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Flashcards in Prostate cancer Deck (17)
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1
Q

What are some of the causes of inc risk of prostate cancer

A

Heterogenous genetic disruption of androgen signalling pathway
Inactivation of PTEN which can lead to androgen independent activation of the androgen receptor
BRCA2

2
Q

What does the prostate do

A

provide components of the seminal fluid

3
Q

What are the symptoms of prostatic hyperplasia

A

Problems with urination
Lower back pain
Blood in urine

4
Q

Where does prostate cancer spread to

A

Seminal vesicles
Bladder
Lymph
Bone

5
Q

What is the major symptom of metastatic prostate cancer

A

severe bone pain

6
Q

Describe PSA

A

Component of seminal fluid that usually is prevented from entering tissue and serum due to epithelial gap junctions, basal cell layer and basement membrane.
Any damage to prostate allows PSA to escape and be detected

7
Q

What is the cutoff for serum PSA to indicate prostatic disease

A

4ng/ml

8
Q

What is the problem with the PSA test

A

Does not distinguish between benign or malignant

9
Q

What are other indications of a high PSA

A

mechanical damage

prostatitis

10
Q

How are biopsies conducted

A

needle biopsies

Need to have extended sampling techniques and repeat biopsies

11
Q

what is the problem with biopsies

A

not indicative of prognosis because you dont know how aggressive the tumour is

12
Q

What is the argument against PSA screening

A

raised PSA -> further invasive tests and acute anxiety
Malignancy will lead to treatment and unpleasant side effect and reduced quality of life
Unknown whether the lesion would be problematic

13
Q

What are the futures for prostate screening

A

specific for malignant disease
able to predict which will be life threatening
using bodily fluids

14
Q

What are the treatments for prostate cancer

A

Watchful waiting
Radical prostatectomy but incotinence and impotence
External beam radiotherapy if outside prostate capsule but no other organ- incontinence and sexual dysfunction
Metastatic: hormone therapy using a LHRH analogue
and anti androgens : osteoporosis, loss of libido, anaemia, muscle atrophy, memory loss, gynaecomastia

15
Q

What is androgen independence of cancer

A

Biochem relapse at 12 month
Symptomatic relapse 2 years
Expression of androgen receptor (ligand activated TF that mediates response to androgens) is inc by overexpression or gene amplification

16
Q

Why does prostate cancer continue to grow in the absence of circulating androgens

A

amplification of response to low residual levels of androgens by inc levels of androgen receptor, dec levels of co-repressors, mutations of androgen receptor causing it to be activated by other ligands

17
Q

When are mutations of the androgen receptor found

A

advanced metastatic hormone-independent disease