Prostate cancer

Question 1

Pathophysiology of prostate cancer?

Answer 1

It is uncontrolled growth of cells in prostate gland that is malignant.

The basal + luminal cells of prostate rely on androgens:
- Testosterone ( produced by testicles)
- Androstenedione ( produced by adrenal gland)
- Dihydrotestosterone ( made from testosterone in prostate).

With androgens apoptosis of the basal + Luminal cells happen.

Question 2

Risk factors of prostate adenocarcinoma?

Answer 2

Genetic mutation of laminal or basal cells causing cell division

Old age

Obesity

Bad diet

BRAC1 + BRAC2 gene

Question 3

Symptoms of prostate adenocarcinoma?

Answer 3

Early on no symptoms

Difficulty urinating if tumour press on urethra or bladder

Heamaturia

If metastesizes to bones ( hip and back)

Question 4

Diagnosis of prostate adenocarcinoma?

Answer 4

Digital rectal exam

Transrectal ultrasound

Check if PSA elevated

Gleason scoring is done

Question 5

Treatment of prostate adenocarcinoma?

Answer 5

If not metastesize just active survailance

If metastises
- surgery
- chemotherapy
- radiation therapy
-hormonal therapy

Question 6

What is pathophysiology of benign prostate hyperplasia?

Answer 6

Increase f alpha reductase activity in prostate causes increase dihydrotestosterone production and prostate hyperplasia

This causes the prostate to keep growing

Question 7

Symptoms of benign prostate hyperplasia?

Answer 7

Nodules on grown prostate press on prostatic urethra causing difficulty when passing urine.

Urine builds up in bladder making it easier to have:
-bacterial growth
-UTI

Urine dribbles
Dysuria

Question 8

Diagnosis of benign prostate hyperplasia?

Answer 8

Digital rectal examination

Check if PSA levels increased

Question 9

Treatment of benign prostate hyperplasia?

Answer 9

First line A-blocker

5 Alpha reductase inhibitor allow smooth muscle in prostate relax.