Test your understanding of prostate cancer by answering the following quiz questions:
1. Which of the following is NOT a risk factor associated with prostate cancer?
A. High dietary intake of red meats
B. Family history of prostate cancer
C. Inactivity
D. BRCA2 gene mutation
Rationale: There has been no link between exercise and the development of prostate cancer. High dietary intake of fat either from animals or saturated fats, red meats, and dairy are all associated with an increased risk of prostate cancer. Family history and genetics play an important role in explaining roughly 5% to 10% of prostate cancer. Men who have one first degree blood relative with prostate cancer are five times more likely of developing it themselves. BRCA2 gene mutation (most commonly associated with breast cancer in women) confers the highest known genetic risk of developing prostate cancer. (McChance & Huether, 2019, p. 849-851, 854, 856-857)
2. Estrogen has been shown to lead to premalignant lesions in the prostate.
A. True
B. False
Rationale: Since the prostate is involved in the synthesis of androgenic hormones, it is sensitive to the levels of androgens in the blood. One androgen in particular, estrogen, has been show to lead to the development of premalignant lesions in the prostate. This is especially evident when in the presence of relatively low testosterone levels. (McChance & Huether, 2019, p. 854)
3. Which of the following statements made by a patient recently diagnosed with prostate cancer indicates an adequate understanding of the disease?
A. My urinary frequency at night is directly related to my prostate cancer.
B. Being African-American male did not increase my risk of developing prostate cancer.
C. Maybe if I paid more attention to my signs and symptoms we could have diagnosed my cancer in the early stages.
D. The elevation of PSA in my blood help differentiate BPH from prostate cancer.
Rationale: Urinary frequency at night or nocturia is a common sign of prostate cancer. The first manifestations normally seen are due to bladder outlet obstruction: slow urinary stream, hesitancy, incomplete emptying, frequency, nocturia, and dysuria. Across all age ranges, black men have an increased risk of developing prostate cancer. Black men are approximately twice as likely to die of prostate cancer compared with other men in the United States. Prostate cancer often does not show any signs or symptoms until it is advanced, therefore the patient most likely wouldn’t have noticed signs until it was pasted the early stages. Measurement of PSA level alone cannot diagnosis prostate cancer as PSA level can be elevated in both BPH and prostate cancer. (McChance & Huether, 2019, p. 851-855)
4. You’re assessing a patient with late stage prostate cancer. What do you least likely expect the patient to present with?
A. Urinary frequency
B. Bilateral lower extremity edema
C. Rectal bleeding
D. Urinary Retention.
Rationale: Rectal bleeding can manifest itself in prostate cancer but is very rare. It usually only manifest itself with metastasizes to the rectum or when radiotherapy is used for treatment. Urinary frequency and urinary retention are common signs and symptoms associated with prostate cancer due to bladder outlet obstruction. Bilateral lower extremity edema is a symptom of late stage prostate cancer. Other symptoms of late disease include bone pain at sites of bone metastasis, enlargement of lymph nodes, enlargement of the liver, development of pathological fractures, and altered mental status associated with brain metastases. (McChance & Huether, 2019, p. 851-855)
5. Which of the following does NOT lead to the development of prostate tumor cells?
A. Inflammatory damage to the prostate as a result of autoimmune disease.
B. The continuous damage and healing of the prostate activates the immune response which leads to prostate cell proliferation.
C. Recurrent urinary tract infections causing inflammatory response.
D. An age dependent increase in testosterone and decrease in estrogen.
Rationale: Testosterone usually decreases with age and estrogen increases. This means that as men age the ratio of testosterone to estrogen increases. It is this ratio of being relatively high in estrogen and low in testosterone that seems to play the most significant role in the development of precancerous lesions in the prostate. Autoimmune disease and infections like urinary tract infections can cause inflammatory damage to the prostate. As this damage is done over time to the epithelium of the prostate a lesion called a prostatic epithelial neoplasia (PIN) can be seen. PIN can be viewed as the beginning of a series of progressive stages culminating in invasive carcinoma. As the prostate is damaged and healed repeatedly, a change in the stroma of the prostate can be seen. These changes promote an immune response that leads to the proliferation of cells in the prostate. (McChance & Huether, 2019, p. 854-857)