Term
| Risk Factors for Prostate Cancer |
|
Definition
- Age (> 65)
- Race/Ethnicity (African-American)
- Family History
- Occupation (cadmium exposure)
- Diet (high fat)
- Hormonal (exogenous androgens)
|
|
|
Term
| Presentation of Prostate Cancer |
|
Definition
Early
Asymptomatic
Invasive
- Urinary frequency
- Dribbling
- Hesitancy
- Blood in urine or semen
Advanced Disease
Pain |
|
|
Term
| Diagnosis of Prostate Cancer |
|
Definition
- DRE
- PSA
- Transrectal Ultrasonography
- Biopsy (2 samples)
|
|
|
Term
|
Definition
- Indicates how fast the cancer is growing
- 2 specimens are scored, then added
- 2-6 average, 7 fast, 8-10 very fast
|
|
|
Term
| Other than prostate cancer, PSA may be elevated due to: |
|
Definition
- Acute urinary retention
- Prostatic ischemia/infarct
- Prostatitis
- BPH
|
|
|
Term
| PSA and DRE are used annually for screening if: |
|
Definition
> 50
- normal risk
- > 10 yr life expectancy
> 45
High risk (family history, African-American) |
|
|
Term
| Treatment for Prostate Cancer: Stage I |
|
Definition
Expectant Management
Local Therapy
- Radiation OR
- Radical prostatectomy
|
|
|
Term
| Treatment for Prostate Cancer: Stage II |
|
Definition
Expectant Management
Local Therapy
- Radiation OR
- Radical prostatectomy
|
|
|
Term
| Treatment for Prostate Cancer: Stage III |
|
Definition
Expectant Management
Local + Systemic Therapy
- Local: Radiation OR Radical Prostatectomy w/ pelvic lymphadenectomy
- Systemic: Hormonal Therapy
|
|
|
Term
| Treatment for Prostate Cancer: Stage IV |
|
Definition
Hormonal Manipulation
Palliative Radiation Therapy
|
|
|
Term
| Expectant Management is indicated for what type of prostate cancers? |
|
Definition
- Asymptomatic
- Slow growing (low Gleason score)
- Small and contained
- PSA and DRE monitored regularly (6-12 months)
|
|
|
Term
| Types of Radiation Therapy Used for Prostate Cancer |
|
Definition
External Beam Radiation
Radiation focused on prostate gland from source outside body
Internal Beam Radiation - Brachytherapy
- Small radioactive pellets are inserted in the prostate surrounding the tumor
- Used for slow growing cancers
|
|
|
Term
| Adverse Effects of Radiation Therapy |
|
Definition
- Bowel problems
- Bladder problems
- Incontinence
- Impotence
|
|
|
Term
| Types of hormonal therapy in prostate cancer |
|
Definition
- Orchiectomy
- LHRH analogs
- Antiandrogens
|
|
|
Term
| Patients eligible for Hormone Therapy in Prostate Cancer |
|
Definition
- Not able to have surgery or radiation
- Surgery or radiation therapy failure
- (+) radiation therapy as initial treatment
- Metastatic disease
|
|
|
Term
Adverse Effects of Hormone Therapy
|
|
Definition
- Diarrhea
- Nausea
- Liver problems
- Fatigue
- Loss of libido
- Impotence
- Hot flashes
|
|
|
Term
|
Definition
- Prevents testes from producing testosterone
- Causes downregulation of LHRH receptors on pituitary gland
- Inhibits gonadotropin secretion
- Testosterone levels similar to castration
|
|
|
Term
|
Definition
- Leuprolide
- Goserelin
- Triptorelin
|
|
|
Term
| Adverse Effects of LHRH Agonists |
|
Definition
- "Flare Up"
- Hot flashes
- Impotence
- Decreased libido
- Peripheral edema
- Fatigue
|
|
|
Term
|
Definition
- Bicalutamide
- Flutamide
- Nilutamide
|
|
|
Term
| Adverse Effects of Antiandrogens |
|
Definition
- Breast tenderness
- Gynecomastia
- Diarrhea
- Hot flashes
- Liver function abnormalities -- DC if liver enzymes >2-3 x upper limit of normal
|
|
|
Term
| If patient relapsed after orchiectomy/LHRH agonist, then: |
|
Definition
Add/change to antiandrogen
If patient fails that, then they are considered androgen independent/refractory --> start chemo/immunotherapy |
|
|
Term
| If patient relapsed after LHRH agonist + Antiandrogen, then: |
|
Definition
Stop antiandrogen
If patient fails that, then they are considered androgen independent/refractory --> start chemo/immunotherapy |
|
|
Term
| Hormone-Refractory Tumors |
|
Definition
- Pt failed 2 hormonal therapies
- Tumor growth despite testosterone levels < 50 ng/mL
- Immunotherapy or chemotherapy
|
|
|
Term
| Chemotherapy is indicated in patients: |
|
Definition
- Cancer which has spread beyond prostate
- Failed hormone therapy
|
|
|
Term
| Chemotherapy for Prostate Cancer |
|
Definition
- Docetaxel + Prednisone
- Cabazitaxel + Prednisone
- Mitoxantrone + Prednisone
|
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