21881224
Description
Flashcards by Sam Adeyiga, updated more than 1 year ago
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Created by Sam Adeyiga
about 4 years ago
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| Question | Answer |
| For an American male, the lifetime risk of developing prostate cancer is ----- %, but the risk of dying of prostate cancer is only --------- %. | a. 16% b. 2.9% |
| What is the role of 5 alpha-reductase in prostate cancer? | 5 alpha-reductase is an enzyme that converts testosterone to its active form dihydrotestosterone (DHT) in the prostate. |
| ----------- testosterone and ---------- AR (androgen receptors) activation may account for the increased risk of prostate cancer | 1. increased 2. increased |
| RFs for PC | 1. Male 2. Race 3. Family Hx 4. high-fat diet 5. decreased vitamin D levels 6. access to healthcare |
| LH complexes act on ----- to stimulate production of testosterone and small estrogen. | Leydig cell |
| FSH acts on the ------- within the testes to promote the maturation of LH receptors and to produce an androgen-binding protein. | Sertoli cells |
| prostate-specific antigen (PSA) an enzyme that is involved in --------- | preventing the coagulation of seminal (sperm) fluid. |
| PSA + a1-antichymotrypsin (endogenous protease inhibitor) = | inactive PSA |
| American Urological Association (AUA) and the American Cancer Society (ACS) recommend screening (PSA and DRE) every ----- years be considered in all men between age ------ years. | a. 2 years (every other year) b. 50 - 75 yrs |
| African-Americans and men with a strong family histories of prostate cancer shd consider screening starting at age -------? | 45 |
| Symptoms of Prostate Cancer (Localized Disease Stage I - II) | Asymptomatic |
| Symptoms of Prostate Cancer (Localized invasive / Regional Disease) Stage III | 1. Ureteral frequency 2. Ureteral hesitancy 3. Ureteral dribbling 4. Impotence 5. Blood in urine or semen |
| Symptoms of Prostate Cancer (Advanced Disease) Stage IV | 1. Back pain 2. Cord compression 3. Lower-extremity edema 4. Pathologic fractures 5. Anemia 6. Weight loss |
| patients with a PSA > 20ng/mL, Gleason score > 8, or large primary tumors (T3-4) should receive a bone scan (CT or MRI) to assess for | metastatic disease |
| Gleason Score 6 | Well differentiated -slight anaplasia |
| Gleason Score 7 | Moderately differentiated -moderate anaplasia |
| Gleason Score 8 - 10 | Poorly differentiated -marked anaplasia |
| How do you calculate life expectancy? | 1. (age * .5)/2 2. (65 * 50%) / 2 = 16.5 yrs 3. Health? then adjust by + 8 = 24 4. unhealthy? then adjust by -8 = (16 - 8) = 8yrs. |
| Trt for patients with a life expectancy of less than 5 years and without clinical symptoms ------- | 1. further workup or 2. treatment may be delayed until symptoms develop (watchful waiting) 3. Monitoring involves a. PSA testing every 3 to 6 months, b. DRE every 6 to 12 months, |
| Trt for Localized (stage I-II) and locally invasive (stage III) prostate cancer | 1. surgery (Radical prostatectomy) 2. radiation therapy a. external-beam RT b. brachytherapy *** Treatment is given over 8-9 weeks |
| Advanced prostate cancer (stage IV) | No cure yet. |
| Brachytherapy involves -------? | placing small radioactive pellets (often called seeds) into the prostate tissue |
| How does Androgen Deprivation Therapy (ADT) work? | 1. decrease prostate tissue exposure to testosterone and DHT. 2. ADT can be accomplished through medical or surgical castration (orchiectomy) |
| Two types of drugs used for medical castration are ------ | 1. LHRH agonist (in combo w. antiandrogen) 2. LHRH antagonist |
| The therapeutic goal of medical castration is to achieve a serum testosterone ------? | < 50 ng/dL |
| RFs of ADT are ----- | 1. osteoporosis 2. insulin resistance 3. hypercholesterolemia 4. obesity 5. cardiovascular disease 6. depression 7. gynecomastia 8. hot flashes |
| -------------- may be used in patients with androgen-independent or castration-resistant prostate cancer (CRPC). | Cytotoxic chemotherapies |
| Immunotherapies such as the ---------, is an option for asymptomatic advanced CRPC treatment. | 1. autologous cancer vaccine 2. sipuleucel-T |
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