Editing Management of Localized Prostate Cancer (section)

== Answers ==

# What is the risk of cancer-specific death and the risk of metastasis at 10-years in males on watchful waiting for prostate cancer?
## Risk of death from prostate cancer: 15%
## Risk of metastasis: 20%
# Which patients should be considered for watchful waiting as management for their prostate cancer?
## Preferred for all males without high-risk disease who have < 5-year life expectancy
## Option for those without high-risk disease and a life expectancy < 10 years
# List the indications for intervention on active surveillance for prostate cancer
## Progression in cancer grade
## Increased cancer volume on repeat biopsy
## Rapidly rising PSA
## Patient anxiety
# What are the contraindications to radical radiotherapy for prostate cancer?
#* '''ST-LIAR'''
## Size >60g for brachytherapy
## Prior TURP for brachytherapy
## LUTS
## IBD
## Ataxia telangiectaisia
## Radiation
# What are advantages/disadvantages of the perineal vs. retropubic prostatectomy?
#* Advantages: reduced blood loss, shorter operating time
#* Disadvantages: inability to do lymph node dissection, potential for rectal injury
# What are the definitions of biochemical failure following radical radiotherapy for localized prostate cancer?
#* ASTRO: 3 consecutive PSA increases measured 6 months apart, and back-dates the time of cancer progression to halfway between the PSA nadir and the first rising PSA level
#* Phoenix definition: rise of 2 ng/mL or more above the nadir; failure is not backdated
# What is the definition of a PSA bounce? Is it more common after EBRT or brachytherapy?
#* Definition: a rise in PSA of 0.1-0.5ng/mL above nadir followed by a decline
#* More common after brachytherapy
# What is the optimal timing to perform a prostate biopsy to rule out recurrence after radiation treatment?
#* After 30-36 months
# What is the toxicity profile of radiotherapy for prostate cancer? How does the toxicity differ for EBRT and brachytherapy?
#* GI toxicity (urgency, frequency, bleeding), GU toxicity (frequency, hematuria), secondary malignancies, sexual dysfuncion
#* GU toxicity more likely with brachy, GI and ED toxicity more likely with EBRT