cancer confirmed?

Transurethral/transperineal US guided biopsy with 12-20 cores taken and sent for Gleason score

13

What is normal for PSA?

<4ng/ml

14

What are some side effects of adrogenic depreviation therapy?

CNS - Low mood, cognitive change

CVS - Hypercholesteraemia, IHD risk

Bone - Osteoporesis

Obesity

General - Low lidido, lethargy

15

Outline how the Gleason score works

12-20 biopsies are taken and scored with a grade of 1-5 depending on the glandular pattern of differentiation. The two highest scores are added to get a score out of 10

 

2-4 = Well differentiated cancer

5,6 = Intermediate grade tumour

7 = Moderate to poorly differentiated cancer

8-10 = High-grade tumour

16

What are some risk factors for prostate cancer?

Age

FHx

African-American