______ men have higher incidences and a worse prognosis of prostate cancer
African American
IS, Swedan and European men have a ___ risk of prostate cancer
increased
Japan, Tiawan & Jewish men have a ____ risk of prostate cancer
decreased
Prostate cancer is a ___ growing malignancy
slow
NOTE CARD:
The younger at diagnosis, the worse the prognosis.
Younger men have hormones that fuels the cancer allows it to rage out of control.
What does BPH stand for?
Benign Prostatic Hyperplasia
Prostate cancer is oftern found concurrently with _____. Cause or effect of this has yet to be determined.
BPH
True or Flase
Prognostic factor of Prostate Cancer:
Larger & less differentiated tumors are the most aggressive and have a greater incidence of lymphatic & metastatic disease.
True
Is age a prognostic factor for prostate cancer?
no
African American men present with a ___ stage but if there is no difference when presented with _____ pretreatment prognostic factors.
higher
no
same
The higher the nadir ______ treatment, the higher the risk of _____.
** less than 1 is desirable
however, an 80 year old be ok with a 3 or 4
after
failure
What does nadir mean?
at its lowest point
Is prostate cancer a tumor or a diffused disease?
diffused disease
How many biopsy's are obtain with most prostate cases?
7-10 cores
Cancer is ____ and develops in the peripheral of the prostate.
Benign disease is central.
multifocal
____ invasion is present in almost all prostate cancer cases.
perineural
**meaning nerves are affected
What nodes does prostate cancer involve first?
then follows the _____, hypogastric, _____, and paraaortics.
Periprostatic
external iliacs
internal iliacs
Where are the periprostatic nodes located?
outside the prostate capsule
Where are the external iliac nodes located?
brim of pelvis
Where are the para-aortic nodes located?
side of the vertebral body
Once prostate cancer is in the blood stream where does it usually go?
Bone (hip & femor)
Liver
Brain
What are some of the clinical presentation signs of Prostate Cancer?
Dysuria (most common)
Decreased urinary stream
Frequency
Difficulty starting
Hematuria
What is a normal PSA?
4ng/ml or less
What is the most common pathology for Prostate Cancer?
Adenocarcinoma
THe higher the Gleason score the more ____ the tumor
aggressive
Gleason score is only associated with ____ cancer
Prostate
What is a normal treatment for patients over the age of 75 with prostate cancer?
Observation
THe following is the criteria for what prostate cancer treatment:
T1 ot T2
Life expectancy of atleast 10 years
Has not invaded seminal vesicles
prostatectomy
What are side effects of a Prostatectomy?
nerve damage
unable to get an erection
This willl stop in tissue, charge particle
Proton
This willl go straight through tissue, no charge
Photon
Prostate Cancer doses for
Nodal:______
Seminal vesicle _______
Prostate ________
Nodal: 45-50
Seminal vesicle: 54-56
Prostate: 72-80
A full bladder helps ______ and displaces smal bowel on lateral fields.
decrease bladder dose
What are the side effects of surgery? (Prostate Cancer)
Incontience & sexual impotence
Penis cancer is kind of like ____ cancer
skin
Penis & mae urethra incidence is ___ in Asia, Africa, and South America
higher
_____ cancer is related to neonatal circumcision
Penile
____ cancer is linked to chronic irritation, and infetions, HPV, veneral disease, and strictures
Urethral
Penis & Male urethra cancer age of presentation is ______.
58-60
Clinical Presentation of Penile Cancer is
Phimosis
Secondary infections & foul smells
Inguinal Lymph nodes
Mass
Ulceration, bleeding, discharge
What are some side effects of RT? (Prostate Cancer)
diarrhea
abdominal cramping
rectal discomfort
rectal bleeding
proctitis
frequency or urgency in urination
sexual impotence
hemmoroids
What are some clinical presentations of urethral cancer?
Obstructon
tenderness
dysuria
urethral discharge
hematuria
True/Flase
In urethral cancer distal lesions have enlarged inguinal lymph nodes
True
If it is closer to the prostate 1st will be iliac
NOTE CARD
Detection & Diagnosis of urethral & Penile Ca.
**Penile lesions can be seen on exam
** Urethral lesions are evaluated by urethroscopy & cystoscopy
**Ct can help evaluate lymph nodes
What is the Pathology of Penile lesions?
Well Differentiated squamous cell
What is the pathology of urethral lesions?
Well to moderately differentiated squamous cell
What is the pathology of Prostatic Urethral lesions?
Transitional cell
What is the pathology of Bulbomembranous urethral lesions?
Adenocarcinomas
What is the most common site nodal spread of penile lesions
Inguinal nodes
Where is the blood spread of Penile Lesions?
Lung, Liver, Bone, Brain
Urethral Lesions:
Distal Lesions drain to the _____ nodes and proximal lesions drain to the ___ ____, obturator and ____ ____.
Inguinal
external iliacs
internal iliacs
Surgury, 5-FU cream, Radiation Therapy,
65-70 Gy include inguinal nodes, Brachytherapy molds 60-65 Gy in 5-7 days is treatment for what?
Penile Lesions
Transurethral resection & distal lesions are treated like penile lesions is treatment techniques for what?
urethral lesions
What are some of the side effects of Penile & Urethral treatments?
Erythema
Dry & Moist desquuamation
swelling of the shaft
Telangiectasis
fibrosis
strictures
ulcerations
necrosis
lymphedema
Testicular cancers are ____ but the most common malignancy in men between the ages of ___ & ___.
rare
20-34
Testicular cancer incidence is higher in males with _____ _____
undecended testes
Define BPH
benign prostate hyperplasia
Benign enlargement of the prostate
Define TURP
Transurethral Resection of the Prostate
Trims away excess prostate tissue that blocks urine flow
Define PSA
Prostatic Specific Antigen
Enzyme secreted by the prostate gland, increased levels are found in men with cancer of the prostate
list the interstital isoptopes used for prostate cancer
