Prostate Gland Flashcards
What zones of the prostate are most common for benign and cancerous lesions?
Benign - transition zone
Cancerous - peripheral zone
What is the name for benign growth of the prostate?
What is the proposed cause?
Nodular hyperplasia
Cause unknown - theorised to be DHT overload - 5-alpha-reductase activity increases as we age.
Consequences of nodular hyperplasia
Affects transition zone:
- Compresses urethra
- Difficulty storing and passing urine
- Frequency, nocturia, urgency, incontinence
- Hypertrophy of bladder
- UTIs
Can nodular hyperplasia progress to prostate carcinoma?
No
What is the most common cause of cancer in men?
Prostate cancer.
What is the most common type of prostate carcinoma ?
Prostatic adenocarcinoma in the peripheral zone
Risk factors for prostate cancer
- Age
- Genetic and family history
- Ethnicity (rare in Asians, common in black men)
- Obesity
What are the two types of screening done for prostate cancer?
- Physical examination
- Serum PSA
- PSA protein made in prostate
- HIgher levels of PSA in prostate cancer
Is serum PSA an accurate test to pick out prostate cancer?
No - many false positives as high PSA can be caused by many things:
- NOdular hyperplasia
- Prostatitis
- Perineal trauma (e.g. Cyclists)
What is the issue with non-specificity of PSA screens?
Due to high rate of positive tests, biopsies and post-surgical complications such as unnecessary prostate removal (most people won’t die from the prostate cancer) can cause morbidity.
How is prostate cancer diagnosed and what are they looking for?
Prostate biospy
Looking for acinar adenocarcinoma
- GLands that are too small and crowded
What grading method is used for prognosis of prostate cancer?
Gleason Scoring
Architecture of cells is rated from 3 to 5, 5 being worst.
Sum of the most prevalent pattern and the worst pattern is added.
Treatment options for prostate cancer:
- Surgery
- Radiation/chemo
- Hormone therapy
- Active surveillance
