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Duke PA Male Cancer

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