carcinoma of the prostate Flashcards
describe prostatic zones
transitional zone
- around urethra
- site of benign prostatic hyperplasia
peripheral zone
- atrophy
- most carcinoma
etiology and pathogenesis of prostatic carcinoma
genetic factors
- familial incidence
- higher in black Africans
Environment
- diet
clinical features of prostatic carcinoma
no specific symptoms - obstructive symptoms late
examination = firm area/nodule
diagnosis of prostatic carcinoma
- PSA
- transrectal ultrasound / MRI
- digital rectal examination
- biopsy
describe the grading system of prostatic carcinomas
Gleason grading
- pattern 1-5
- add two most common patterns to get score
<6 = grade 1 7 (3+4) = grade 2 7 (4+3) = grade 2 8 (4+4 or 3+5) = grade 3 9, 10 = grade 4
describe the problems with the grading system of prostatic carcinomas
- patterns 1 & 2 stopped being used therefore no longer a score from 1-5
- as 6 is the lowest, patients perceive this negatively thinking its the middle of the range
how do prostate cancers progress
local spread
- extraprostatic fat
- seminal vesicles
- other pelvic structures e.g. bladder, rectum
lymph nodes
- pelvic, aortic - may block off ureters
distant metastasis
- particularly vertebral bodies
where does the prostatic nerve lie
between prostate and rectum
describe the management of prostate cancer
small low-grade tumours - no treatment (active surveillance)
significant tumours - radical treatment
advanced tumours - palliative treatment
describe radical treatment
radical prostatectomy - entire prostate removed
radical radiotherapy - high dose radiation
describe palliative treatment
anti-androgen treatment
- giving drugs or removing testes
palliative radiotherapy
- local or metastases
describe the aetiology and pathogenesis of carcinoma of the bladder
aetiology = smoking, industrial chemicals
pathogenesis = arises from transitional cell CIS
clinical features (symptoms) associated with carcinoma of the bladder
- haematuria
- recurrent or new tumours often
- follow by urine cytology, cystoscopy
morphology of carcinomas of the bladder
macro: most are papillary, may become invasive
micro: most are transitional, some squamous, adenocarcinoma
treatment for carcinomas of the bladder
local therapy = BCG
if tumour is in detrusor muscle cystectomy is required
