Male associated malignancies_ Patient care

What is prostate cancer known as?

The "Watch and wait disease"

What are the risk factors for prostate cancer?

-Age (65% over age of 65)

-Race(Common in black males)

-Geography (common in North America)

-family history

What are some risk factors that are less clear for prostate cancer?

-Diet

-Obesity

-Smoking

-Chemical exposure

-Vasectomy

What is a Digital Rectal Exam (DRE) used for?

Feels for nodules as many prostates begin in the back part of the gland. (Performed annually if over 50)

Men without a prostate have a PSA level under...

4

When prostate can develops what does the PSA level rise above?

4 ng/mL

If PSA is more than______, The chance of having prostate cancer is over 50%

10

What are some clinical presentations for Prostate cancer?

-Decreased urinary stream

-Urinary frequency

-Difficulty starting urinary stream

-Hematuria

What are later clinical presentation for prostate cancer?

-Bone pain

-Lower numbness

-Bladder incontinence

What does a Gleason score of 1 mean?

Looks a lot like normal tissue

What does a Gleason score of 5 mean?

Tissue looks very abnormal

What are some Prognostic factors for prostate cancer?

-Gleason score

-DNA analysis by flow cytometry

-PSA level

What are ways to detect prostate cancer?

-Pelvic/ Abdominal CT

-Chest X-ray

-Bone scan

-Liver function test

-Serum PSA

What type of technique can be considered in lower grades of prostate cancer?

Observations

What are more intensive treatment techniques for prostate cancer?

-EBRT

-Brachytherapy

-Hormonal Therapy

What is the goal for EBRT in Prostate Patients?

Maximize damage to tumor, while minimizing damage to surrounding tissue.

With EBRT what symptoms occur during treatment, but subside after completion?

-Diarrhea

-Cramping

-Fatigue

-Painful uriation

-Hematuria

What is interstitial application of Brachytherapy consist of?

Placement of radioactive source directly into a tumor. (Rigid needles or Flexible tubes) (Neck, Breat, Prostate)

What is Intraluminal application of Brachytherapy consist of?

Placement of sources of radiation within body tubes. (catheters)(Esophagus, Trachea, Bronchus)

What is Intravascular application of Brachytherapy consist of?

Limited in practice and reserved for selected recurrent cases.

What is Surface application of Brachytherapy consist of?

Placement of radioactive sources on top of the area to be treated. (Non-melanoma skin cancer, oral cavity, nasal cavity)

What does LDR consist of for prostate brachytherapy?

Radioactive seeds are implanted into the prostate via ultrasound- guided needles

What does HDR consist of for prostate brachytherapy?

Tubes are inserted into prostate and left in place for a few minutes to deliver the radiotherapy through wires fed into the tubes.

What are side effect/ complications of brachytherapy?

-High initial dose of radiation that slowly fades over a year.

-Prostate inflamation

-Urinary/ Bowel frequency

-Erectile dysfunction

What is quadramet (Samarium 153)?

-Bone seeking isotope

-Systemic does to "Hot" areas

-Look lie PET scan (i thought this)

How would you manage bone mets with prostate cancer?

Methods: bisphosphonates, radiation of detected metastatic lesions, surgery.

What ages are most common for testicular cancer?

15-35

What are the clinical presentations for testicular cancer?

-painless swelling or nodular mass

-Dull ache

-Heaviness or pulling sensation on scrotum

What is the most common testicular cancer?

Seminoma

What are the side effects for testicular cancer?

-Nausea

-Diarrhea

-Decreased sperm count

What is penile cancer rare in?

Circumsied men

What age group does penile cancer affect?

Ages 58-60

What are the lymphatics of the prepuce

Superficial inguinal nodes

What are the lymphatics of the Gland & Deep penile; Fossa Navicularis & penile urethra

Superficial or deep inguinal lymph nodes

What are the lymphatics for the bulbo-membranous & Prostatic urethra

-External iliac

-Obturator & Internal Iliac

- Pre-sacral lymph nodes

What is Phimosis?

inability to retract foreskin

What are the clinical presentation of penile cancer?

- Palpable inguinal lymph nodes

-Urethral carcinoma

What are some treatments for penile cancer?

-Partial or total penectomy

-Transurethral resection for urethra

-Chemo

-Radiation

What are the side effects of radiation for penile cancer?

-Brisk Erythema

-Dry or moist Desquamation

-Sweeling

- Telangiectasia