Prostate and Bladder cancer Flashcards
how much should a prostate weigh in a young adult
20 grams
what cell type covers the prostatic urethra
transitional epithelium
what are the apex and base of the prostate continuous with
apex= inferior portions of the prostate, continuous with the striated sphincter
base= superior portion= continuous with the bladder neck
what are the zones of the prostate
transitional (surrounds prostatic urethra)
central (surrounds ejaculatory ducts)
peripheral zone (majority of prostate glandular tissue, posteriolatera; prostate)
where is prostate does BPH arise from
transitional zone
where do 70% of prostate adenocarcinomas originate from
the peripheral zone
how common is prostate cancer
most common in UK for men
what is the peak of for prostate cancer
70-74 years
who is most at risk of prostate cancer
black men
western world (scandinavia and north america)
FH
what is the presentation of prostate cancer
vast majority asymptomatic (found by PSA (raised) and abnormal DRE findings)
can have lower urinary tract symptoms
haematuria/ haematospermia
bone pain, anorexia, weight loss
what are the findings on DRE of prostate cancer
asymmetry
nodule
fixed craggy mass
is PSA definitive for prostate cancer
no can be raised by anything that inflamed the prostate
some patients with prostate cancer will have a normal PSA
what is PSA
a glycoprotein enzyme produced by the secretory pithelial cells of the prostate gland
-involved with the liquidation of semen
what are PSA levels meant be
normal= semen PSA high, serum low
in prostate cancer the serum PSA rises
what else can elevate PSA
BPH prostatitis/ UTIs retention catheterisation DRA
what is mandatory for asymptomatic patients before a PSA test
counselling:
Cancer identified in <5% of patients
Sensitivity-80-90%
Specificity- 40%
when would you do a trans-rectal USS guided prostate biopsy
abnormal DRE and raised PSA
previous abnormal biopsy
normal biopsy but rising PSA trend
what are the risk with trans rectal biopsys
(10 biopsies should be taken)
- sepsis
- rectal bleeding
- vaso-vagal fainting
- haematospermia and haematuria
what are the majority of prostate cancers
multifocal adenocarciomas
how do prostate cancers spread
through prostatic capsule urethra bladder base seminal vesicals perineural invasion along autonomic nerves
most common mets sites:
- pelvic lymph nodes
- skeleton
what lesions are characteristic of prostate cancer
sclerotic lesions
what is a predictor of prostate cancer prognosis
gleasons scoring (used to grade cancers)
what imaging to stage prostate cancer
bone scan
MRI
CT scan
what are the broad classifications of prostate cancer
organ confined:
-T1-2 N0 M0
locally advanced
-T3-4 N0 M0
metastatic
- N+ M+
