42. Prostate Cancer Flashcards
Why is prostate cancer important in terms of diagnosis
why is prostate cancer important for men
NB:
- Most common dg solid tumor in males worldwide
- 2nd mc cause of cancer related deaths
what are the 4 major risk factors for prostate factors
what are the two types of family history
which one is the the case 91% of the time
- Increased age
- Ethnic Origin
- Family history of prostate cancer
- familial Pca: increased risk in 1st grade relatives
- true hereditary Pca: found in 91% of cases
What is the Histological type of Pca
where does it usually arise
adenocarcinoma
w/ irregular tubules and Adenoma formation
presents as a nodule in posterior lobe of the prostate
what is the histological grading of the prostate gland according to the International Society of Urological Pathology
according to the ISoUP Pca is graded according to the Gleason score
RCC= filmar grading score
where does Pca originate from
how does this dx for BPH
peripheral zone
BPH originates from transitional zone
what is the histological grading of the Gleason score
describe the cells and glands at each point
Grade 1
- Glands= well defined, medium to large size, seperated by scanty stroma
- Cells= Uniform w/ normal size and inconspicous nuclei
Grade 2
- Glands= medium to small. moderate amount of infiltrating stroma
- Cells= pleomorphic, Conspicous & small nuclei
Grade 3
- Glands= small, poorly formed acini, Loss of glandular organisation showing a scirrhos pattern
- Cells= Pronounced pleomorphism, Large and Acidophilic nuclei
Grade 4
- Glands= Round solid masses of tumor cells, NO GLAND FORMATION
- Cells= Small or Large, Uniform or Pleomorphic, Mitotic activity is present
Describe grade one of GLEASON
Glands= well defined, medium to large size, seperated by scanty stroma
Cells= Uniform w/ normal size and inconspicous nuclei
Grade 2 GLEASON
Glands= medium to small. moderate amount of infiltrating stroma
Cells= pleomorphic, Conspicous & small nuclei
Grade 3 GLEASON
Glands= small, poorly formed acini, Loss of glandular organisation showing a scirrhos pattern
Cells= Pronounced pleomorphism, Large and Acidophilic nuclei
Grade 4 GLEASON
Glands= Round solid masses of tumor cells, NO GLAND FORMATION
Cells= Small or Large, Uniform or Pleomorphic, Mitotic activity is present
what is the TNM system for Pca
what are the speficic
T, N, & M for Pca
T: when is it localised and when is it advanced
N: what are the regional LN for pca
M: 3 routes of metastasis
TNM 2017 is used to classify Pca
T
- T1-T2: Localised= confined to PG
- T3-T4: Advanced= Extracapsular invasion
N
- regional LN’s= Iliac LN’s and LN’s around illiac vessels
M
- Direct : Bladder, Seminal vesicles, Rectum
- Lymph: Regional LN of illiac and illiac vessels
- Hematogenous: bones= Pelvis, Vertebrae, Sternum
what are the FOUR Clinical Sx of Pca
- DYSURIA
- SLOW URINARY STREAM
- DRIBBLING
- RETENION
Diagnostic methods for Pca
purpose of screening of Pca
- DRE: abrnormal findings
- hard/stony,
- irregular induration ,
- Obliteration of Median sulcus
- ↑ PSA for early detection (0-4mg/ml/cc)
SCREENING = for ealy detection
- PSA
- DRE
- RECTAL U.S
dg indications for Transuretheral US guided Prostate Biopsy
elevated PSA
abnormal DRE
types of treatment of Pca
for local
for advanced
Rx for localised Pca
-
Radical Prostactectomy w/ LN dissection and radiotherapy
- OPEN laparoscopy or Robot assisted approach
Rx for Advanced/ Metastatic Pca
COMPLETE ANDROGEN BLOCKADE using Adrogen deletion therapy
