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
Correct Answer :
D. it has a role in guiding the appropriate treatment options
self-explanatory.
Related Questions
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%
Regarding radical prostatectomy, the commonest site of positive surgical margins is the:
apex
posterior
postero-lateral
anterior
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 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
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
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
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
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
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
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 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
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
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 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 is the primary mechanism of prostate tissue ablation using high-intensity focused ultrasound?
disruption of protein synthesis
coagulative necrosis
cell wall destruction
DNA damage
Which of the following tests has the highest positive predictive value for prostate cancer?
PSA
digital rectal examination
transrectal ultrasonography
human kallikrein 2
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 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
Solid lesions in the seminal vesicles are most likely to be a result of:
imperfect prostate biopsies
immature teratoma
schistosomiasis
liposarcoma
All of the following modalities are used as salvage therapies after failing radiation therapy for prostate cancer treatment, EXCEPT:
cryotherapy
chemotherapy
brachytherapy
radical prostatectomy
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 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
Ectopic expression of PSA occurs in all of the following, EXCEPT:
thyroid gland
breast tissue
adrenal glands
renal carcinomas
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
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
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
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 the commonest complication of high-intensity focused ultrasound on treating localized prostate cancer?
temporary incontinence
vasculogenic impotence
urinary retention
hyper-reflexive detrusor