Cancer of the glandular epithelium in the prostate. Most common prostate cancer
TNM staging
Causes/Factors
- Male%
- Ethnicity
- FH - BRCA1/2
- Pesticide exposure
- Increasing age
- Family history
- Black African or Caribbean origin
- Tall stature
- Anabolic steroids
Risk of cancer age
Clinical Features
Local Primary Tumour Effects
- Frequency, urgency, dysuria
- Haematuria
- Urinary obstruction
Effects of Distant Metastases
- Bone - check calcium
Paraneoplastic Syndromes
Rare
Diagnostic Tests
Prostate exam
Benign
- Smooth
- Symmetrical
- Central sulcus
Infected
- Enlarged
- Tender
- Warm
Cancerous
-
Firm
-
Asymmetrical
-
Craggy/irregular
-
Loss of central sulcus
-
May be hard nodule
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Prostate-Specific Antigen (PSA) Test: Blood test to measure PSA levels (elevated levels may indicate prostate issues). See here for details
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Biopsy: Removal and examination of a tissue sample to confirm cancer.
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Imaging: MRI, CT, or Bone scans to determine cancer spread (if applicable).
Management
- Active Surveillance: Monitoring for slow-growing/early cancers.
- Surgery: Radical prostatectomy to remove the prostate gland.
- Radiation Therapy: Targeted radiation to kill cancer cells.
- Hormone Therapy: Reducing testosterone levels to slow cancer growth.
- Chemotherapy: For advanced or aggressive cases.
Brachytherapy involves implanting radioactive metal “seeds” into the prostate
Complications/red Flags
- Metastasis: Cancer can spread to nearby tissues or distant organs.
- Urinary and Sexual Dysfunction: Treatments may affect urinary and sexual function.
- Recurrence: Cancer may return after treatment.