While at Pete’s Coffee to write my bi-monthly blog I ran into another regular who occasionally hangs out at Pete’s. Vandana is a professor at Loyola University.  She is an expert in the psychology of learning.  While we were talking I started to bemoan my struggles to educate people about prostate cancer. One of the biggest bugaboos I face is how people overestimate their grasp of the prostate cancer situation. Once I verbalized my complaint, Vandana immediately proposed I create a basic test of prostate cancer knowledge so men could self-assess their level of knowledge.  Thanks Vandana!


1.    Which of the following is NOT a Prostate Cancer Staging System?

a.    D’Amico

b.    AJCC

c.    Whitmore-Jewett

d.    Gleason


2.    Seed implant radiation compared to surgery causes:

a.    More erectile dysfunction

b.    More incontinence

c.    More urinary symptoms

d.    Lower cure rates


3.    Men with Gleason Score:

a.    Less than 7 never metastasize

b.    Over 7 always metastasize

c.    Of  4 or less have undergone surgery

d.    Both a and c are correct  


4.    Which of the following is true about robotic surgery compared to standard surgery?

a.    Gives higher cure rates and lower rates of incontinence

b.    Results in quicker recovery after surgery

c.    Improves the chances for preserving erectile function

d.    Causes less shrinkage of the penis


5.    Hormonal therapy with Lupron improves survival when combined with:

a.    Radiation

b.    Surgery

c.    Alkaline water

d.    All of the above


6.    Which of the following is not true about PSA levels? 

a.    Measures cancer cells in the blood

b.    Is affected by testosterone

c.    Rises after sex

d.    Rises with infections in the prostate


7.    Incontinence occurs in more than 5% of men who have: 

a.    Surgery

b.    Radiation

c.    Hormone therapy

d.    All the above


8.    What is climacturia after surgery?

a.    The urge to urinate after climbing

b.    The ejaculation of urine

c.    Goes away with time

d.    Only occurs with unskilled surgeons


9.    Which of the specialty doctors listed are  Board Certified in Internal Medicine?

a.    Radiation therapists

b.    Urologists

c.    Medical oncologists

d.    Radiologists


10. Which of the specialty doctors listed are least-likely to see patients with early-stage prostate cancer?

a.    Radiation therapists

b.    Urologists

c.    Medical oncologists

d.    None of the above


11. The risk of dying within 30 days of having prostate surgery is:

a.    1 in 20

b.    1 in 200

c.    1 in 2000

d.    1 in 20,000


12. What does Medicare pay $28,000 for?

a.    Radical prostatectomy

b.    Intensity modulated radiation (IMRT)

c.    Proton therapy

d.    Seed implant radiation


13. Patients referred to radiation therapy doctors most frequently come from:

a.    Other patients

b.    Advertisements

c.    Urologists

d.    Medical oncologists


14. Biopsy misses high-grade disease in what percentage of men diagnosed with low grade disease?

a.    0%

b.    5%

c.    15%

d.    30%


15. Hormone therapy with Lupron does not cause:

a.    Baldness

b.    Weight gain

c.    Osteoporosis

d.    Dry Skin                                                                                                                               




1.    d. Gleason is a grading system not a staging system

2.    c. More urinary symptoms

3.    d. Gleason less than 6 on needle biopsy indicates an error in interpretation

4.    b. Robotic surgery is accomplished with smaller incisions resulting in quicker recovery

5.    a. Radiation is the only correct answer

6.    a. PSA is a protein  from cancer cells that rises proportionate to the number cancer cells

7.    a. Surgery is the only type of treatment associated with such a high risk of incontinence

8.    b. Ejaculation of urine occurs in 20% of men undergoing surgery at a center of excellence

9.    c. Medical oncologist are the only cancer doctors with basic internal medicine training

10. c. Fewer than 1% of medical oncologists in US consult on men with early-stage PC

11. b. Mortality risk of prostate surgery in the US is one in 200

12. b. IMRT is $28,000, Medicare pays far less for either surgery or seed implants

13. c. Urologists refer most of the prostate patients to radiation docs.  That’s why radiation docs never say a bad word about surgery

14. c. 15% of men with low grade disease have higher grade disease that the biopsy missed

15. a. Men with baldness treated with hormone therapy  often notice a return of their scalp hair


Article originally posted January 27, 2015, on Prostate Snatchers: The Blog, by Mark Scholz, MD

More about Dr. Scholz:

A board-certified medical oncologist, Mark C. Scholz, MD, serves as medical director of Prostate Oncology Specialists Inc. in Marina del Rey, CA, a medical practice exclusively focused on prostate cancer. He is also the Executive Director of the Prostate Cancer Research Institute. He received his medical degree from Creighton University in Omaha, NE. Dr. Scholz completed his Internal Medicine internship and Medical Oncology fellowship at University of Southern California Medical Center. He is the co-author of the book Invasion of the Prostate Snatchers: No More Unnecessary Biopsies, Radical Treatment or Loss of Potency.  He is a strong advocate for patient empowerment.