Prostate Cancer
Statistics of prostate cancer Incidence Prostate- 32% Lung – 16% Mortality Lung- 33% Prostate 13%
Statistics of prostate cancer Association with race : Most common in African-Americans Common in Caucasians Less common in Asians
Risk factors of prostate cancer Advanced age Positive family history Environmental influence Smoking
Male/ female genital homologues Male Prostate Female Urethral glands Paraurethral glands
Anatomy of prostate Transmits the prostatic urethra Secretions enter the urethra through minute ducts Blood comes from the internal iliac artery Lymph drains to internal iliac nodes The prostatic venous plexus communicates with the vertebral venous plexus
Histology of prostate It is an aggregation of small branched tubuloalveolar glands Most of cancer are adenocarcinomas a) well differentiated; b) poorly differentiated; c) non-differentiated.
Physiology of prostate Prostatic secretion is rich in: 1)Citric acid; 2)Lipids; 3)Zinc; 4)Acid phosphatase activity
Physiology of prostate Androgens Testosterone DHT Androstenedion
Diagnoses of prostate cancer Elevated PSA (more than 10ng/ml) DRE Biopsy Gleason histological system
Classification of prostate cancer TNM system (plus m) T1 – lesion inside the glandule T2 – lesion deforms the shape of prostate T3 – lesion extends outside the glandule T4 – lesion extends into the other organs N1 – N4
Clinical features of prostate cancer Urinary retention Lymphedema Back pain Weight loss
Clinical features of prostate cancer BPH Prostate sclerosis Chronic prostatitis Tuberculosis Prostate stones
High-yield facts An elderly man with osteoblastic metastases visible on X-ray should be considered to have prostate carcinoma until proven otherwise
Treatment of prostate cancer Radical prostatectomy Radiation therapy Androgen ablation a) GnRH agonists b) orchiectomy/ flutamide c) chemotherapy
Prevention of prostate cancer Annual DRE after the age of 50 is the current screening method for prostate cancer
Prognosis of prostate cancer After-treatment survival rate 3 years 62% 5 years 51% 10 years 30%