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
Correct Answer :
C. most diagnosed cases have normal DRE and PSA values
most diagnosed cases have normal DRE but abnormal PSA readings.
Related Questions
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
BPH patients on finasteride longer than 6 months are expected to have:
decreased t-PSA but increased f-PSA
decreased t-PSA but unaltered f-PSA
decreased t-PSA and decreased f-PSA
any of the above
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 condition does NOT appear as a hypoechoic lesion in the prostate on TRUS?
prostate cancer
corpora amylacea
transitional zone
tuberculous prostatitis
Regarding treating prostate cancer patients, watchful waiting strategy involves:
periodic PSA testing
periodic TRUS
all of the above
none of the above
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
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 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
All of the following modalities are used as salvage therapies after failing radiation therapy for prostate cancer treatment, EXCEPT:
cryotherapy
chemotherapy
brachytherapy
radical prostatectomy
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
Solid lesions in the seminal vesicles are most likely to be a result of:
imperfect prostate biopsies
immature teratoma
schistosomiasis
liposarcoma
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
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
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
Regarding radical prostatectomy, the commonest site of positive surgical margins is the:
apex
posterior
postero-lateral
anterior
In which of the following situations prostate biopsy is most indicated?
normal DRE, abnormal PSA
abnormal DRE, abnormal PSA
abnormal DRE, normal PSA
hyperechoic areas on TRUS
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 the likelihood that patients with positive surgical margins after radical prostatectomy will be cured for prostate cancer?
never
unlikely
likely
always
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, 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
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
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
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
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 the first-line chemotherapeutic agent for metastatic castration-resistant prostate cancer?
bisphosphonate
docetaxel
sipuleucel-T
enzalutamide
During retropubic radical prostatectomy, what complication could be encountered on dividing the dorsal vein complex anteriorly?
incontinence
retrograde ejaculation
impotence
anejaculation
For prostate cancer patients, what do Partin tables predict?
survival rate
pathologic stage
extracapsular extension
lymph node involvement
Which of the following tests has the highest positive predictive value for prostate cancer?
PSA
digital rectal examination
transrectal ultrasonography
human kallikrein 2
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