Endocrine Related Cancer: Prostate Flashcards
how many men show incidence of benign prostatic hyperplasia (BPH)?
70% of men > 50 and prob. 100% of men >80
what is the pathological description of pT2 on the Gleasons scores?
Tumor confined to the prostate
what is the pathological description of pT2a on the Gleasons scores?
Tumor affects one-half of one lobe or less
what is the pathological description of pT2b on the Gleasons scores?
Tumor affects more than one-half of one lobe but not both lobes
what is the pathological description of pT2c on the Gleasons scores?
Tumor affects both lobes
what is the pathological description of pT3 on the Gleasons scores?
Tumor extends beyond the prostate
what is the pathological description of pT3a on the Gleasons scores?
Tumor extends beyond the prostate
what is the pathological description of pT3b on the Gleasons scores?
Tumor invades seminal vesicle(s)
what is the pathological description of pT4 on the Gleasons scores?
Tumor invades the bladder, rectum
what is the link between fat and prostate cancer?
strong association but no specific fat components identified.
what is the link between fibre and prostate cancer?
decreased fibre in diet associated with prostate cancer.
what is the link between phytoestrogens and prostate cancer?
very high in oriental diet. May disturb androgen-oestrogen balance
what are the risk factors associated with prostate cancer?
fat
fibre
phytoestrogens
oestrogens
what is the prostate highly dependent on?
androgen
which is more important in the mechanism of disease - testosterone or dihydrotestosterone?
Dihydrotestosterone
how is testosterone converted to dihydrotestosterone?
Conversion (via 5a-reductase) occurs in prostate –> maintenance & growth of glandular epithelium.
how are the effects of dihydrotestosterone and testosterone mediated?
androgen receptors
Also a ligand-dependent transcription factor
how can prostate cancer progress to hormone independent form?
mutation of androgen rec. (AR) gene –>
responds to other steroids or to growth factors or cytokines;
amplification of rec. or cofactors;
or bypass of AR pathway.
what is the treatment for prostate cancer?
- Prevention/early management (BPH): finasteride (antiandrogens); vitamin E/Se supplements
- Early stages may respond to local treatment e.g., radiation therapy, surgery (prostate reduction)
- Removal of androgens induces apoptosis in epithelium –> involution of tissue. Effective even in metastatic stage.
how is removal of androgens achieved?
Castration - radical & now rel. uncommon in UK & USA.
Inhibition of 5DHT reductase e.g. by finasteride.
GnRH (ant)agonists to reduce LH & FSH & hence T and thus DHT.
Cyproterone acetate: both anti-androgenic in prostate & inhibits LH release.
Combination of local anti-androgen with anti-GnRH treatment seems promising.
what happens if prostate cancer is further advanced?
chemo/radiotherapy required
what is prostate-specific antigen used for?
marker for progress of the disease
what level is the threshold indicator of disease?
4ng/ml
