Prostate Cancer Overview

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Questions and Answers

What is the T-stage classification for prostate cancer that involves both lobes?

T3b

T2b

T2a

T2c (correct)

The Gleason Score is calculated by taking the two lowest scores from multiple biopsy samples.

False

What type of examination is a DRE?

Digital rectal exam

In TNM staging, M0 indicates that there is _____ spread outside of the pelvis.

no Signup and view all the answers

Match the following Gleason grades with their descriptions:

G1 = Well differentiated (Gleason 2-4) G2 = Moderately differentiated (Gleason 5-6) G3 = Poorly differentiated (Gleason 7-10) G4 = Poorly differentiated (Gleason 7-10) Signup and view all the answers

What is the most common type of prostate cancer?

Acinar adenocarcinoma Signup and view all the answers

Ductal adenocarcinoma tends to grow and spread more quickly than acinar adenocarcinoma.

True Signup and view all the answers

What percentage of prostate cancers are classified as transitional cell carcinoma?

2 to 4 Signup and view all the answers

Adenocarcinomas develop in the gland cells that line the __________ of the prostate gland.

gland Signup and view all the answers

Match the following types of prostate cancer with their characteristics:

Acinar adenocarcinoma = Most common type of prostate cancer Ductal adenocarcinoma = Grows and spreads more quickly than acinar type Transitional cell carcinoma = Usually starts in the bladder before spreading Small cell prostate cancer = Classified as a type of neuroendocrine cancer Signup and view all the answers

Which type of prostate cancer can develop from flat cells covering the prostate?

Squamous cell carcinoma Signup and view all the answers

Nearly everyone with prostate cancer has ductal adenocarcinoma.

False Signup and view all the answers

Smoking and obesity are not factors that affect the aetiology of rectal cancer.

False Signup and view all the answers

What term is sometimes used to describe transitional cell carcinoma of the prostate?

urothelial carcinoma Signup and view all the answers

List one common symptom of rectal cancer.

Rectal bleeding Signup and view all the answers

In rectal cancer grading, Grade 4 is characterized by __________ cells that look completely different from normal cells.

undifferentiated Signup and view all the answers

Match the following terms with their corresponding descriptions:

Grade 1 = Well differentiated, looks like normal cells Grade 2 = Moderately differentiated, somewhat normal Grade 3 = Poorly differentiated, looks very abnormal Grade 4 = Undifferentiated, looks completely different from normal cells Signup and view all the answers

Which diagnostic test is used to check for cancer at the earliest stage?

FOB test Signup and view all the answers

Advanced rectal cancer may present with symptoms like weight loss and bowel obstruction.

True Signup and view all the answers

What is one method of treatment for T1-2, N0 rectal cancer?

Primary surgery Signup and view all the answers

Study Notes

Prostate Cancer

Summary: This presentation covers prostate cancer, encompassing aetiology, epidemiology, histology, investigations, staging, grading, spread, treatment, and survival. It also provides statistics about prostate cancer in the UK, including cases, deaths, survival rates, and prevention.

Session Outline

Sections Covered: Aetiology/epidemiology, histology, investigations, staging/grading/spread, and treatment/survival.

Prostate Anatomy

Location: The presentation shows a cross-section of the pelvis, highlighting the prostate's position relative to the bladder, urethra, penis, and rectum.

Prostate Cancer Statistics UK

Cases: 55,093 new cases of prostate cancer annually (average 2017-2019).
Deaths: 12,039 deaths from prostate cancer in the UK (2017-2019).
Survival: 78% survive for 10+ years (2013-2017 in England).
Prevention: Prevention is not clearly linked to any preventable risk factors.

Prostate Cancer Prevention and Risk Factors

Prevention Status: Not clearly linked to any preventable risk factors.
PSA Testing Challenges: Difficulty interpreting risk factors due to PSA testing.

Prostate Cancer Risk Factors

Family History: Individuals with a family history of prostate cancer are more likely to develop the disease.
Ethnicity: Black men are more prone to prostate cancer at a younger age compared to other men.

Prostate Cancer Incidence

Age of Diagnosis: The most common age for prostate cancer diagnosis is between 65 and 69 years. Risk increases with age.
Incidence Trends: Prostate cancer incidence rates have increased by 53% since the early 1990s in males.
Age-Specific Incidence: A graph showing average cases per year by age at diagnosis, displaying the incidence rate and demonstrating the peak age of diagnosis.

Prostate Cancer Histology

Adenocarcinoma: The most common type of prostate cancer. Can be acinar or ductal.
Acinar Adenocarcinoma: Develops in gland cells that line prostate glands.
Ductal Adenocarcinoma: Develops in cells lining the ducts and tends to spread faster.

Prostate Cancer Transitional Cell Carcinoma

Origin: Begins in cells that line the urethra.
Prostate Association: Often spreads from the bladder into the prostate, less commonly starts in the prostate and spreads to bladder.
Frequency: Between 2% and 4% of prostate cancers are transitional cell type.

Less Common Prostate Cancer Types

Squamous Cell Carcinoma: Develops from flat cells covering the prostate, tends to grow and spread faster.
Small Cell Prostate Cancer: Classed as neuroendocrine cancer, shows rapid growth.
Other rarer types: Sarcoma, Lymphoma.

Prostate Cancer Symptoms

Frequent Urination:
Weak/Interrupted Urine Flow:
Blood in Semen:
Straining to Urinate:
Blood in Urine:
Pain/Burning During Urination:
Urination Urgency at Night:
Erectile Dysfunction:

Prostate Cancer Investigations

Digital Rectal Exam (DRE): A physical exam
PSA test: A blood test measuring prostate-specific antigen.
Transrectal Ultrasound (TRUS): An ultrasound of the prostate.
Needle Biopsy: A tissue sample to analyze.
MRI: Magnetic resonance imaging.
CT: Computed tomography.

TNM Staging - Prostate

T-Stage: Characterizes the extent of tumor spread in the prostate. Different codes define tumor location, size, or involvement of adjacent tissues.
N-Stage: Characterizes lymph node involvement.
M-Stage: Defines the presence or absence and extent of spread to other organs outside the pelvis.
Overall Stage: A combination of T, N, and M stages categorizes cancer severity.

Grading

Gleason Scale: A grading system to categorize the degree of cancer differentiation (or abnormality) on a scale from 1 (well-differentiated) to 5 (poorly differentiated). Grade 2-4 is well-differentiated. Grade 5-6 is moderately differentiated. Grade 7-10 is poorly differentiated.

Gleason Score

Importance: Multiple samples are tested to get the highest two scores, which are then combined to determine the overall Gleason score, reflecting the level of differentiation/abnormality of the cells.

Spread of Prostate Cancer

Lymph Nodes: Inside or outside the pelvis
Bones: Bone metastasis

Possible Treatments

Active Surveillance: Close monitoring
Prostate Cancer Surgery: Removing the prostate
Radiation Therapy: Using radiation beams to kill cancer cells
Prostate Cancer Hormone Therapy: Medicines that lower the body's hormones to slow down the cancer
Chemotherapy: Drugs for treating cancer
Immunotherapy: Using the body's immune system to fight cancer

Prostate Management Flow Chart

Flowchart Description (detailed): A flowchart depicting a logical path for patient management from suspect cases (PSA and abnormalities in DRE, requiring biopsy etc.), to locally advanced, and metastatic stages, with the recommended treatment at each juncture including hormonal therapy, surgery, and radiotherapy, and their sequencing.

Rectal Cancer

Summary: Covers various aspects of rectal cancer, including aetiology, epidemiology, histology, investigations, staging, grading, spread, treatment, and survival.

Rectal Cancer Statistics UK

Number of New Cases: 44,063 per year.
Deaths: 16,808.
Survival: 53% of patients survive 10 or more years post-diagnosis (2013-2017 in England).
Prevention: 54% of cases might be preventable.

Rectal Cancer Prevention and Risk Factors

Prevention Strategies: Eat less processed or red meat, maintain a healthy weight, limit alcohol.
Risk Factors (overview): Existing bowel issues (Polyps, ulcerative colitis, Crohn's Disease etc.), smoking, obesity, limited exercise and a poor diet.

Rectal Cancer Risk Factors

Bowel Disease: A history of conditions.
Diet, Lifestyle : Smoking, obesity, inactivity, or a poor diet.
Genetics: Familial history.

Rectal Cancer Epidemiology

Incidence: Similar to trends in colorectal cancers.
Age of Diagnosis: Peak age range similar to 85-89 for prostate.
Stable Overall Trends: Bowel cancer incidence has been stable in recent years.

Rectal Cancer Histology

Adenocarcinoma: Predominant type, with percentages of subtypes (Mucinous, Signet Ring - rare, and other much rarer types such as Leiomyosarcoma, Lymphoma and Melanoma).

Rectal Cancer Symptoms

Symptoms: Bleeding from the rectum, blood in stools, changes in bowel habits, weight loss, fatigue, pain, and sensation of incomplete emptying of the rectum.

Rectal Cancer Investigations

FOB testing: Fecal Occult Blood, to check for blood in stools.
DRE: Digital rectal exam
Colonoscopy: Visual inspection of the colon.
Blood Tests: FBC and CEA assays.
Imaging: X-rays, Chest X-ray, CT/CT scan, MRI.

Rectal Cancer Grading

Grades: 1-4 based on cell differentiation (1 = well, 4 = poorly differentiated).

Rectal Cancer TNM Staging

T-stage: Classifies tumor depth.
N-stage: Defines lymph node involvement.
M-stage: Indicates distant metastasis.

Rectal Cancer Spread

Local Invasion: Growth into surrounding tissues.
Transcoelomic: Cancer travels within body cavities.
Lymphatic: Cancer spreads via lymphatic channels.
Blood-borne: Cancer travels through blood vessels to other parts like liver, lungs.

Rectal Cancer Staging

Stage Description (1-4): 0 = cancer confined to inner lining. I = invasion beyond inner lining. II = spread away from the inner lining. III = spread to lymph nodes. IV = spread to other parts of the body.

Rectal Cancer Management

T1-2, NO: Treatment with primary surgery, can be managed with chemo/radiotherapy (RT) in certain situations.
T3 or N+: Preoperative chemo-RT to reduce tumour size, then surgery and/or more chemo.
Metastatic (liver mets only): Chemo-RT for de-bulking or treatment with surgery or chemo alone, if resectable.
Non-resectable metastatic: Chemotherapy with localised radiotherapy if not curable.

Rectal Cancer Chemotherapy

Common Drugs: 5-Fluorouracil (5FU) with leucovorin, capecitabine, oxaliplatin.
Targeted therapies: Monoclonal antibodies (such as Avastin and Cetuximab)

Metastatic Spread

Organ Sites: Bone, brain, prostate, and lung are common sites of metastasis for various cancers.

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Description

This quiz covers key aspects of prostate cancer, including its aetiology, epidemiology, histology, and treatment options. It also discusses important statistics regarding prostate cancer cases, deaths, and survival rates in the UK. Prepare to test your knowledge on this prevalent condition and its management.