reduces positive surgical margins
reduces local recurrence
has no proven advantage
reduces cardiac complications
A. reduces positive surgical margins
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
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
patients who have a life expectancy ≤ 10 yrs. and/or well to moderately differentiated cancer
≥ 70 yrs. of age
PSA < 10 ng/mL, ratio < 0.22
patients with good performance status
urethral stricture, impotence, and rectal bleeding
impotence, rectal bleeding, and urethral stricture
impotence, urethral stricture, and rectal bleeding
rectal bleeding, impotence, and urethral stricture
pathological bone fractures
biochemical failure following radiation therapy
hepato-renal disease following chemotherapy
upgrading the pre-treatment risk stratification
54 Gy
64 Gy
74 Gy
84 Gy
survival rate
pathologic stage
extracapsular extension
lymph node involvement
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
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
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
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
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
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
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
disruption of protein synthesis
coagulative necrosis
cell wall destruction
DNA damage
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
seminal vesicle invasion and lymph node metastases
positive surgical margins and seminal vesicle involvement
capsular penetration and lymph node metastases
rectal and bladder neck involvement
is almost always due to direct extension (T2c)
it is involved in 85% of positive surgical margins following radical prostatectomy
it carries a poor prognosis
none of the above
4, 2 respectively
8, 5 respectively
6, 3 respectively
7, 4 respectively
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
reduces positive surgical margins
reduces local recurrence
has no proven advantage
reduces cardiac complications
low risk
intermediate risk
high risk
data not adequate
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
apex
posterior
postero-lateral
anterior
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
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%
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
incontinence
retrograde ejaculation
impotence
anejaculation
elevated LH, elevated testosterone, elevated estrogen
elevated LH, elevated testosterone, declined estrogen
declined LH, declined testosterone, elevated estrogen
declined LH, elevated testosterone, declined estrogen
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