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PATH3309 > Prostate Cancer > Flashcards

Prostate Cancer Flashcards

1
Q

What and where is the prostate gland?

A

Cone shaped solid organ in retroperioneum
Just below bladder
Anterior to rectum
No capsule

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2
Q

How much does the prostate gland weight?

A

20g

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3
Q

What does the prostate gland look like histologically?

A

Branched tubulo acinar glands with fibromuscular stroma

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4
Q

How much of seminal fluid does it secrete?

A

50%

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5
Q

How many zones can it be divided into?

A

4

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6
Q

What are 4 of the zones of the prostate?

A

Transition zone - 5% of tissue - BPH occurs here

  • 20% of Pr. Ca
    • Surround urethra

Central zone - 25% of tissue -
- Surrounds ejaculatory ducts at base of gland

Peripheral zone - 70% of tissue

  - 75% of PC
  - Pulpable
  - Surrounds central zone

Anterior fibro muscular stroma

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7
Q

What is the verumontanum?

A

Where the ejaculatory ducts from seminal vesicles enter into prostatic urethra

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8
Q

Where is benign prostatic hyperplasia most common?

A

In the transition zone

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9
Q

Where is prostate cancer most common?

A

In the peripheral zone

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10
Q

What is the normal architecture of the prostate?

A

Lobular architecture
Large, irregularly shaped glands
2 cell layers - Epithelial cells + basal cells
Epithelium has folded/papillary appearance
Tall columnar cells with basaly located nuclei
Androgens control growth

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11
Q

What are the three main diseases of the prostate?

A

1) Inflammation (prostatitis)
2) Benign nodular enlargement (BPH) - most common
3) Tumours

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12
Q

How common is BPH?

A

Seen in all men over 50 yrs

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13
Q

Why does BPH generally result in lower urinary tract symptoms?

A

Obstruction and irritation of bladder due to occuring in transitional zone of prostate

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14
Q

What are some symptoms of BPH?

A 
Increased pee frequency
Dribbling
Hard to initiate 
Decreased size + strength of stream
Cannot post pone 
Pushing to get it out
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15
Q

Where does prostate cancer deaths rate?

A

3rd most common

Most diagnosed in men

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16
Q

What is chance at age 85?

A

1 in 5

17
Q

What are some risk factors for prostate cancer?

A 
Old age
Family history
Race
High levels of testosterone
Diets high in fat
18
Q

What are symptoms of prostate?

A

Similar to BPH

Mostly asymptomatic

19
Q

How is PC tested?

A 
Palpation on digital rectal examination
Symptoms
Rectal ultrasound
Tran rectal ultrasound guided biopsy (trusBX)
Serum PSA
20
Q

What is PSA?

A

Prostate specific antigen

21
Q

What can raise PSA levels?

A

1) Age
2) BPH
3) Subclinical prostatitis
4) Prostate carcinoma

22
Q

What is disease median age of prostate cancer diagnossi?

A

67

median age of 80 at death

23
Q

How long is pre-clinical phase of prostate cancer?

A

10 or 15 years

24
Q

What is the commonest epithelial malignancy of the prostate gland?

A

Acinar adenocarcinoma (>95%)

25
Q

What are some other types of Epithelial neoplasms associated with PC?

A

Ductal adenocarcinoma
Adenosquamous Carcinoma
Small cell carcinoma
Sacromatoid carcinoma

26
Q

What are the 4 characteristic histological features of prostate carcinoma?

A

1) Infiltrative glands - Too small, corwded and clear
2) Absence of basal cell layer
3) Large nuclei
4) Prominent nucleoli

27
Q

What immunohistochemical stain cocktail can demonstrate absent basal cell layer in prostate Ca?

A

PIN4

28
Q

What is the second most common form of prostate cancer?

A

Ductal adenocarcinoma

29
Q

Why was ductal adenocarcinoma known as endometrioid adenocarcinoma?

A

Because it looks look similar to endometrioid adenocarcinoma

30
Q

What is the current internationally accepted grading system for prostate cancer?

A

The Gleason score

31
Q

What is the Gleason score based upon?

A

The architectual patterns of the tumour
- The more irregularly structured the worse
4x or 10x magnification
Not influenced by anything else

32
Q

What are the most common sites of metastasis of prostate cancer?

A 
Bone
Lung
Lymph nodes
Liver
Brain

Metastases often sclerotic on imaging

33
Q

What are the 4 T stages of TNM staging key?

A

T1 = not palpable, incidentally discovered

T2= Organ confined

T3=Extends through capsule including seminal vesicles

T4= Invades adjacent structures

N1 = regional LN metastases

M1 = Distant metastases

34
Q

What are the AJCC key components of prostate cancer staging?

A

TNM
Pre op serum PSA
Gleason score

35
Q

What are some radical treatments for locally or advanced prostate cancer?

A

1) External Beam Radiotherapy
2) Radical radiotherapy and androgen deprivation therapy
3) Brachytherapy
4) Radical prostatectomy

36
Q

How is advnaced/metastatic ca treated?

A

Endocrine therapy - Orchidectomy or administration of LHRH

37
Q

What does the androgen receptor play a role in?

A

Normal development of prostate
Prostate carcinogenesis
Progression to metastasis

38
Q

Have AR mutations been linked to PC?

A

Yes, especially in african american population

PATH3309 (14 decks)

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