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18 Cards in this Set
- Front
- Back
what is the primary therapeutic approach in metatstatic prostate cancer?
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androgen deprivation therapy (ADT)
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does ADT prolong survival?
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yes it may, but is not curative
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how is ADT accomplished?
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removing the testes or by giving:
GnRH agonists Estrogens androgen receptor blockers |
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how do GnRH agonists work?
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reduce LH production --> decrease testicular androgens
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what is abarelix?
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GnRH agonist
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how does estrogen therapy used in prostate cancer?
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reduces LH production
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what are the nonsteroidal androgen receptor blockers?
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flutamide
nilutamide bicalutamide |
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what are the steroidal receptor blockers?
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cyproterone
megestrol |
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what is complete androgen blockade (CAB)?
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use of androgen receptor blockers and GnRH agonists
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what are the adverse effects of androgen receptor blockers?
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less: sexual dysfunction, hot flashes more sparing of bone and muscle than GnRH
more gynecomastia than GnRH |
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what are alternatives to ADT?
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intermittent androgen deprivation (IAD)
antiandrogen monotherapy |
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what are the adverse effects of ADT?
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osteoporosis
vasomotor symptoms (hot flashes) gynecomastia |
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how is osteoporosis due to ADT manages?
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Ca, vit D
increase exercise bisphosphonates: pamidronate and zoledronate |
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how are the vasomotor symptoms of ADT managed?
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megesterol
transdermal estrogen SSRIs acupuncture |
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how is gynecomastia due to ADT managed?
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radiation therapy
tamoxifen aromatase inhibitors surgery |
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what are the treatment options of androgen independent prostate cancer?
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antiandrogen withdrawal
second-line hormone therapy systemic chemotherapy adjunctive therapies |
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what is antiandrogen withdrawal syndrome?
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when prostate cancer becomes unresponsive to antiandrogens, withdrawing them reduces the cancer
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what chemotherapy is recommended for prostate cancer?
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docetacel plus prednisone
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