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Prostate cancer
- 16. (1 โ 4ng/ml)
- 17. DRE Findings PSAValues < 4ng/ml 4 โ 10ng/ml >10ng/ml Normal DRE 3 โ 9 % 13 โ 20% 31 -44% Abnormal DRE 10 โ 21% 42- 74% 75 โ 96%
Editor's Notes
- 1st โ Lung; 2nd โ Breast; Colorectal-3rd 70% of cases were diagnosis were in the developed countries Even in the Asian countries the incidence is increasing as they adopt a westernized lifestyle.
- 14% at 50yrs and 80% at 70years Hereditary โ 3 or more members of the nuclear family Susceptibilty locus โ Chromosome 1 (1q24-25) Familial โ occurrence in 3 of the generations Sporadic โ A cluster of 3 relatives affected at 55 years
- Dietary fat is lower in Japanese diets than Americans
- Arise from bladder neck and prostatic urethra Primary or Secondary to ALL or CLL
- Grade 1 โ most well-differentiated tumors Grade 5 โ no glandular differentiation The most differentiated tumors have a Gleason score of 2 (1 + 1) The least differentiated tumors merit a score of 10
- Site of the tumors Bony deposit are osteoblastic or osteolytics
- Depends on the stage of the tumor
- from the collapse of vertebrae or compression of cord by metastasis
- Accuracy of diagnosis by DRE is 30 โ 50%
- Although ectopic expression of PSA has been reported in smaller concentrations in the tissue of malignant breast tumors, normal breast tissue, breast milk, and adrenal and renal carcinomas.
- The DRE findings and/or PSA are the indicators for prostate biopsy not USG In view of the stauging benefits of PSA, it can be used to rule out some staging investigations (eg. PSA < 10ng/ml may not need a radionucleotide studies).
- Pathologic staging more accurately estimates disease burden and is more useful than clinical staging for outcome prediction The cancer-specific survival are both inversely related to the pathologic stage of disease
- What is Tx and T0
- Hormonal therapy is given to cause apoptosis of the androgen-sensitive tumpor cells
- Medications are very expensive (How much is Bicalutamide) There is an initial surge of testosterone which lasts for 5WEEKS Some patients are still put on Tb Bicalutamide even after surgery because 10% of the testosterone is from the adrenals for maximal blockage Exogenous oestrogeen activate the negative feedback and reduce LHRH and