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Prostate carcinoma
Most prostate cancers are slow growing and do not manifest during a man's lifetime. While many men are found to have microscopic prostate cancer at autopsy, most die with rather than from prostate cancer. Prostate cancer most commonly presents as adenocarcinoma in the peripheral zone of the prostate and has local spread through the prostate capsule or seminal vesicles and distant spread via lymph nodes or hematogenously to bones and lungs. Imaging like ultrasound, CT, MRI, and bone scans are used to diagnose and stage prostate cancer.
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Prostate carcinoma
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- 2. Prostate Carcinoma • Manymen are found to have had incidental microscopic foci of prostate cancer at postmortem examination, and most prostate cancers are slow growing and do not manifest during the man's lifetime. • Thus, many men die with prostate cancer rather than die from prostate cancer.
- 3. Prostate Carcinoma • 95%of prostate cancers are adenocarcinomas developing in the acini of prostatic ducts. Pathology
- 4. Prostate Carcinoma • 70%of cancers occur in the peripheral zone (PZ), and approximately 20% are found in the transition zone (TZ). Pathology
- 5. Prostate Carcinoma • Localspread: capsular penetration, invasion of the seminal vesicles, or local extension along the neurovascular bundles. • Lymphatic spread: obturator LNs and from there to the common iliac and para-aortic lymph nodes. • Hematogenous spread: bones, and lungs. Skeletal metastases are common in advanced prostate cancer, but hepatic metastases are uncommon. Spread
- 6. Prostate Carcinoma • Asymptomatic. •Symptoms of advanced disease with weight loss, lethargy, bladder outflow obstruction, or bone pain. Clinical presentation
- 7. Prostate Carcinoma • SerumPSA levels increase with age: PSA Patients aged 40-49 years, 0-2.5 ng/mL Patients aged 50-59 years, 0-3.5 ng/mL Patients aged 60-69 years, 0-4.5 ng/mL Patients aged 70-79 years, 0-6.5 ng/mL
- 8. Prostate Carcinoma • Elevatedserum PSA levels may also be associated with prostatitis, prostate infarction, PIN, prostate biopsy, transurethral resection of the prostate, and urethral catheterization. PSA
- 9. Prostate Carcinoma • SerumPSA levels are lowered with finasteride treatment for benign prostatic hyperplasia PSA
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- 11. Prostate Carcinoma • Scleroticmetastases or lytic lesions with bone destruction. Plain X-Ray
- 12. Prostate Carcinoma • Scleroticmetastases or lytic lesions with bone destruction. Plain X-Ray
- 13. Prostate Carcinoma • CThas a limited role in assessing prostatic cancer, but it may be helpful in detecting nodal involvement and metastases. CT
- 14. Prostate Carcinoma • CThas a limited role in assessing prostatic cancer, but it may be helpful in detecting nodal involvement and metastases. CT
- 15. Prostate Carcinoma • MRIcan demonstrate the internal anatomy of the prostate, and it can identify areas of altered signal intensity, which representing focal pathology in the gland. • MRI is used primarily for staging, but the availability of interventional MRI units means that MRI is likely to have a future role in the diagnosis of prostate cancer. MRI
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- 19. Prostate Carcinoma ULTRASOUND • TRUSplays a central role in the contemporary diagnosis of prostate cancer because it enables accurate image-guided biopsy of the gland.
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