Prostate Cancer

Question 1

How common is prostate cancer?

Answer 1

• not common in young men, occurs most often after age of 65

- 3rd in cancer deaths, often very aggressive

Question 2

What causes prostate cancer?

Answer 2

genetic mutation

Question 3

What are risk factors for prostate cancer?

Answer 3

• age
• diet
• ethnicity
• familial (1st and 2nd degree relatives)
• androgens

Question 4

What is the pathology of prostate cancer?

Answer 4

• adenocarcinomas, are peripheral, multicentric
• no early manifestations (delays detection and diagnosis)
• manifestations appear after invasion or metastasis
• extension to bladder and seminal vesicles
• metastasis to bone, liver, lungs

Question 5

What are the manifestations of prostate cancer?

Answer 5

• asymptomatic in early stages
• prostatitis common
• late hip and back pain due to metastasis to bone

Question 6

How is prostate caner diagnosed?

Answer 6

• history and presentation
• DRE
• PSA
• biopsy (use US to guide, done transurethrally)

Question 7

How is prostate cancer treated?

Answer 7

• may not treat (ex. non-aggressive in an elderly man)
• stage, grade, age based (if localized = low risk, active surveillance)
• androgens nurture cancer growth in this case, so:
  1st - antiandrogens
  2nd - surgery, radical prostatectomy (seminal vesicles also removed)
  3rd - radiation
• chemo not usually very effective