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42 Cards in this Set
- Front
- Back
- 3rd side (hint)
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What is Brachytherapy?
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Type of radiation therapy in which radioactive materials are placed in direct contact with the tissue being treated.
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What does 3D-CRT/IMRT with daily IGRT stand for?
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3 dimension - Conformal RadioTherapy/Intesity Modulated Radiation Therapy with Image Guided RadioTherapy
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What is ADT?
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Androgen Deprivation Therapy
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Type 1 prostatectomies consist of...
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TURP (Transurethral resection of the prostate)
Open prostectomy |
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Type II prostatectomies consist of
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Partial prostectomy
Radical prostectomy |
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What are the common side effects of prostatectomy?
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Impotence, incontinence
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2 side effects
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What is a partial prostatectomy?
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Removal of part of the prostate gland, leaving the posterior portion intact
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What is a radical prostatectomy?
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Removal the whole prostate along with nearby tissues such as the seminal vesicles
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What are the systemic therapies available to treat prostate cancer and which one is first line?
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Androgen Deprivation Therapy (first line)
Chemotherapy Ketoconazole +/- glucocorticoids (salvage therapy) |
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Surgical ADT is called
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Bilateral orchiectomy
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Medical ADT is performed using...
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LHRH analogs
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What is the benefit of combined androgen blockade (CAB)?
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Antiandrogen therapy should precede or be co-administered with LHRH agonist and be continued in combination for at least 7 days for patients with OVERT METASTASES who are a risk of developing symptoms of tumor flare.
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True or false? CAB has no proven benefit over single ADT.
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TRUE
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True or false? Antiandrogens can be used as monotherapy.
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False. Antiandrogen monotherapy appears to be less effective than medical or surgical castration and should not be recommended.
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What is the recommended duration of intial treatment with ADT?
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Short term: 4-6 months
Long term: 2-3 years (preferred) |
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True or false? Patients with a short PSA doubling time and long life expectancy should be considered for ADT, if tolerable.
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TRUE.
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When should treatment with ADT be initiated?
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-Patient has short PSA doubling time and long life expectancy.
-Patient has tumor-related symptoms or overt metastasis. |
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Immediate adjuvant ADT is recommended in men with
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Positve nodes following radical prostatectomy (due to overall survival benefit compared with those with delayed ADT)
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What agents can you add to reduce the risk of osteoporosis caused by ADT?
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Zolendronate, pamidronate, alendrongate, raloxifene and toremifene
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5 agents
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If patient has a CrCl<30, which agent(s) can be used to prevent osteoporosis?
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Raloxifene, toremifene. Bisphosphonates should not be used.
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When should antiandrogen withdrawal be considered?
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When patient has been receiving complete hormonal therapy and shows clear signs of disease refractory to this form of therapy. Patients receiving LHRH for testosterone suppression should be maintainted on this treatment.
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Goserelin
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Zoladex
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Leuprolide
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Lupron
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Triptorelin
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Trelstar
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Histrelin
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Vantas
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What are the adverse reactions of LH-RH analogs?
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TUMOR FLARE, osteoporosis, hot flashes, impotence, decreased libido, gynecomastia, breast pain, pain at injection site, anemia in men
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Flutamide
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Eulixin
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Bicalutamide
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Casodex
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Nilutamide
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Nilandron
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What are the adverse reactions of antiandrogens?
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Gynecomastia, hot flashes, decreased libido, hepatitis.
Flutamide (more diarrhea) Bicalutamide (less diarrhea) Nilutamide (nausea, constipation) |
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What are the special problems associated with Flutamide?
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Diarrhea, fatal liver dysfunction
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What are the special problems associated with Bicalutamide?
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High protein binding
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What are the special problems associated with Nilutamide?
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Interstitial pneumonitis, disulfuram reaction, delay in dark adaptation, CYP450 inhibtior, DDI with warfarin
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What is the dose for ketoconazole?
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Ketoconazole 400mg TID +/- hydrocortisone.
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Systemic chemotherapy should be used for...
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Castration-recurrent metastatic prostate cancer
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What is the first line for systemic chemotherapy?
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Docetaxel + Prednisone
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Estramustine
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Emcyt
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Mitoxantrone
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Novantrone
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What are the adverse effects of estramustine?
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Thrombosis, glucose intolerance, elevated BP, hypersensitivity reactions, hepatic impairment, fluid retention, exacerbation of peripheral edema, Ca/P metabolism disturbance, gynecomastia/impotence/decreased libido, carcinogenesis, mutagenesis.
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What are the instructions you should give to patients while taking estramustine?
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1. Keep in refrigerator
2. Do not take milk, milk products, calcium rich foods or drugs simultaneously 3. Take with water at least 1 hour before or 2 hours after meals. |
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What are the adverse effects of mitoxantrone?
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Myelosuppression, mild N&V, diarrhea, mucositis, cardiomyopathy, extravasation (less than anthracyclines), blue urine and sclera.
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Bank
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Banco
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