This document discusses prostate cancer, including its causes, diagnosis, signs and symptoms, and treatment options. It begins with background information on the prostate gland and how cancer develops. Risk factors for prostate cancer are then outlined, such as age, race, and family history. Methods for diagnosis include digital rectal exam, PSA testing, and imaging. A case study is presented of a 66-year-old man whose tests revealed prostate cancer. The document concludes by emphasizing the importance of early detection and treatment to achieve the best outcomes.

1. BY: PHELOKAZI NGQONDO
212350757

2. INTODUCTION
 AETIOLOGY AND PATHOGENESIS
 DIAGNOSIS
 SIGNS AND SYMPTOMS
 CASE STUDY
 TREATMENT
 DISCUSSION


3.  THE
PROSTATE GLAND
It is the small walnut-sized gland
that exists only in men .
 It is situated just below the
bladder in the lower pelvis .
Due to undefined reasons,cells in
this gland start to grow in an outof-control and unregulated manner.
And this is called Prostate cancer.

4. Fig 1:shows
the location of
the prostate

5.  The
development of cancer is viewed in a
two-step process.
Initiation through genetic alterations in the
cell.
 Cancer promotion (process allowing cancer
cells to grow and progress).

 Epidermiological
studies suggest a variety
of aetiological factors, which are-:
 Age
 Race
 Family
history of prostatic cancer.

6. Life
style factor
High intake saturated fat intake
Low intake of carotinoids
Vasectomy
Other sexual factors
Excessive weight
Energy balance

7.  This
done by -:
Digital rectal examination
Prostate-specific antigen test
Imaging studies
Histology
Haematology and Chemistry

8. DIGITAL
RECTAL EXAMINATION
 This cannot be used alone in the early
stages of cancer because it can miss
30-40% of the cancer.
Fig 2: shows risk
percentage of
prostatic cancer
versus PSA levels in
the blood.

9.  PROSTATE-SPECIFIC
ANTIGEN TEST
It measures the enzyme being
produced by glandular cells of the
prostate.
It is expressed as ng/mL.
PSA is normally found in small
amounts in the blood.
 PSA levels rise when there is an
abnormality in the prostate.

10. PSA (ng/mL)
RISK OF PROSTATIC CANCER
RISK OF AGGRESSIVE
PROSTATIC CANCER
<0.5
7%
1%
0.6-1.0
10%
1%
1.1-2.0
17%
2%
2.1-3.0
24%
5%
3.1-4.0
27%
7%
Fig 3:shows normal values of PSA found in each of the cases

11.  IMAGING
STUDIES
Some men need to undergo a bone scan
to determine the spreading of the
cancer to bone.
fig 4: Radionuclide
bone scan showing
metastatic bone
disease secondary to
prostatic
adenocarcinoma.
Osseous sites of
increased uptake can
be identified in the
spine (T1 to T12) and
ribs.

12.  There
are no signs in the early stages.
 Men with advanced disease may
experience
Difficulty in urination.
Erectile dysfunction/ decrease firmness
of erection.
 In some men the symptoms originate in
areas of the body where the cancer has
spread

13. 
Patient profile
A
66-year-old black man with a
family history of prostatic cancer.
 He woke up one morning with a
difficulty in urination accompanied
by severe sweating.

14.  His
physical exam was normal and the
digital rectal examination revealed a
slightly enlarged prostate.
 The doctor suspected prostatic cancer
and requested a PSA test which showed a
PSA level of 8 ng/mL.
 A needle biopsy was sent to histology.
 A blood sample was sent to haematology
and urine sent to chemistry.

15. RESULTS
 Histology

Fig 5:shows the patient’s prostate
gland with some infiltration.
Fig 6:shows a normal
prostate gland.

16. 
Haematology and Chemistry
Patient’s results
Normal values
HAEMATOLOGY
Haemoglobin
15 g/ml
N
13.5-17.5 g/mL
Haematocrit
43%
N
40-52%
WBC
7.5 ×109 /L
N
4.0-11.0 ×109 /L
Platelet count
507×109 /L
N
150-400×109 /L
CHEMISTRY
Blood urea
nitrogen
15 mg/dL
N
6-20mg/dL
Creatinine
1.0 mg/dL
N
0.9-1.3 mg/dL
Phosphate
Normal
N
O-3.5 ng/mL
PSA
8 ng/mL
H
4 ng/mL

17.  Surgery
 Radical
prostatectomy
 Radiation therapy
 Hormonal therapy (depending on cancer
risk category and age ,to slow
progression)
 Cryotherapy (for men at low risk for
disease progression)
 Immunotherapy
 chemotherapy

18.  The
studies show that: Early diagnosis is the most important
determinant of outcome in
malignant spinal cord compression .
 MRI evaluation is the most sensitive
diagnostic procedure when
accompanied by heightened
awareness of the potential threat.

19.  Cord
compression is due to axial
skeletal metastases of prostate
cancer.
 Patients should be instructed to
bring bladder, bowel, and muscle
strength changes to the physician’s
attention as early as possible.

20.  Prostatic
cancer, like any other
cancer has no specific cause.
 People should always go get
screened for cancer,more especially
those with a family history of
cancer.
 Cancer treatment is very expensive,
especially when cancer has
progressed to other body part.

21. 
Johns Hopkins Medicine 2013

Essential Haematology A.V Hoffbrand sixth edition

Clinical Chemistry Michael L. Bishop sixth edition
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