Urology lecture Flashcards
What is PSA?
Prostate-specific antigen
- A glycoprotein enzyme secreted by the epithelial cells of the prostate
- It liquefies semen in the seminal coagulum and allows sperm to swim freely
- It helps dissolving cervical mucus, allowing the entry of sperm into the uterus
What are some surgical treatments for prostate cancer?
- RARP (robotic assisted radical prostatectomy)
TURP (transurethral resection of the prostate). Doesn’t remove the cancer but it cuts away the blockage to allow passage of urine through the urethra
How is cryotherapy used to treat prostate cancer?
It uses extreme cold to destroy cancer cells
What is HIFU?
High-intensity focused ultrasound
- It uses very powerful sound waves to heat and destroy cancer cells in the prostate
What are the types of radiation therapy used in prostate cancer?
- External Beam Radiotherapy
- Brachytherapy: permanent low dose rate / temporary high dose rate. A radioactive seed is inserted into the body
- Combination
What are the different drug therapies used to treat prostate cancer?
Hormone therapies
- “castration therapies”;
- Antiandrogens
- Novel “ARTAs”
Chemotherapy
- Taxotere / Cabazitaxel
Others
- PARP inhibitors
Symptomatic
- Tamsulosin / Flomax
What is a targeted biopsies Gleason score?
It ranges from 1-5 and describes how much the cancer from your biopsy looks like healthy tissue (lower score) or abnormal tissue (higher score).
The two most dominant grades of cancer cells are each given a score that falls within that range. For example, a patient may be assigned a 3 and a 4
What are TRUS biopsies?
Transrectal Ultrasound guided prostate biopsy
- Used to diagnose prostate cancer
- Performed in men with an abnormal PSA, a palpable abnormality on a digital rectal examination (DRE) or a rapidly increasing PSA level
What is IMRT in radiotherapy?
Intensity-modulated radiation therapy
It delivers different doses of radiation to different areas. The doses are more controlled
What is Multileaf collimation in radiotherapy?
A tool used to to deliver radiation therapy doses
What is IGRT (image guided radiotherapy)
Images of the cancer are used to plan treatment so doses are more controlled
What type of patient is put in the ‘watchful waiting group’ instead of receiving immediate treatment with cancer?
- > 80
- Multiple co-morbidities
- Low / intermediate grade cancer where local control RT not deemed appropriate
- Start hormones when PSA> 20 and doubling time <6month
What are some side effects of prostate radiotherapy?
Bowel
- Diarrhoea
- More wind
Sexual function
- Erectile dysfunction
- Increased time until orgasm
- Decreased intensity of orgasm
- Dry ejaculate
Bladder
- Radiation cystitis
- Increased urinary frequency
- Urinary urgency
- Retention
General
- Loss of pubic hair
- Tiredness and weakness
- Sore skin
What are some hormone therapy for prostate cancer side effects?
- Loss of libido
- Cognitive difficulties (concentration, word finding)
- Hot flushes/night sweats
- Gynaecomastia
- Fatigue
- Sarcopenia (muscle wasting)
- Weight gain
- High cholesterol
How do Castration and anti-androgen hormone therapies work?
They cause they cancer cells to die off because they no longer have the testosterone they need to reproduce
