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
Correct Answer :
B. coagulative necrosis
HIFU results in mechanical and thermal effects on tissues leading to coagulative necrosis.
Related Questions
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 pathologic findings after radical prostatectomy are predictive for occult metastases?
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
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
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
What fraction of men with a PSA value between 4 and 10 ng/mL has an organ-confined prostate cancer?
¼
½
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
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
During retropubic radical prostatectomy, what complication could be encountered on dividing the dorsal vein complex anteriorly?
incontinence
retrograde ejaculation
impotence
anejaculation
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
Regarding radical prostatectomy, the commonest site of positive surgical margins is the:
apex
posterior
postero-lateral
anterior
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
All of the following modalities are used as salvage therapies after failing radiation therapy for prostate cancer treatment, EXCEPT:
cryotherapy
chemotherapy
brachytherapy
radical prostatectomy
Concerning prostate cancers, a pre-treatment PSA velocity of > 2 ng/mL/yr is associated with an increased risk of:
pathological bone fractures
biochemical failure following radiation therapy
hepato-renal disease following chemotherapy
upgrading the pre-treatment risk stratification
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 primary mechanism of prostate tissue ablation using high-intensity focused ultrasound?
disruption of protein synthesis
coagulative necrosis
cell wall destruction
DNA damage
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 treating prostate cancer patients, watchful waiting is a reasonable option for:
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
For prostate cancer patients, what do Partin tables predict?
survival rate
pathologic stage
extracapsular extension
lymph node involvement
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
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
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
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
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 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
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
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 are the possible complications of CO2 pneumoperitoneum during laparoscopic/robotic prostatectomy?
hypoxia and acidosis
tachycardia and tachypnea
bradycardia and hypotension
hypercarbia and oliguria
Solid lesions in the seminal vesicles are most likely to be a result of:
imperfect prostate biopsies
immature teratoma
schistosomiasis
liposarcoma
What condition does NOT appear as a hypoechoic lesion in the prostate on TRUS?
prostate cancer
corpora amylacea
transitional zone
tuberculous prostatitis