Lecture 20 - Carcinoma of Prostate

Question 1

Predetermining factors?

Answer 1

genetic (familia incidence, higher in black americans) and environmental (diet)

Question 2

Clinical features?

Answer 2

no specific symptoms (obstructive symptoms late), firm area/nodule

Question 3

Diagnosis of prostate cancer?

Answer 3

PSA, DRE, MRI, biopsy

Question 4

Histological pattern of prostatic adenocarcinoma development?

Answer 4

Gleason grading/prognosis

Question 5

Problems with gleason grading?

Answer 5

2-5 no longer used, 6 bottom of range but appears to be middle, combinations have same score for different prognosis (3+4, 4+3)

Question 6

Progression?

Answer 6

local spread (fat, vesicles, other organs), lymph nodes (pelvic, aortic), distant metastases (vertebrae)

Question 7

Management categories of prostatic tumour?

Answer 7

small low grade - active surveillance; significant tumours - radical treatment; advanced tumours - palliative treatment

Question 8

Components of palliation treatment?

Answer 8

anti-androgen treatment, palliative radiotherapy (protastectomy being the other form of treatment)

Question 9

Clinical Presentations of Bladder Carcinoma?

Answer 9

haematuria, recurrent or new tumours, urine cytology & cystoscopy

Question 10

Treatment of bladder carcinoma?

Answer 10

superficial - local therapy, BCG; inside detrusor muscle - cystectomy

Question 11

Clinical presentations of renal carcinoma?

Answer 11

late symptoms, haematuria, flank pain, palpable abdominal mass, ectopic hormone production