Duke PA Male Cancer
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| __ is the most common cancer that occurs in men and the second leading cause of cancer death | Prostate cancer
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| There is no association with prostate cancer and __ | Smoking, sexual activity, or prior history of prostatitis or BPH
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| There is histological evidence of prostate cancer in more than __% of men over the age of 60 | 50
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| Men with a less than __ year life expectancy may not benefit from prostate cancer screening | 10
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| Men younger than __ years of age and in otherwise good health are recommended to have routine screening for prostate cancer | 70-75
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| Prostate cancer typically arises from what portion of the prostate | Peripheral portion which can be palpated on DRE
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| __ of the prostate on DRE should be considered suggestive of prostate cancer | Induration or nodularity
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| __ values increase as men age | PSA
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| Probably the most important prostate cancer diagnostic piece of information | Increase in PSA greater than 0.75ng/mL per year
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| What system is most often used to grade prostate cancer | Gleason system
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| What is the most useful test in determining the local tumor extent with prostate cancer | DRE
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| __ is of limited value and usually not indicated clinically for determining either local extent or nodal metastasis (prostate ca) | CT scanning
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| In patients with high grade tumors or a substantially elevated PSA, __ is indicated | A bone scan
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| What is the most common site of distant spread for prostate cancer | Bone
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| What treatment for prostate cancer has the most proven ability for long term cure | Radical prostatectomy
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| With radical prostatectomy significant incontinence occurs in only __% of men, but up to __% may have at least some degree of mild stress incontinence | 2, 10
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| What should happen to PSA levels after radical prostatectomy | They should fall to undetectable levels
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| __ is an extremely sensitive and specific marker for monitoring men after radical prostatectomy | PSA
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| __ remains the primary form of treatment for patients with advanced or metastatic carcinoma of the prostate | Endocrine manipulation
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| What is the goal of endocrine manipulation with metastatic prostate cancer | To deprive the cancer cells of serum androgens
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| Testosterone declines to castrate values within __ after surgical orchiectomy and __ after administering an LHRH analog | A few days, a few weeks
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| Hormonal therapy to treat prostate cancer usually causes what AE’s with long term use | hot flushes, osteoporosis, wt gain, loss of muscle mass
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| The prognosis for patients with prostate cancer is poor when __ | The cancer shows evidence of progression despite hormonal therapy
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| __ can sometimes provide palliation for metastatic progressive prostate cancer, but has not been shown to increase survival | Chemotherapy
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| __ of the penis is an uncommon tumor in the united states and the rest of the developed world | Squamous cell carcinoma
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| Squamous cell carcinoma of the penis is diagnosed almost exclusively in __ men | Uncircumcised
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| __ are not routinely recommended for penile cancer b/c physical examination has been proven to be the most accurate predictor of tumor stage | Imaging studies
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| A diagnosis of carcinoma of the penis is confirmed by __ | Histological evaluation of an excisional biopsy
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| The prognosis for patients with distant metastatic disease or nodal metastasis above __ is poor | Inguinal ligament
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| With testicular cancer, as a result of effective surgery, radiation therapy and combination chemotherapy survival approaches __% for low risk disease and __% for high risk disease | 99, 80
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| The most common solid malignancy in men age 15-34 years | Testicular tumors
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| __ is a well accepted risk factor for subsequent development of testicular carcinoma | Cryptorchidism
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| What is the most common presenting sign or symptom of testis cancer | Firm painless mass arising from the testis
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| Up to __% of patients with testicular cancer are treated for presumed epididymitis | 33
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| __ is diagnostic for testicular cancer | Scrotal ultrasonography
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| Testicular cancer is unique in that __ play an important role in tumor staging | Serum tumor markers
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| Which nodes are the most common site of metastasis for testicular cancer | Retroperitoneal lymph nodes
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| Chest x-ray or thoracic CT scanning completes the clinical staging of what cancer, b/c the lungs and posterior mediastinum are the most common sites of distant metastatic disease | Testicular cancer
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| __ is the standard of treatment for patients with advanced testicular cancer | Platinum based chemo
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| What population groups are at highest risk for developing prostate cancer | Blacks, those with a family history of prostate cancer, high dietary fat intake
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| What is the standard method for detection of prostate cancer | Transrectal ultrasound guided biopsy
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| Detection rates for prostate cancer with DRE alone vary from __% | 1.5-7
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| Most prostate cancers detected with DRE are __ | Advanced (stage T3 or greater)
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| What is the serial measurement of PSA over time | PSA velocity
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| A rate of change in PSA greater than __ng/mL per year is associated with an increased likelihood of cancer detection | 0.75
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| The majority of prostate cancers are __ | Adenocarcinomas
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| Most primary testicular tumors are __ tumors | Germ cell (seminoma and nonseminoma)
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| The lifetime probability of developing testicular cancer is __% for an American white male | 0.2
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| With testicular cancer, acute pain resulting from intratesticular hemorrhage occurs in approximately __% of cases | 10
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| __ is never elevated with pure seminomas | Alpha fetoprotein
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| __ is occasionally elevated in seminomas | hCG
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| How can prostate cancer lymph node metastasis present itself | Lower extremity lymphedema
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| What is the clinical presentation of advanced prostate cancer | Bone pain/pathologic fractures, hematuria, hematospermia
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| Gleason grades for prostate cancer >__ are associated with aggressive tumors | 8
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| Gleason grades for prostate cancer of __ are most common | 5 or 6
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| What do you do for a patient with prostate cancer who already has a <10 year life expectancy regardless of the cancer (significant comorbidities) | Watchful waiting
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| What do you do for a patient with prostate cancer who has a >10 year life expectancy | Curative therapy (radical prostatectomy)
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| Post radical prostatectomy consider __ if PSA levels remain detectable | Metastasis
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| What kind of outcome can be expected when treating localized prostate cancer with external beam radiation | Outcomes comparable to radical prostatectomy
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| What are some complications of external beam radiation used to treat prostate cancer | Cystitis, radiation proctitis, impotence
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| What is the method of action for anti-androgen therapy | Blocks the cellular metabolism of androgen
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| When would cryotherapy be used to treat prostate cancer | For cancer cells resistant to radiation and hormonal therapy
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| What are some contraindications for prostate cancer cryotherapy | Prior TURP, extensive disease
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| __ is not recommended by the USPSTF | PSA screening
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| What is the key etiologic factor in developing penile cancer | Chronic inflammation and irritation
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| What are some possible risk factors for penile cancer | Lack of neonatal circumcision, HPV 16 & 18, tobacco use, poor hygiene
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| What are the common locations for penile cancers | Glans penis, coronal sulcus, foreskin
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| What is the most important diagnostic test in the evaluation of penile cancer | Lesion biopsy
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| What are some organ sparing procedures for the treatment of penile cancer | 5 fluorouracil (topical), external beam radiation, Moh’s microsurgery, laser ablation, circumcision
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| Of the two types of testicular cancers which one is the pure tumor, is most common and originates in the seminal vesicles | Seminoma
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| Which serum tumor marker is elevated in most testicular tumors | Beta hCG
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| Which serum tumor marker is elevated in non-seminomas, and excludes a diagnosis of seminoma | AFP
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| Which serum tumor marker is very non-specific, and is useful for monitoring advanced seminoma | LDH
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