Post on 20-Mar-2017
transcript
Tumors of Prostate
SLOs
• Epidemiology • Pathogenesis • Gross features • Histomorphology • Clinical features • Tumor markers • Treatment
Epidemiology
• >50 years of age • Most common cancer of men • Mortality is 9%
“Many men die with prostate cancer than of prostate cancer”
Pathogenesis
• Androgens – Provide the soil • Hereditary – Questionable – myc, 1q24-25 • Environment – Dietary factors (japanese
men)• Acquired genetic mutations
– TMPRSS2-ETS (40-50%) - Androgen regulator promoter
– PTEN
Gross
• Most – not visible grossly • Advanced
Histomorphology
Simplification of glands Minimal nuclear pleomorphism, rare mitosis
Gleason’s grading
• Sum of 2 most common patterns
• Min = 2• Max = 10
Clinical features
• Peripheral zone • Accessible per-rectum • Less obstructive symptoms
Clinical features
• Osteoblastic metastasis
Prostate specific antigen
• Tumor marker • Serine protease– prostatic epithelium • Liquefy the seminal coagulum • Cut off – 2.5 to 4 ng/ml • Adv: Detects early cancer (organ specific)• Dis adv: Not cancer specific • Modifications – volume, age, velocity, ratio
Treatment
• Depends on stage – Orchidectomy – LNRH agonists – Radiotherapy – Prostatectomy
Summarise
Questions ?