carcinoma of the prostate Flashcards Preview

GU > carcinoma of the prostate > Flashcards

Flashcards in carcinoma of the prostate Deck (17):
1

describe prostatic zones

transitional zone
- around urethra
- site of benign prostatic hyperplasia

peripheral zone
- atrophy
- most carcinoma

2

etiology and pathogenesis of prostatic carcinoma

genetic factors
- familial incidence
- higher in black Africans

Environment
- diet

3

clinical features of prostatic carcinoma

no specific symptoms - obstructive symptoms late

examination = firm area/nodule

4

diagnosis of prostatic carcinoma

- PSA

- transrectal ultrasound / MRI

- digital rectal examination

- biopsy

5

describe the grading system of prostatic carcinomas

Gleason grading
- pattern 1-5
- add two most common patterns to get score

<6 = grade 1
7 (3+4) = grade 2
7 (4+3) = grade 2
8 (4+4 or 3+5) = grade 3
9, 10 = grade 4

6

describe the problems with the grading system of prostatic carcinomas

- patterns 1 & 2 stopped being used therefore no longer a score from 1-5
- as 6 is the lowest, patients perceive this negatively thinking its the middle of the range

7

how do prostate cancers progress

local spread
- extraprostatic fat
- seminal vesicles
- other pelvic structures e.g. bladder, rectum

lymph nodes
- pelvic, aortic - may block off ureters

distant metastasis
- particularly vertebral bodies

8

where does the prostatic nerve lie

between prostate and rectum

9

describe the management of prostate cancer

small low-grade tumours - no treatment (active surveillance)

significant tumours - radical treatment

advanced tumours - palliative treatment

10

describe radical treatment

radical prostatectomy - entire prostate removed

radical radiotherapy - high dose radiation

11

describe palliative treatment

anti-androgen treatment
- giving drugs or removing testes

palliative radiotherapy
- local or metastases

12

describe the aetiology and pathogenesis of carcinoma of the bladder

aetiology = smoking, industrial chemicals

pathogenesis = arises from transitional cell CIS

13

clinical features (symptoms) associated with carcinoma of the bladder

- haematuria
- recurrent or new tumours often
- follow by urine cytology, cystoscopy

14

morphology of carcinomas of the bladder

macro: most are papillary, may become invasive

micro: most are transitional, some squamous, adenocarcinoma

15

treatment for carcinomas of the bladder

local therapy = BCG

if tumour is in detrusor muscle cystectomy is required

16

macroscopic features of renal cell carcinoma

well-circumscribed mass
mottled red, yellow and brown
part cystic
may invade renal vein

17

clinical features of renal cell carcinoma

symptoms arise late
- haematuria
- flank pain
- palpable abdominal pain
- ectopic hormone production