Prostate Cancer Detection and Diagnosis

Flashcards covering the diagnosis, genetics, pathology, and treatment modalities for prostate cancer mentioned in the lecture notes.

Adenocarcinoma

The histological classification for the majority of prostate cancers.

Nocturia

A urinary symptom characterized by waking at night to urinate.

Hematuria

A clinical sign of advanced disease or benign prostatic hyperplasia characterized by blood in the urine.

Dysuria

A genitourinary complaint referring to painful urination.

Benign prostatic hyperplasia

A non malignant enlargement of the prostate that often presents with urinary signs similar to cancer.

Digital rectal exam (DRE)

A diagnostic component where a doctor assesses the size, symmetry, and consistency of the prostate tissue.

First-degree relative risk

Individuals with a sibling or father diagnosed with prostate cancer have a $2.5$ fold increased risk.

Androgen deprivation therapy

A treatment strategy that aims to shrink tumors by lowering hormones like testosterone or blocking their effects.

Androgen receptors

Receptors that bind hormones to form a DNA protein complex, triggering genes responsible for male characteristics and potentially cell survival in cancer.

TP53

A tumor suppressor gene known as the cells guardian that regulates the transition from the $G1$ to the $S$ phase.

Prostate specific antigen (PSA)

A protein measured in the blood used to assess cancer risk, though it can produce false positives and false negatives.

PSA Density

A metric determined by dividing the serum levels of PSA by the prostate volume obtained via MRI.

BRCA1 and BRCA2

Specific genetic mutations that, if confirmed in people aged $45$ to $61$, warrant PSA screening every $2$ years in the UK.

Multi parametric MRI (MP MRI)

A first line investigation that uses several imaging sequences to highlight suspicious lesions and guide targeted biopsies.

Transperineal biopsy

A biopsy method using ultrasound guidance that carries a lower risk of serious infection and sepsis compared to the transrectal method.

AMCR

An antibody marker expressed in prostate cancer used in immunohistochemistry to differentiate malignant from benign tissue.

IBEX

An artificial intelligence system implemented by the Betsy Caballetta Health Board to detect cancers in prostatic biopsies with $99.96\%$ accuracy.

Gleason grading system

A system that categorizes prostate tumors into $5$ grades based on glandular differentiation seen under a microscope.

Gleason score

The sum of the primary (predominant) grade and the secondary (next most common) grade assigned to a tumor.

Predict Prostate

An innovative Cambridge based prognostic tool used to estimate the potential impact of various treatment options on mortality risk.

Radical prostatectomy

The surgical removal of the prostate gland often performed using robotic assistance.

Brachytherapy

A targeted radiotherapy approach involving the direct placement of radioactive sources inside the prostate gland.

GnRH or LHRH agonists

Drugs used in hormonal therapy that signal the brain to switch off testosterone production, potentially causing a temporary testosterone flare.

Radioligand therapy

A targeted radiation treatment delivered through the bloodstream, such as Plutico, which binds to PSMA positive cells.

PSMA (Prostate specific membrane antigen)

A protein found on the surface of prostate cancer cells used as a target for radioligand therapy and PET scans.

Pembrolizumab

An immunotherapy drug that blocks the $PD-1$ pathway, showing benefit in a small subgroup of prostate cancers with microsatellite instability.

Provenge

The first approved personalized immunotherapy vaccine for metastatic castration resistant prostate cancer that trains immune cells to recognize prostatic acid phosphatase.

TMPRSS2-ERG

A common gene fusion discovered in $2005$ that drives abnormal gene activity to help prostate cancer cells grow.