2. Prostate Cancer
Prostate cancer is the carcinoma of prostate gland that may spread to other parts of the body
particularly bones and lymph nodes.
3. Pathophysiology
In prostate cancer, the cells of these prostate glands mutate into cancer cells. Mutation is
majorly in p53 gene, BCL2 and ERK5 or alteration in Akt kinase signaling contribute toward the
development of prostate cancer. The prostate glands require hormones, known as androgens
that are involved in cell survival and apoptosis. Androgens include testosterone,
dehydroepiandrosterone and dihydrotestosterone.
Initially, small clumps of cancer cells remain confined to prostate glands, a condition known as
carcinoma in situ or prostatic intraepithelial neoplasia (PIN). Over time, these cancer cells begin
to multiply and spread to the surrounding prostate tissue forming a tumor. Eventually, the tumor
may grow large enough to invade nearby organs such as the nearby lymph nodes or the rectum,
or metastasize to bone, lymphatic system and bladder.
4. Risk Factors
A complete understanding of the causes of prostate cancer remains elusive.
Obesity
Age
Family History
Lower levels of Vit. D
Prostatitis
Elevated Blood levels of Testosterone
5. Symptoms
Weak or interrupted urine flow
Blood in urine
Nocturia
Dysuria
Pain in Pelvis, spine and ribs
Lymphedema
Renal insufficiency
6. PC imaging
Radiography
Plain radiographs of the pelvis cannot be
used to demonstrate localized disease in
the prostate, and they are generally only
needed in the evaluation of metastatic
disease. Most skeletal metastases from
prostate cancer (about 85%) are
osteoblastic and are visible as an area of
abnormal tracer activity on a radionuclide
bone scan.
7. PC imaging
Computed Tomography
CT scanning has little value in demonstrating
intraprostatic pathology and in local staging.
However, it may be helpful in detecting
metastatic disease, such as lymph node
involvement or bone metastases.
8. PC imaging
Magnetic Resonance Imaging
MRI evaluation for prostate cancer includes
morphologic imaging (T1- and T2-weighted),
complemented with one or more functional
techniques (diffusion-weighted imaging, dynamic
contrast-enhanced MRI, and/or spectroscopy).
The technique is therefore called multiparametric
MRI (mpMRI). [17] Potential roles of MRI are in
guiding prostate biopsy, local staging of biopsy-
proven cancers, treatment planning, and
posttreatment surveillance.
9. PC imaging
Transrectal ultrasonography (TRUS)
TRUS is widely available, well tolerated by
patients, and relatively inexpensive. It is
optimally performed with high-frequency TRUS
probes, and the entire prostate is imaged in the
transverse and sagittal plane. The prostate
volume can be approximated by multiplying the
height, depth, and width of the prostate by 0.52
(prolate ellipsoid formula).
10. Prostate biopsy
A prostate biopsy is a procedure to remove samples of suspicious tissue from the
prostate. The prostate is a small, walnut-shaped gland in males that produces fluid that
nourishes and transports sperm.
During a prostate biopsy a needle is used to collect a number of tissue samples from
your prostate gland.
The urologist may recommend a prostate biopsy if results from initial tests, such as a
prostate-specific antigen (PSA) blood test or digital rectal exam, suggest that you may
have prostate cancer. Tissue samples from the prostate biopsy are examined under a
microscope for cell abnormalities that are a sign of prostate cancer. If cancer is present,
it is evaluated to determine how quickly it's likely to progress and to determine the best
treatment options.
11. Type of Prostate biopsy
Passing the needle through the wall of the rectum (transrectal biopsy): This is the
most common way of performing a prostate biopsy.
Inserting the needle through the area of skin between the anus and scrotum
(transperineal biopsy): A small cut is made in the area of skin (perineum) between the
anus and the scrotum. The biopsy needle is inserted through the cut and into the
prostate to draw out samples of tissue. An MRI or CT scan is generally used to guide this
procedure.
