Prostate MCQs

Lung cancer is one of the most common cancers throughout the world. In the UK, there are approximately 45 000 new cases a year. From the time of diagnosis, 60% of patients are dead within 1 year and only 15% survive 5 years, making lung cancer the most common cause of cancer death. Survival is dependent on the stage that the patient presents with lung cancer. Reference: Bailey & Love's short practice of surgery 28th Edition, Chapter 59, Cardiac Surgery, Pg: 984.

Vesico-ureteral reflux (VUR) does not cause bladder outlet obstruction (BOO). VUR is the retrograde flow of urine from the bladder to the ureter. Urodynamically proven BOO may result from- BPH - Benign prostatic hyperplasia Bladder neck stenosis Bladder neck hypertrophy Prostate cancer Urethral strictures Functional obstruction due to neuropathic conditions Urodynamically proven BOO may result from: BPH; bladder neck stenosis; bladder neck dyssynergia or functional bladder neck obstruction; bladder neck hypertrophy; prostate cancer; urethral stricture; functional obstruction due to neuropathic conditions. Reference : Bailey & Love's short practice of surgery 28 th Edition, Chapter 84, The prostate and seminal vesicles, Pg: 1524.

brachytherapy for prostate cancer is passed via trans- perineal needles Radio-isotopes commonly used are- iodine-125 and palladium-103 Theses isotopes deliver an intense, confined radiation dose. Iodine-125 ( 125 I) is a radioisotope of iodine which has uses in biological assays, nuclear medicine imaging and in radiation therapy as brachytherapy to treat a number of conditions, including prostate cancer, uveal melanomas, and brain tumors. It is the second longest-lived radioisotope of iodine, after iodine-129. Permanent seed implants are used as monotherapy in cases of prostate tumors with a high probability of being limited to the prostate, without any need to combine it with external radiotherapy or hormone therapy https://pubmed.ncbi.nlm.nih.gov/11103823/

Once the diagnosis has been established, if metastatic spread is suspected (on the basis of a high PSA [>10 ng/mL], locally advanced disease or presence of Gleason 7 or higher) a bone scan should be carried out. This is because prostate cancer is predominantly osteoblastic lesions which shows increased uptake in bone scans.

Radical prostatectomy is suitable for- Localised disease Carried out only in men with a life expectancy of >10 years . Exclusion of metastases would require a negative bone scan and MRI of the pelvis. Procedure - Removal of the prostate down to the distal urethral sphincter , in addition to the seminal vesicles . The bladder neck is reconstituted and anastomosed to the urethra. It results in a high incidence of impotence , but a low incidence of severe stress incontinence ( Reference : Bailey & Love's short practice of surgery 28 th Edition, Chapter 84, The prostate and seminal vesicles, Pg: 1536.