Prostate Cancer

Question 1

What are the methods used by pathologists to identify the primary source of a malignancy?

Answer 1

Immunohistochemistry testing: tissue is stained to identify antigens by using specific antibodies and staining techniques e.g. peroxidase. In prostate Ca an antibody against PSA is used.

Question 2

Pros and Cons of PSA testing?

Answer 2

Pros:
- Early detection, better prognosis

Cons:

• False +ves/-ves
• If detected prostate Ca would have had no effect on life-expectancy, pt receives unnecessary investigations + management
• Management has high chance of side effects with important implications for QOL

Question 3

Can you get AKI secondary to prostate cancer? How?

Answer 3

Yes - post-renal obstruction leads to hydronephrosis.

Question 4

How does prostate Ca spread to the vertebral column?

Answer 4

Haematogenously:
Prostatic venous plexus > vesical plexus > internal iliac veins > IVC >(backflow)> lateral sacral veins > internal vertebral venous plexus (valveless)

Question 5

Name the zones of the prostate

Answer 5

Transition zone
Central zone
Peripheral zone
Anterior fibromuscular stroma