3. ANATOMY & PHYSIOLOGY
• A donut shaped gland
about the size of a golf
ball which is inferior to the
urinary bladder and
surrounds the prostatic
urethra.
• The fluid from the
prostate is clear and
slightly acidic (pH level of
7.2-7.9).
5. ANATOMY & PHYSIOLOGY
LOBES OF
PROSTATE:
• Anterior lobe or Isthmus
- corresponds to
transition zone
• Median lobe -
corresponds to central
zone
• Posterior lobe -
corresponds to
peripheral zone
• Lateral lobe - spans all
zones
9. SIGNS & SYMPTOMS
• Frequent urination • dysuria
• Urgent feeling of • Hematuria
urination • Painful ejaculation
• Difficulty in starting
or stopping the
urine flow
• Anuria
• Bladder retention
10. PROSTATE CANCER
• is
the most common cause of cancer
death in men > 75 yrs. old
rarely found in men < 40 yrs. old
People who are at higher risk include the
following:
1. African- American men
2. Men > 60 yrs. old
3. Men who have a father or brother
with prostate cancer.
11. OTHER PEOPLE AT RISK INCLUDES:
Excessive alcohol intake Farmers
High fat diet
(especially animal fat)
Tire plant workers Painters
Men who have been
around cadmium.
12. PROSTATE CANCER
• is less common with vegetarians
Benign Prostatic Hyperplasia (BPH)
- a common problem
- enlarged prostate as men ages.
13. PROSTATE CANCER STATISTICS AT A
GLANCE (CANADA)
Year: 2012 Males
Cases 26,500
Incidence Rate (per 100,000) 121
Incidence Rank 1st
Deaths 4,000
Death rate (per 100,000) 19
Death rank 3rd
5- year relative survival (2004-2006) 96%
14. OUTLINE THE MODALITIES USED:
1.Digital rectal examination (DRE)
2. Transrectal ultrasound (TRUS)+/-
3. Pelvic CT scan and MR
4. Nuclear Medicine
5. Contrast Enhanced Ultrasound
6. Computer- Aided Ultrasonography
15. OTHER PROCEDURES TO BE
DONE FOR DIAGNOSIS:
1. Serum level of PSA
2. Biopsy:
• Indications:
A. Palpable mass
on DRE
B. Elevated PSA
C. Both high PSA &
Palpable mass
23. DIAGNOSTIC EXAMINATION
• HORMONE THERAPY
help some type of
cancer cell to grow
such as: prostate
cancer
as a cancer TX
may involve taking
medication.
may involve surgically
removing the gland
that is producing the
hormones
42. Pre-techniques
and Procedures
Simulation
Note:
• Color Red
(target) –
Prostate Gland
• Color Light Blue
– Urinary Bladder
• Color Dark Blue –
Rectum
Biancz :)
56. PORTALS AND FIELDS
• Superiorly, the fields extends from
the acetabulum and
• Laterally to include the two thirds
of the obturator foramen
• 100% Isodose line
57.
58.
59. When regional lymph nodes are
included:
Superior border level of midsacroiliac joints
Inferior border is usually 1-1.5cm
inferior to the junction of membranous
prostathic urethra
• Lateral borders in AP and PA fields are
1.5- 1.2 cm lateral to the pelvic brim
65. Long term side effects
incontinence
Impotence
Infertility
Short term side effects
Bladder inflammation
Diarrhea
Sore skin in the genital area
Loss of pubic hair
Editor's Notes
especially at nightanuria = inability to urinateBladder retention = weak, decreased or incompletely emptying the bladderDysuria = painful urinationhematuria = blood in the urine or semen
African- American men, who are also likelyto develop cancer at every ageMen > 60 yrs. old.Men who have a father or brother withprostate cancer.
It does not raise your risk of prostate cancer. However, it can increase your blood test results.
Psa – prostate-specific antigenDRE – DIGITAL RECTAL EXAM
Elastography = Ultrasonic imaging technique that displays the elasticity of soft tissue and has been found useful in demonstrating abnormalities of both muscleElastography-supported image of a patient with suspected prostate cancer. Arrow indicates suspicious area. Biopsy was positive
Hormone treatment (also called androgen deprivation therapy or androgen suppression therapy) removes, blocks, or adds hormones to treat prostate cancer. Hormones are chemical substances produced by glands in the body that enter the bloodstream and affect other tissues.By taking medication they preventing the production of the hormones.
an open – surgery procedure
a less-invasive type of radical prostatectomy in which the prostate gland is removed through small incision using a laparoscope and special long, thin surgical tools.
TURP is used as a palliative procedure not as a procedure to cure the cancerSurgery to remove part of the prostate gland that surrounds the urethra by using a small tool that is place inside the prostate through the urethra at the tip of the penis.There is no incision with this method.
involves killing the cancer by freezing the cell with a small metal cool placed in the tumor.
Distance decreases- larger the dose.
Some men who receive treatment for prostate cancer experience one or more side effects depending on the type of treatment they receive:Long term:incontinence (inability to control urination)Impotence (inability to get an erection)
