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PROSTATE CANCER

QuestionAnswer
Prostate cancer Risk Factors Age, Gender, Ethnicity, Family History, AGENT ORANGE EXPOSURE, increases risk of death in AA males
Prostate anatomy Helps control urine flow Produces fluid component of semen Produces PSA and acid phosphate
Prostate Cancer Screening DRE (digital rectal exam) PSA Transrectal US (NOT DX) Biopsy (DIAGNOSTIC)
THINGS THAT INCREASE PSA BPH (prostate growing) Age Prostatits Ejaculation DRE
THINGS THAT DECREASE PSA Drugs: Finasteride, Dutasteride, Herbs?? Obesity
Prostate Cancer S/Sx decreased urinary stream Bladder/bowel incontinence urinary frequency (need to go often and cant) Hematuria (blood in urine) Bone pain Lower extremity numbness or weakness
PCPT TRIAL Finasteride 5mg vs placebo Finasteride decreases PC but showed no difference in overall survival Finasteride increased high grade PC compared to placebo making the cancer more aggressive (AD)
REDUCE TRIAL Dutasteride VS Placebo Dustasteride showed a 23% reduction compared to placebo
COMBAT Trial Dutasteride + Tamsulosin VS Tamsulosin 40% lower incidence of prostate cancer with dutasteride + tamsulosin alone
ASCO Recommendation for prostate cancer 5-AR inhibitors decrease but DO NOT eliminate risk for prostate cancer. MAIN IDEA: no difference in survival. ADEs for 5-AR inhibitors: gynecomastia, ED, decreased libido, nausea, abdominal pain, asthenia, dizziness, flatulence, headache, rash, muscle weakness, teratogenicity
SELECT Trial Selenium & Vitamin E Men only taking Vit E had a 17% increase risk in developing prostate cancer DO NOT GIVE VITAMIN E ALONE TO AT RISK PATIENTS
Diagnosing Prostate Cancer DRE, PSA, Transrectal US, US guided biopsy NORMAL PSA = 0-3 ng/mL 3ng/mL - needs further eval >10 ng/mL - highly sus!!
GLEASON SCORE grading system for evaluating architectural details of cancer cells 2-4 = BEST prognosis = 12% risk of spread 5-6 = Intermediate = 33% risk 7-10 = Worst = 61% risk the higher the score the higher the risk of spread and the worse the cancer is
Recurrence Risk & Treatment (LN
Created by: texantaco
 

 



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