Prostate Cancer Quiz

Tumor flair is caused by the initial increase in gonaotropins due to the LH-RH agonist. With the increase in gonadotropins, there is a negative feedback effect and with chronic administration we see sustained suppression of pituitary gonadotropins. The initial increase in gonadotropins leads to increased androgens such as testosterone which is what causes the tumor flair. With antiandrogens on board, the androgen increase has no affect on the tumor.

There are actually many types of radiation for prostate cancer. She said we didn't have to memorize them all, just know that there are many types.

For active surveillance, progression will start curative treatment. For observation, progression will start palliative treatment. Patient must understand that tumor will progress during active surveillance or observation.

BPH does not increase the risk, although it may delay diagnosis. Smoking does not increase the risk but it does increase mortality once diagnosed.

A bilateral orchiectomy is removal of the testes to create an immediate drop in testosterone within 12 hours. The other options listed above are options to treat metastatic disease but in this emergency situation, the patient's best option was surgery.

A rising PSA is an indicator for recurrent cancer.

There is actually a lot of controversy between the guidelines.

Radiation is an option for every risk except for very low.

Enzalutamide is a strong CYP3A4 inducer and a moderate CYP2C9 and CYP2C19 inducer. Avoid co-administration with CYP2C8 inhibitors. If you can't avoid, then decrease the dose to 80mg.

False, it is the other way around. Cabazitaxel is used for metastatic prostate cancer previously treated with a docetaxel-containing regimen.

Used with radiation therapy for 2-3 years in high risk of very high risk patients and for 4-6 months in intermediate risk patients.

Degarelix and abaralix are LHRH antagonists.

The two drugs are both bisphosphonates, a drug class used for bone metastases.

Continuous ADT shows the slight survival benefit. If there are no symptoms from the ADT then it should be continued. If there are symptoms but the patient is low or intermediate risk, then intermediate use should be considered for QoL.

Very low: observation only if life expectancy is less than 20 yrs. Observation, prostatectomy, or radiation if life expectancy is 20+ yrs.
Low: observation only if life expectancy is Intermediate: Observation, prostatectomy, or radiation +/- ADT (4-6 months) if life expectancy is

Androgen receptor blocker examples are bicalutamide and flutamide.

Biopsies are actually disadvantages. Patient will undergo periodic biopsies and multiple biopsies can make prostatectomy challenging. Other disadvantages: increased anxiety, 1/3 men will require treatment, and missed opportunity for cure.