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%