Prostate CA

Question 1

how come no compression of urethra with prostate CA

Answer 1

this CA is peripheral/subcapsular meaning the CA develops below capsule lining outside of prostate (peripherally)

Question 2

risk factors

Answer 2

• aging
• diet & ethnicity
• familial
• androgens

Question 3

how does diet & ethnicity inc risk

Answer 3

• Japanese men yellow seaweed in diet –> protects prostate

- African American men predisposed genetically

Question 4

how do androgens inc risk

Answer 4

Male sex hormones support growth & Fx of prostate along with growth of malignant CA cells

Question 5

patho (type, spreading)

Answer 5

• 98% are adenocarcinomas
• arises peripherally & multicentric
• malignancy locally invasive, as it advances, it spreads through extension –> impacts seminal vesicles & urinary bladder

Question 6

mnfts

Answer 6

early symptoms:

• dysuria
• hematuria
• lower back pain

Question 7

when do mnfts appear

Answer 7

after invasion or mets

Question 8

dysuria

Answer 8

pain upon urination

Question 9

why does lower back pain mnft

Answer 9

d/t mets to bone or referred pain from prostate region (bone CA –> necrosis of bone tissue)

Question 10

Dx

Answer 10

• Hx, Px
• DRE (direct rectal exam)
• PSA (prostate-specific antigen)
• Kallikreen
• ProPSA
• transurethral U/S
• biopsy

Question 11

screenings for Dx

Answer 11

• Kallikreen

- ProPSA

Question 12

Tx

Answer 12

stage, grade, and age-based

• active surveillance
• antiandrogen
• radical prostatectomy
• radiation

Question 13

active surveillance Tx

Answer 13

for localized, low risk older men whose probability of death from natural causes is high; watch for spreading but no Tx

Question 14

antiandrogen Tx

Answer 14

Suppress hormones that support growth of tumor (ex. Synthetic estrogen will oppose action of androgens)

Question 15

radical prostatectomy

Answer 15

Removal of prostate & surrounding structures (incl seminal vesicles where CA most likely will spread)