PT 3: Oncology: Prostate Cancer (EXAM 10)

1. Goals of therapy for stage I, II & IIIa prostate cancer? A. Cure B. Increase survival, progression free survival & improve QOL 2. Goals of therapy for stage IV prostate cancer? A. Cure B. Increase survival, progression free survival & improve QOL

1. A 2. B

*KNOW* Match the following prostate cancer agents with their classes: 1. Leuprolide, Goserelin, Triptorelin 2. Degarelix 3. Flutamide, Bicalutamide, Nilutamide, Enzalutamide A. LHRH agonists B. LHRH antagonists C. Androgen receptor antagonists

1. A 2. B 3. C

Match the following ACS recommendations with their age: 1. Men who are at *average risk* of prostate cancer and are expected to live at least 10 more years. 2. Men at *high risk* of developing cancer (ex: African Americans & men with at least 1 first degree relative with prostate cancer diagnosis early <65) 3. Men at *even high risk* (more than 1 first degree relative with prostate cancer diagnosis early <65) A. 50 yrs B. 45 yrs C. 40 yrs

1. A 2. B 3. C

Match the following stages with their treatment options: 1. Initial diagnosis (early stage) 2. Advanced prostate cancer 3. Androgen Independent prostate cancer A. Curative therapy (surgery) B. Androgen ablation or Androgen deprivation therapy (ADT) C. Chemotherapy/supportive care

1. A 2. B 3. C

*EASYGENERATOR Q* Match the prostate cancer therapy with the most appropriate mechanism. 1. Goserelin 2. Degarelix 3. Bicalutamide A. LHRH antagonist B. Androgen Receptor antagonist C. LHRH agonist

1. C 2. A 3. B

*EASYGENERATOR Q* Which of the following age ranges is the most appropriate for prostate cancer screening? A. > 50 years old B. 30 - 65 C. 45 - 85 D. 55 - 74

A

*KNOW* "The American Cancer Society recommends that men make an informed decision with a doctor about whether to be tested for prostate cancer. Research has not yet proven that the potential benefits of testing outweigh the harms of testing and treatment. We believe that men should not be tested without learning about what we know and don't know about the risks and possible benefits of testing and treatment." A. True B. False

A

*KNOW* Once all hormonal manipulations have failed, the patient is considered to have androgen independent prostate cancer (AIPC). A. True B. False

A

*KNOW* The primary chemotherapy used in prostate cancer is? A. Docetaxel B. Goserelin C. Degarelix D. Bicalutamide

A

*KNOW* There is NO recommendation that men should be screened for prostate cancer UNLESS they are high risk. A. True B. False

A

*KNOW* What is the 1st line treatment for androgen independent prostate cancer (AIPC)? A. Docetaxel-based regimens B. Abiraterone-based regimens C. Finasteride-based regimens D. Leuprolide-based regimens E. Enzalutamide-based regimens

A

Diagnosis and pathologic grading (Gleason grade/score) of prostate cancer is via biopsy. A. True B. False

A

LHRH agonists are dosed IM Qmonthly-Q6months depending on formulation. A. True B. False

A

LHRH antagonist (Degarelix) should be used with caution with meds that can increase QT interval. A. True B. False

A

Men who want to be screened for prostate cancer should be tested with the prostate-specific antigen (PSA) blood test. A. True B. False

A

Orchiectomy is a surgical procedure performed in prostate cancer. A. True B. False

A

Prostate cancer is typically asymptomatic (localized disease). A. True B. False

A

Prostate tissue/tumor growth is primarily hormone ________. A. Dependent B. Independent

A

The MOST common form of cancer in men is? A. Prostate B. Lung C. Pancreas

A

Incidence of prostate cancer increases with age. A. True B. False

A *NOTE: statistically, all men who reach 100 will have prostate cancer*

*KNOW* Bisphosphonate therapy should be considered in patients with castration-recurrent metastatic prostate cancer (aka androgen independent PC) as it may prevent bone related events. A. True B. False

A *REMEMBER: Bisphosphonate therapy does not have a role in oncologic treatment*

Patients with a diet high in lycopene and carotene have a/an __________ risk of prostate cancer. A. Decreased B. Increased

A *low incidence of prostate cancer also in castrated men or men with cirrhosis*

AEs associated with LHRH agonists are REVERSIBLE with discontinuation. A. True B. False

A *monitor PSA, CT & bone scans every 6-12 months*

Triple androgen blockade therapy is NOT recommended. A. True B. False

A *this is the addition of a 5-a reductase inhibitor (finasteride or dutasteride)*

*EASYGENERATOR Q* Which of the following statements BEST describes the reason for the decline in incidence and mortality for prostate cancer in the 1980's and 1990's? A. Prostate cancer incidence and mortality has not decreased but in fact increased since the 1980's and 1990's B. Increased screening using PSA C. Decreased dietary risk due to the introduction of the Mediterranean diet D. Vastly improved treatments for prostate cancer

B

*EASYGENERATOR Q* Which of the following statements best describe the mortality rate of prostate cancer in the US? A. The most common cause of cancer related deaths in men in the US B. The 2nd most common cause of cancer related deaths in men in the US C. The 3rd most common cause of cancer related deaths in men in the US D. The 4th most common cause of cancer related deaths in men in the US

B

*EASYGENERATOR Q* Which of the following statements regarding prostate cancer is MOST correct? A. Prostate cancer is the second leading cause of death in the United States B. Prostate cancer represents the highest number of new cases of cancer in men in the United States C. Prostate cancer is the leading cause of cancer related death in the united states D. Prostate cancer is more prevalent in women than men in the United States

B

2nd leading cause of cancer death in men is? A. Prostate B. Lung C. Pancreas

B *Lung is 1st*

*EASYGENERATOR Q* Which of the following prostate cancer screening modalities would be BEST for a 59 yom with no other risk factors? A. FOBT B. LDCT C. PSA D. FIT

C

Prostate cancer that has invaded the bladder & rectum can be staged as? A. pT2 B. pT3 C. pT4

C

Screening modalities for prostate cancer include: A. PSA (Prostate Specific Antigen) B. DRE (Digital Rectal Exam) C. Both A & B

C

*KNOW* What is the PRIMARY therapy used in prostate cancer? A. Observation (watch & wait) B. Surgery or radiation C. Hormonal therapy D. Chemotherapy

C *commonly used agents: LHRH agonists, LHRH antagonists & antiandrogens*

*EASYGENERATOR Q* Concerning the at risk populations for prostate cancer, which order of risk (highest to lowest risk) below represents the BEST description of race related risk for prostate cancer in the US? A. Asian American > African American > Caucasian American B. African American > Asian American > Caucasian American C. Caucasian American > African American > Asian American D. African American > Caucasian American > Asian American

D

Possible (low) risk factors of prostate cancer include: A. Diet/obesity - high fat/low VitD B. Environmental C. Hormonal D. All the above

D

Strategies to reduce risk of prostate cancer include? A. Healthy diet (low fat, low calorie, weight reduction) B. Increased vegetables & fruits (with lycopene & carotene - tomatoes/tomato sauce) C. Decreased alcohol & smoking D. All the above

D

Androgen Source Ablation therapy involves the use of: A. Orchiectomy B. LHRH agonists C. LHRH antagonists D. All the above

D *NOTE: these therapies are used alone or in combination with antiandrogens*

AEs associated with antiandrogens include: A. Gynecomastia B. Hot flashes C. GI disturbances D. All the above

D *monitor PSA, CT & bone scans every 6-12 months*

*KNOW* Treatment failure with primary hormonal therapies constitutes use of secondary hormonal manipulations. These include: A. Antiandrogen withdrawal (cyclic) B. Switching antiandrogens C. Addition of 5a-reductase inhibitors (Finasteride or Dutasteride) D. Addition of androgen synthesis inhibitors (Abiraterone) E. All the above

E

*KNOW* Which of the following information is important to patients using bisphosphonates? A. Intake of a minimum of 500 mg Calcium daily B. Intake of a minimum 400 IU vitamin D daily C. Good oral hygiene (to prevent ONJ - brush/floss teeth) D. Reporting any urinary or kidney problems E. All the above

E

Probable (high) risk factors of prostate cancer include: A. Age B. Race C. Family history D. Genetics E. All the above

E

Risk factors for prostate cancer include? A. Age B. Race (African Americans > Caucasian > Asian Americans) C. Family history D. Hormonal E. All the above

E

Therapeutic options for prostate cancer include? A. Observation (watch & wait) B. Surgery or radiation C. Hormonal therapy D. Chemotherapy E. All the above

E

Combined Androgen Blockade (CAB):

LHRH agonist or Orchiectomy + Antiandrogen