Quiz 1

  1. The decline of both incidence and mortality rates for prostate cancer demonstrates the success of PSA screening.
  2. True
  3. False
  1. Early stage prostate cancer is frequently accompanied by urinary symptoms like burning or pain during urination, difficulty urinating, or trouble starting and stopping while urinating, or hematuria.
  2. True
  3. False
  1. Which of the following statements is true?
  2. most men die with prostate cancer not of prostate cancer, so we should not promote population based screening of any kind
  3. the difference in prostate cancer incidence rates among whites and black is due to differences in screening uptake
  4. the high survival rate of unstaged prostate cases is likely driven by the use of watchful waiting/active surveillance
  5. smoking increases a man’s risk of prostate cancer
  1. Benign prostatic hypertrophy occurs in which zone of the prostate?
  2. Peripheral Zone
  3. Central Zone
  4. Transition Zone
  5. Anterior zone
  1. The most common metastatic site for prostate cancer is?
  2. Liver
  3. Lung
  4. Bone
  5. Supraclavicular nodes
  1. These nodes are considered regional for Prostate
  2. Deep inguinal
  3. Common Iliac
  4. Scalene
  5. Internal Iliac
  6. Final Diagnosis on pathology report states: Acinar adenocarcinoma. The histology would be coded to:
  7. 8000/3 Cancer, NOS
  8. 8010/3 Carcinoma, NOS
  9. 8140/3 Adenocarcinoma, NOS
  10. 8550/3 Acinar Adenocarcinoma
  1. Majority of prostate cancers develop in which zone of the prostate?
  2. Anterior Zone
  3. Central Zone
  4. Peripheral Zone
  5. Transition zone
  1. Which lobe makes up the main mass of the prostate?
  2. Anterior Lobe
  3. Lateral Lobes
  4. Median Lobe
  5. Posterior Lobe
  1. According to the 2014+Grade Coding Instructions which would you use to determine the grade?
  2. Gleason score form prostatectomy ONLY
  3. Gleason score from biopsy/TURP ONLY
  4. Physician statement only
  5. Highest Gleason score from biopsy/TURP or prostatectomy

Quiz 2

  1. A physician documented a normal DRE for a patient with benign prostatic hyperplasia (BPH) and a PSA of 7.0 ng/ml. A biopsies of the prostate revealed a focus of adenocarcinoma Gleason 3+4=7 in the right lobe of the prostate. Biopsies from the left lobe were negative. The patient had a radical prostatectomy which showed a 5mm focus of adenocarcinoma Gleason 3+4 in the right lobe. No further malignancy identified within the prostate. Two pelvic lymph nodes were negative for malignancy.

Please assign an AJCC and Summary Stage in the table below.

Staging Table
T / N / M / PSA / Gleason / Stage Group
Clin / c1c / C0 / C0 / 070 / 007 / IIA
Path / P2a / p0 / C0 / 070 / 007 / IIA
Summary Stage / 1-Localized

July 1, 2015 - A patient with an elevated PSA, but benign prostate on DRE had a needle biopsy that showed a single core of adenocarcinoma. The patient and physician chose active surveillance as their treatment plan on July 15, 2015. No disease progression was identified during the three month (September 15, 2015) follow-up or the six month follow-up visit (January 12, 2016). However, during the six month follow-up visit the patient asked to have the cancer treated with brachytherapy. The patient received brachytherapy with low dose interstitial seed implants onFebruary 2, 2016.

  1. What is the Date of First Course Treatment?
  2. July 1, 2015
  3. July 15, 2015
  4. January 12, 2016
  5. February 2, 2016
  1. What is the code for Regional Treatment Modality?
  1. 00: No radiation treatment
  2. 53: Brachytherapy, interstitial, low dose
  3. 54: Brachytherapy, interstitial, high dose
  4. 60: Radioisotopes, NOS
  1. What is the code for RX Summ-Treatment Status
  2. 0-No treatment given
  3. 1-Treatment given
  4. 2-Active Surveillance
  5. 9-Unknown if treatment given