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Pathobiology of Neoplasia > Prostate Cancer > Flashcards

Flashcards in Prostate Cancer Deck (31):
1

Risk factors for Prostate ca

Age (>50)
Ethnicity
Family hx
Genes
Diet high in fat
Obesity
Vasectomy

2

Screening recommendations for prostate ca

PSA and DRE >50yrs
High risk start at 40-45yrs
NOT recommended in men >70, life expectancy

3

What are two PSA markers?

PCA 3
Proenzyme PSA

4

Signs and symptoms of prostate ca

Urinary symptoms
Abnormal DRE or elevated PSA
Worsening symptoms with advanced disease

5

Gold standard of diagnosis for prostate ca

Prostate biopsy

6

What is considered low risk prostate ca?

A Gleason score of less than or equal to 6 with a PSA of 10

7

What is intermediate risk prostate ca?

PSA 10-20 and Gleason of 7

8

What is high risk prostate ca?

PSA >20 and Gleason of 8-10

9

What is the most common type of prostate cancer?

Adenocarcinoma at 90%

10

Surveillance methods for low risk prostate ca

PSA q3-6mo
Annual DRE and bx

11

When do you switch to active treatment of prostate ca?

Gleason score >7 on rpt bx
More positive samples
PSA doubling

12

What is the gold standard for prostate surgery?

Robotic assisted surgery

13

What is post treatment surveillance for prostate cancer?

Initial definitive therapy
-PSA Q6-12mo x5yrs, then q yr

N1 or M1
-physical exam with DRE and PSA q3-6mo

14

What is treatment for high risk prostate ca?

XRT + Neoadjuvant ADT
OR
Radical prostatectomy with lymph node dissection

15

What is the biological effect?

Period of time between the breaking of chemical bonds and expression of biological effect
-could be hours, days, months, years

16

What is image guided radiation therapy?

Ultrasound used to detect prostate motion and delivers XRT when prostate is in field

17

What is the tolerance dose?

Dose that produces acceptable probability of tx complication
-involves radiobiology, socioeconomic and psych factors

18

What do androgens do?

Promote the development and progression of prostate cancer

19

What is a LHRH Antagonist?

Stimulates release of LHRH
Stops testosterone production
*may have initial tumor flare
Ex: Lupron

20

What is a LHRH Antagonist?

Suppresses LH production
Castrate level testosterone
*no tumor flare
Ex: Degarelix

21

What are anti androgens?

Block absorption of testosterone into cells
Prevent tumor flare
Ex: casodex

22

What are androgen synthesis inhibitors?

Inhibits testosterone and LH synthesis
Ex: Zytiga

23

What is biochemical failure?

Failure of PSA to fall to undetectable level
-After prostatectomy: PSA = or > 0.2 on two separate occasions
-After XRT: rise in PSA by 2 above nadir

24

What is treatment of biochemical failure?

Intermittent androgen blockade

25

What is CRPC?

Disease from rising PSA w/o mets or symptoms despite ADT
OR
mets and debilitation from cancer symptoms

26

Treatment for CRPC

Zytiga with prednisone

27

What is immunotherapy vaccine for prostate ca?

Provenge
Done by pheresis using patients own cells

28

Common sites of mets in prostate ca

Bone
Spine
Liver
Lung
Lymph nodes

29

What is a rare but severe side affect of Zometa use?

Osteo necrosis of the jaw

30

When is radium 223 chloride used?

Symptomatic bone mets without known visceral disease
-mimics calcium

31

Incidence of Prostate Cancer

Most common cancer found in American men