1What do most prostate cancer treatments do?
Supress testosterone
2What percent of testosterone do the testes and adrenal glands make?
95% and 5% respectively
3What other source of testosterone might there be in prostate cancer patients?
Prostate cancer cells can sometimes start producing testosterone
4What is PSA?
Prostate specific antigen, an antigen produced by prostate cells that can be a useful marker for the prescence of prostate cancer or progession of disease
5What PSA is found in healthy people?
<4ng/mL, a level of 4-10 suggests they may have prostate cancer
6What is the ideal PSA for someone with prostate cancer that is being treated
Undetectable
7Prostate cancer risk factors
65+ years old
black men
genetic- family history and germline mutations
8When to generally start talking about prostate cancer screening?
50 years old, 40 if high risk
PSA test every 1-4 years
9What to do if a patient is on ADT and their PSA continues to rise?
If the doubling time is >10 months, observe, if it is <10 months, start a second generation antiandrogen
10What is the gold standard for castration niave metastatic prostate cancer?
ADT + chemotherapy with docetaxel + anti-hormonal therapy with abiraterone acetate or darolutamide
11What to do for castration resistance metastatic prostate cancer?
Continue ADT
evaluate tumor for mutations
add additional therapy depending on tumor type, makup, and metastatic site
palliative radiation therapy
supportive care
12What are the LHRH agonists?
Leuprolide
Goserelin
Triptorelin
13What are the LHRH antagonists?
Degarelix
Relugolix
14What drug is given when starting an LHRH agonist to avoid complications with initial GNRH stimulation?
Biclutamide, a first generation anti-androgen
15What are the second generation antiandrogens?
Darolutamide
Apalutamide
Enzalutamide
16What are abiraterone acetate's brand names and what to know about them?
Zytiga, given on an empty stomach with prednisone
Yonsa (micronized form), given with no food restrictions and methylprednisolone
17What to avoid giving with radium 223?
Abiraterone
18Osteoperosis high risk prostate cancer treatments?
Denosumab (Prolia) 60mg SQ q 6 months
Zolendronic acid (Reclast) 5mg IV yearly
Alendronate (Fosamax) 70mg PO weekly
19Drugs to give for castrate resistance bone metastatic prostace cancer?
Zolendronic acid (Zometa) 4mg IV over 15 minutes every 3-4 weeks
Denosumab (Xgeva) 120mg SC q 4 weeks
20What are potential drugs for hot flashes?
Paroxetine or clonidine