Prostate Cancer Overview

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Questions and Answers

What is a common early symptom of prostate cancer?

Severe headaches

Chronic coughing

Chest pain

Frequent urination (correct)

Which investigation is primarily used for an initial workup of suspected prostate cancer?

DRE (correct)

Blood culture

Lung function test

CT scan

What does a significantly high PSA level indicate in the context of prostate cancer?

Potential prostate cancer (correct)

Psoriasis

Benign prostatic hyperplasia (BPH)

A urinary tract infection

Which of the following treatments is typically used for localized prostate cancer?

Radical prostatectomy Signup and view all the answers

What kind of lesions are typically found in bone metastasis from prostate cancer?

Osteoblastic lesions Signup and view all the answers

In advanced metastatic prostate cancer, what is a common hormonal treatment approach?

Orchidectomy or synthetic LHRH Signup and view all the answers

Which imaging study is often used for staging prostate cancer?

MRI Signup and view all the answers

What is a reported symptom associated with advanced prostate cancer?

Bone pain Signup and view all the answers

What is the primary cause of urinary tract obstruction in benign prostatic hyperplasia (BPH)?

Nodular enlargement of the peri-urethral area Signup and view all the answers

Which enzyme is primarily responsible for the conversion of testosterone to dihydrotestosterone (DHT) in the prostate?

5-alpha-reductase Signup and view all the answers

What surgical intervention might be employed in managing symptoms of benign prostatic hyperplasia?

Transurethral resection of the prostate (TURP) Signup and view all the answers

Which of the following conditions can result in elevated prostate-specific antigen (PSA) levels?

Benign prostatic hyperplasia Signup and view all the answers

What symptom is least likely to be associated with benign prostatic hyperplasia?

Erectile dysfunction Signup and view all the answers

Which investigation is typically performed to rule out urinary tract infections before diagnosing BPH?

Urine Mikroskopie and culture (MCS) Signup and view all the answers

What is the primary role of prostate-specific antigen (PSA) in semen?

To liquefy semen for sperm mobility Signup and view all the answers

Clinical investigations for prostate cancer may reveal abnormal findings in which region during a digital rectal exam?

Peripheral zone Signup and view all the answers

What is a key microscopic characteristic of prostate adenocarcinoma?

Back-to-back glands Signup and view all the answers

Which factor is NOT linked to an increased risk of developing prostate cancer?

Low hormone levels Signup and view all the answers

How is the Gleason Score determined in prostate cancer diagnosis?

By grading the two most common growth patterns Signup and view all the answers

In prostate cancer, what happens to the normal papillary infoldings of glands?

They disappear completely Signup and view all the answers

What likely describes the tissue composition in benign prostatic hyperplasia (BPH) compared to prostate adenocarcinoma?

Stromal hyperplasia in BPH, glandular hyperplasia in cancer Signup and view all the answers

What common pathological change occurs in prostate cancer compared to normal prostate tissue?

Dysplastic change in the epithelial cells Signup and view all the answers

What is commonly noted about the size of the prostate gland in cases of significant benign prostatic hyperplasia?

It typically becomes enlarged Signup and view all the answers

In what zone of the prostate does cancer growth typically occur?

Peripheral zone Signup and view all the answers

Study Notes

Prostate Cancer Presentation

Early stages are usually asymptomatic; symptoms may resemble benign prostatic hyperplasia (BPH).
Symptoms include frequent urination, nocturia, weak urinary stream, dribbling, and haematuria.
Advanced cases can cause fatigue, weight loss, and significant bone pain.

Metastasis

Prostate cancer often metastasizes to bones, particularly the vertebrae and pelvis.
Bone lesions resulting from metastasis can be osteoblastic, indicating increased bone formation.

Investigations

Digital Rectal Exam (DRE) is an essential initial diagnostic tool.
Prostate-Specific Antigen (PSA) levels are monitored; significantly high levels indicate further investigation.
Prostate biopsy may be performed using trans-rectal ultrasound guidance.
MRI and CT scans are conducted for staging the cancer.

Management

Radical prostatectomy is recommended for localized prostate cancer.
Radiation therapies include external beam radiation and brachytherapy (interstitial radiation).
Advanced metastatic disease may be managed with androgen deprivation therapy, utilizing orchidectomy or synthetic LHRH agents.

Prostate-Specific Antigen (PSA)

PSA is secreted by prostate epithelium, aiding in semen liquefaction and sperm mobility.
Elevated PSA levels in adenocarcinoma correlate with increased dysplastic gland numbers and activity.
High PSA can also occur in prostatitis and BPH, making it an imperfect screening tool.

Benign Prostatic Hyperplasia (BPH)

Most common benign prostate condition in men over 50, caused by stromal tissue hyperplasia influenced by androgens.
Dihydrotestosterone (DHT), generated by 5-alpha-reductase, plays a significant role in BPH development.
Symptoms include poor urine stream, nocturia, difficulty urinating, and overflow dribbling due to urethral obstruction.

Treatment Options for BPH

Lifestyle changes: reduction of alcohol and caffeine intake.
Medications such as alpha-blockers (e.g., tamsulosin) relax prostate smooth muscle, and 5-alpha-reductase inhibitors (e.g., finasteride) reduce testosterone effect.
Surgical options include transurethral resection of the prostate (TURP) and high-intensity focused ultrasound (HIFU).

Investigations for BPH

Urine culture to rule out UTI and prostatitis.
PSA measurement.
Prostate ultrasound (USS) to evaluate size, typically affecting the inner periurethral zone.

Prostate Adenocarcinoma Overview

Most prevalent cancer in men, influenced by age, race, family history, hormone levels, and environmental factors.
Growth primarily occurs in the peripheral zone of the prostate and is driven by androgens.

Grading and Diagnosis of Prostate Adenocarcinoma

The Gleason Scale grades tumors from 1 (well-differentiated) to 5 (poorly differentiated); two patterns are assessed for a combined Gleason Score.
Microscopically characterized by back-to-back gland formation and lack of normal papillary infoldings.
Invasion of dysplastic glands into surrounding smooth muscle may occur in advanced stages.

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Description

This quiz covers essential information on prostate cancer, including its symptoms, metastasis, diagnostic investigations, and management strategies. Learn about the importance of early detection and the various treatment options available for patients. Test your knowledge on key aspects of this common male cancer.