Fill the blanks: on treating prostate cancer patients, the median time from PSA failure to the development of metastatic disease after radical prostatectomy is approximately (…) yrs. and from the time of metastases to death is approximately (…) yrs..
4, 2 respectively
8, 5 respectively
6, 3 respectively
7, 4 respectively
Correct Answer :
B. 8, 5 respectively
thus there is a total of 13 years beginning from the onset of detectable PSA to death due to prostate cancer.
Related Questions
What is the likelihood that patients with positive surgical margins after radical prostatectomy will be cured for prostate cancer?
never
unlikely
likely
always
Prostate-specific membrane antigen has been detected in:
the prostate gland only
the central nervous system, intestine, and the prostate
malignant ovarian cysts, skeletal muscles, and the prostate
thyroid glands, adrenals, and the prostate
Which factor(s) determine(s) the return to normal erectile function after radical retropubic prostatectomy?
the age of the patient
preoperative potency status
extent of nerve-sparing surgery
all of the above
Which PSA value interpretation is incorrect?
> 50% of men with PSA > 10 ng/mL have the disease beyond the prostate
pelvic lymph node involvement is found in PSA > 20 ng/mL
70% of men with a PSA between 4 and 10 ng/mL have organ-confined disease
80% of men with PSA < 4 ng/mL have organ-confined disease
Ectopic expression of PSA occurs in all of the following, EXCEPT:
thyroid gland
breast tissue
adrenal glands
renal carcinomas
In which of the following PSA readings prostate cancer is least suspected?
PSA velocity of 0.35 ng/mL/y, when the PSA is ≤ 2.5 ng/mL
PSA velocity of 0.75 ng/mL/y, when the PSA is 4 10 ng/mL
t-PSA is 2.8 ng/mL, f-PSA 0.94 ng/mL
t-PSA is 3.7 ng/mL, f-PSA 0.51 ng/mL
What is false regarding the diagnosis of prostate cancer?
most cases are identified by screening asymptomatic men
physical examination alone cannot reliably differentiate benign prostatic conditions from cancer
most diagnosed cases have normal DRE and PSA values
prostate biopsy establishes the diagnosis
Solid lesions in the seminal vesicles are most likely to be a result of:
imperfect prostate biopsies
immature teratoma
schistosomiasis
liposarcoma
What is the major advantage of neoadjuvant androgen deprivation before radical prostatectomy on treating clinical stages (cT1-T2) prostate cancers?
reduces positive surgical margins
reduces local recurrence
has no proven advantage
reduces cardiac complications
Genetically, increased risk of prostate cancer has been found in men with:
variants in the 8q24 region on chromosome 8, in sporadic cases
alterations on chromosome 1, chromosome 17, and the X chromosome, in some familial cases
the human prostate cancer gene is on the X chromosome
all are true
What is false concerning thawing procedure to treat prostate cancer cells?
slow thawing is more effective than rapid thawing
the most common complication is erectile dysfunction
for effective thawing a minimum temperature of − 25° C and a double freeze/thaw cycle with urethral warming are recommended
the two most common modalities employed in focal therapy are highintensity focused ultrasound and cryosurgery
What is true surrounding PSA?
black individuals produce more PSA than whites
ejaculation can lead to a false decrease in PSA
pro-PSA is the serum proactive form of PSA molecule
prostate cancer cells make more PSA than normal prostate tissues do
Genetically, what are the changes associated with poor survival in prostate cancer patients?
loss of one or both copies of the tumor suppressor gene PTEN
TMPRSS2ERG chromosome fusion
P53 mutations and overexpression of MYC
all of the above
What is false concerning antiandrogen class of prostate cancer medications?
commonly used in combination with a GnRH agonist
less effective than medical or surgical castration
not recommended for localized prostate cancer
inhibits various cytochrome P-450 enzymes
Partin tables are probability tables for the determination of pathologic stages of prostatic cancers based on:
preoperative clinical stage, PSA level, and Gleason sum
seminal vesicle invasion, lymph node metastases, and Gleason sum
positive surgical margins, capsular penetration, and PSA level
PSA level, perineural invasion, vascular metastasis, and Gleason sum
What is false concerning prostate cancer?
the most common cause of mortality in men with prostate cancer is cardiac disease
is the second most common cause of cancer death in males
androgens have a pivotal role in prostate cancer development
low protein and high carbohydrate diet play a role in the development of prostate cancer
Regarding treating prostate cancer patients, watchful waiting strategy involves:
periodic PSA testing
periodic TRUS
all of the above
none of the above
What is true concerning TRUS prostatic biopsy?
hematospermia might persist for 4 6 weeks after taking biopsies
quinolone antibiotics prophylaxis eliminate possible infections
the right lateral decubitus position is commonly preferred
only hypoechoic lesions should be biopsied
In descending order, to where do prostate cancers metastasize?
lymph nodes, bone, lung, bladder, liver, and adrenal glands
bone, lung, lymph nodes, liver, bladder, and adrenal glands
lung, liver, lymph nodes, bone, adrenal glands, and bladder
liver, lung, bone, lymph nodes, bladder, and adrenal glands
Which of the following tests has the highest positive predictive value for prostate cancer?
PSA
digital rectal examination
transrectal ultrasonography
human kallikrein 2
What are the clinical parameters of tissue ablation achieved by cryotherapy for cancer cells destruction?
the number of freezing cycles
the lowest temperature achieved
the existence of regional heat sinks
all of the above
What is true about the usefulness of Gleason scoring system?
used to stage prostate cancer
a specimen of grade 3 + 4 is worse than 4 + 3
a sum of 6 suggests an intermediate risk for aggressive cancer
it has a role in guiding the appropriate treatment options
What is the likelihood that prostate cells die in a single freeze cycle of cryotherapy when tissue temperature reaches colder than - 400 C?
never
unlikely
likely
always
Following bilateral orchiectomy for prostate cancer, testosterone will:
initially drop to nadir, and then recover over 2 weeks
decline by 50% within 2 weeks and then normalize
decline by 90% within 24 hours
decline by 70%
What is false concerning Gleason scoring system for prostate cancers?
ranges from 0 -10 based on a histologic evaluation of tumor specimens
based on the 2 most common histologic patterns
greatly relies on the skills and experience of the pathologist
a score of 7 indicates a moderate-grade or moderately differentiated tumor
In descending order, the commonest complications of external beam radiation therapy for prostate cancer are:
urethral stricture, impotence, and rectal bleeding
impotence, rectal bleeding, and urethral stricture
impotence, urethral stricture, and rectal bleeding
rectal bleeding, impotence, and urethral stricture
Regarding radiotherapy for prostate cancer, what is the lowest recommended dose for salvage therapy?
54 Gy
64 Gy
74 Gy
84 Gy
What fraction of men with a PSA value between 4 and 10 ng/mL has an organ-confined prostate cancer?
¼
½
What class of prostate cancer medications causes an initial increase in LH, FSH levels and consequently a rise in testosterone level for few weeks?
GnRH agonists
antiandrogens
antimicrotubular
bisphosphonates
In which of the following cases PSA testing is NOT indicated:
72 yrs. man newly diagnosed BPH with normal DRE
2 weeks post TURP for obstructing cancerous prostate
screening for prostate cancer in 75 yrs. old Caucasian man
43 yrs. man with obstructive LUTS, who had a first-degree relative diagnosed with prostate cancer before age 65