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Flashcards in Prostate Cancer Deck (32):
1

Where is the base of the prostate?

Continuous to bladder neck
Superior

2

What is the inferior portion of the prostate called?

Apex

3

What cells cover the prostatic urethra?

Transitional epithelium

4

What is the verumotanum?

Ejaculatory ducts enter here

5

What are the three zones of the prostate?

Transitional zone
Central zone
Peripheral zone

6

What common pathology occurs in the transitional zone?

Benign prostatic hypertrophy

7

Where is the central zone?

Surround the ejaculatory ducts

8

What can form in the peripheral zone of the prostate?

Adenocarcinoma

9

What is the peak age for prostate cancer?

70+

10

True or False
There is no genetic link with prostate cancer

False.
Having a first degree relative with prostate Ca doubles the risk

11

What is the presentation of prostate cancer?

Haematuria
Haematospermia
LUTS

12

What highly sensitive but poorly specific test can be done for prostate cancer?

PSA

13

What is the danger of using PSA as a prostate cancer marker?

Also raised if been instrumented or in infection or after DRE

14

What may be observed on DRE in prostate cancer?

Asymmetrical craggy mass

15

What must occur when testing a patient's PSA?

Must be before a DRE
Must counsel patient as to results

16

What is the next step with a positive PSA and abnormal DRE?

Trans-rectal USS guided prostate biopsy

17

What is the main type of prostate cancer?

Adenocarcinoma

18

Where does prostate cancer metastasise to?

Bone

19

What is characteristic of prostate cancer on x-ray?

Sclerotic lesions on bone

20

What grading score is done for prostate cancer?

Gleason's scoring
1-5

21

What are the treatment options for prostate cancer?

Watch and wait
Radical surgery
Radical radiotherapy
Androgen deprivation drugs

22

True or False
Patient will definitely have ED after radical surgery

False.
Half of patients have ED

23

True or False
Most of the body's testosterone comes from the testis

True

24

Why does androgen deprivation work as a therapy?

If androgens are suppressed for long enough prostate cells die without them

25

How do LHRH agonists work?

Downregulate LHRH receptors so suppress LH and FSH to reduce testosterone production

26

What are the side effects of LHRH agonists?

ED
Loss of libido
Weight gain
Gynaecomastia
Osteoporosis

27

What is testosterone surge?

Transient rise in LH/FSH which causes testosterone production in first few weeks of LHRH agonist therapy

28

How are LHRH agonists given?

Tablets
Injection
Implant

29

How is testosterone surge avoided?

Anti-Androgen cover given for 1 week before LHRH injection

30

How do anti-androgens work?

Compete with testosterone for binding sites, inhibiting prostate Ca growth.

31

What are the two types of anti-androgens?

Steroidal
Non-steroidal

32

Which anti-androgen type is preferable for younger or more sexually active men?

Non-steroidal as this maintains libido