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
Correct Answer :
C. t-PSA is 2.8 ng/mL, f-PSA 0.94 ng/mL
PSA ratio, in this case, is 33% which is on the benign side.
Related Questions
What is true regarding prostatic tissue levels of hK2?
intensely expressed in benign prostatic epithelium
increased in poorly differentiated prostate cancer tissue
helps differentiate benign from malignant causes of high t-PSA
is an organ but not pathology specific marker
What are the possible complications of CO2 pneumoperitoneum during laparoscopic/robotic prostatectomy?
hypoxia and acidosis
tachycardia and tachypnea
bradycardia and hypotension
hypercarbia and oliguria
What is false regarding the histology of prostatic cancers?
benign glands are different from malignant glands, as they contain basal cells
adenosis in the transitional zone carries 15% increase in cancer risk
the prostate has no discrete histologic capsule
intraductal carcinoma is morphologically worse than high-grade PIN and is typically associated with high-grade carcinoma
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
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
Regarding chemotherapy for prostate cancers, nonsteroidal antiandrogens will result in:
elevated LH, elevated testosterone, elevated estrogen
elevated LH, elevated testosterone, declined estrogen
declined LH, declined testosterone, elevated estrogen
declined LH, elevated testosterone, declined estrogen
Regarding radiotherapy for prostate cancer, what is the lowest recommended dose for salvage therapy?
54 Gy
64 Gy
74 Gy
84 Gy
Which factor is closely related to the return to urinary continence function after radical retropubic prostatectomy?
pathologic tumor stage
performing nerve-sparing surgery
patient`s age
performing internal sphincter micro-dissection
What is false regarding prostate adenocarcinoma in the peripheral zone?
85% of prostate adenocarcinomas are located in the peripheral zone
15% of them are multifocal
they tend to extend outside the prostate through the perineural space
the presence of perineural invasion does not worsen the prognosis
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
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
Regarding treating prostate cancer patients, watchful waiting strategy involves:
periodic PSA testing
periodic TRUS
all of the above
none of the above
What is the primary mechanism of prostate tissue ablation using high-intensity focused ultrasound?
disruption of protein synthesis
coagulative necrosis
cell wall destruction
DNA damage
Screening for prostate cancer is recommended for men who are:
at average risk, aging 50 yrs., and have at least a 10-year life expectancy
aging 40 yrs., and had a first-degree relative diagnosed with prostate cancer before age 65
aging 40 yrs., African Americans
all of the above
What is against using TRUS-guided therapy for focal prostate cancer?
it overdiagnoses clinically insignificant cancers
it misses clinically significant cancers in the anterior or apical regions
it may underrepresent true cancer burden
all of the above
What is false concerning the interpretation of Gleason scoring system?
a low score means the cancer tissue is similar to normal prostate tissue
it indicates how likely the tumor will spread
the more cellular atypia observed the higher scoring will be
it relies only on the glandular architectural pattern
What is the proper pre-treatment risk stratification of prostate cancer for a patient with T2a, PSA < 11 ng/mL, and no Gleason score > 6?
low risk
intermediate risk
high risk
data not adequate
What if false concerning the prostate cancer marker PCA3?
entails a genetic analysis of cells in the voided urine
urine sample is collected after a firm massage of the prostate
helps screen patients who are at intermediate risk of cancer
helps avoid the inconvenience of prostate biopsy
Solid lesions in the seminal vesicles are most likely to be a result of:
imperfect prostate biopsies
immature teratoma
schistosomiasis
liposarcoma
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
During retropubic radical prostatectomy, what complication could be encountered on dividing the dorsal vein complex anteriorly?
incontinence
retrograde ejaculation
impotence
anejaculation
What is false concerning TRUS prostatic biopsy?
a 12-core biopsy is the standard
in preparation for the procedure, a self-administered enema is suggested
sepsis might complicate the procedure
the biopsy path is best visualized in the coronal plane
What is the first-line chemotherapeutic agent for metastatic castration-resistant prostate cancer?
bisphosphonate
docetaxel
sipuleucel-T
enzalutamide
Clinically significant prostate cancer is defined as:
volume ≥ 0.5 mL and/or a Gleason score of ≥ 3 + 4
volume ≥ 0.8 mL and/or a Gleason score of ≥ 4 + 4
volume ≥ 1.5 mL and/or a Gleason score of ≥ 4 + 3
volume ≥ 1.0 mL and/or a Gleason score of ≥ 3 + 3
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 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
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
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
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
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