Therapeutics Iii Exam 3 - Prostate Cancer Questions

Front 1

What role does race play in prostate cancer?

Back 1

African-Americans are at a higher incidence for contracting prostate cancer and have twice the mortality as other races.

Front 2

What dietary implications are associated with prostate cancer?

Back 2

-High fat diets increase risk
-Vitamin A or Retinol use over the age of 70 increases the risk
-Vitamin E has antioxidant effects that decrease the risk

Front 3

What are the major screening tests used for prostate cancer?

Back 3

Digital Rectal Exam
Prostate-Specific Antigen

Front 4

How is Prostate-Specific Antigen used to screen for prostate cancer?

Back 4

Glycoprotein is produced and secreted by the eipthelial cells of the prostate gland. Total PSA should be less than 4ng/ml. PSA levels between 4-10ng/ml cannot distinguish between BPH and prostate cancer. Higher PSA levels indicate prostate cancer. PSA velocity over time is another predictor of prostate cancer risk. Other reasons for elevated PSA are acute urinary retention, acute prostatitis, and benign prostatic hyperplasia.

Front 5

Who needs to be screened for prostate cancer?

Back 5

DRE and PSA should be performed annually on men over 50 years of age. High-risk groups should begin getting screenings at 45.

Front 6

What are the symptoms of localized prostate cancer?

Back 6

asymptomatic

Front 7

What are the symptoms of locally invasive prostate cancer?

Back 7

-ureteral dysfunction (frequency, hesitancy, dribbling)
-urinary obstruction
-anuria (may be due to obstruction)
-painful or burning urination (may be blood in urine)
-impotence
-painful ejaculation

Front 8

What are the symptoms of advanced prostate cancer?

Back 8

-bone pain is most common complaint
-back pain
-spinal cord compression
-lower extremity fractures
-pathologic features
-anemia
-weight loss

Front 9

What metastatic locations are associated with prostate cancer?

Back 9

-lymph nodes are most common
-skeletal is the most common distant metastasis; lumbar spine is the most likely site
-viscera including lung, liver, brain and adrenal glands

Front 10

What are the extreme stages of prostate cancer?

Back 10

Stage T1 or A1 is the most benign stage and has a cure rate of 85%. At this stage there are few foci and no metastasis.
Stage M1 or D2 are the worst cases. The cancer has metastasized at multiple points of the body and the cure rate is 1%.

Front 11

What are the general steps in treatment of prostate cancer?

Back 11

1. Management - check PSA and DRE every 6 months
2. Orchietctomy - rapidly reduces androgen levels
3. Radiation - via external beam
4. Radical Prostatectomy - complicated procedure with many complications (cystitis, proctitis, hematuria; chronic - diarrhea, impotence, incontinence)

Front 12

What are the drugs of choice for treating prostate cancer?

Back 12

1. Luteinizing Hormone-Releaseing Agonists
2. Antiandrogens
3. Chemotherapy

Front 13

What is the mechanism of Luteinizing Hormone-Releasing Hormone Agonists?

Back 13

LHRH agonists are a reversible method of androgen ablation that is as effective as orchiectomy.

Front 14

What are the LHRH agonist agents?

Back 14

Leuprolide (tablets, depot, implant)
Triptorelin (depot, implant)
Goserelin (implant)

Front 15

What are the side effects of LHRH agonists?

Back 15

-decrease flareup in the first week of therapy (caused by induction of LH and FSH; manifests as increased bone pain or increased urinary symptoms)
-hot flashes
-erectile impotence
-decreased libido

Front 16

How do antiandrogens compare to LHRH agonists in treating prostate cancer?

Back 16

They are less effective, especially in advanced PCA.

Front 17

What is chemotherapy's place in prostate cancer treatment?

Back 17

Historically, chemotherapy is of little use in hormone refractory PCA. Some new regimens have been shown to provide palliative therapy as well as prolong survival. However, metastatic hormone-independent PCA has preferred agents.