Westra's prostate cancer; 4.1

Question 1

What is the most common male cancer?

Answer 1

Prostate cancer (1:6 lifetime risk in US)

Question 2

Which race is at greatest risk of both developing and dying from prostate cancer?

Answer 2

Africans

Question 3

Is there a genetic component to prostate cancer?

Answer 3

Yes…first degree relative with prostate cancer→ 2x as likely and relative with breast cancer also increases risk

Question 4

What gene is equated with prostate cancer?

Answer 4

Hereditary Prostate Cancer 1 (HPC1)…on chromosome 1q24-25

Question 5

What age group is mostly to present with prostate cancer?

Answer 5

65-74 (avg. age is 66)

Question 6

What can be eaten that INCREASES the likelihood of developing prostate cancer?

Answer 6

High amounts of folic acid (synthetic folate)

also increased dairy/calcium…but that isn’t important

Question 7

What chemicals can men be exposed to at work that increase the likelihood of developing prostate cancer?

Answer 7

Polyaromatic hydrocarbons
Acetic acid and acetic anhydrate
Dioxin

Question 8

What can be eaten/taken that DECREASES the likelihood of developing prostate cancer?

Answer 8

Natural folate (diet)
Finasteride/dutasteride (chemoprevention)

Question 9

What is considered a “normal” PSA level?

Answer 9

<4ng/mL

Question 10

What is considered a high PSA level?

Answer 10

> 10ng/mL

Question 11

What is PSA velocity?

Answer 11

PSA change over time

Question 12

What is a significant PSA velocity?

Answer 12

> 0.75ng/mL

Question 13

What is PSA density?

Answer 13

PSA level relative to size of gland

Question 14

How is PSA density measured?

Answer 14

Transurethral ultrasound (TRUS)

Question 15

What is the Gleason score of a grade II prostate cancer?

Answer 15

5-7

Question 16

What stages of prostate cancer are clinically localized?

Answer 16

T1 and T2

Question 17

What is done with a radical prostatectomy?

Answer 17

Removal of prostate and seminal vesicles

retropubic/perineal approach

Question 18

What is done with a transurethral resection?

Answer 18

Removal of cancerous section of prostate gland

Question 19

Cryosurgery is exactly what it sounds like…but besides the typical side effects of impotence and urinary incontinence, what else can go wrong?

Answer 19

Bladder outlet injury

Rectal injury

Question 20

What are two types of radiation therapy used for prostate cancer?

Answer 20

External beam radiation

Interstitial brachytherapy

Question 21

What is the end goal of hormonal therapy for prostate cancer?

Answer 21

Decrease androgen stimulation of prostate cancer cells

Question 22

Where is the site of action of estrogens in prostate cancer therapy?

Answer 22

Estrogens act on the hypothalamus

Question 23

What is an orchiectomy?

Answer 23

Removal of testicles

Question 24

Where is the site of action of anti-androgens for prostate cancer?

Answer 24

Anti-androgens act directly on the prostate

Question 25

Where is the site of action of LHRH agonists for prostate cancer?

Answer 25

LHRH agonists act in the pituitary

Question 26

When is chemotherapy used?

Answer 26

Progressive or recurrent disease

Question 27

Impotence is a common side effect to many of the prostate cancer treatment options. How is impotence treated?

Answer 27

Phosphodiesterase type 5 inhibitors

Question 28

Hot flushes happen with androgen deprivation therapy...how should this side effect be treated?

Answer 28

Paroxetine or gabapentin

Question 29

How is a local prostate cancer surveyed?

Answer 29

DRE annually | PSA every 6-12months for 5yrs...then annually

Question 30

How is advanced (N1, M1) surveyed?

Answer 30

DRE and PSA every 3-6months