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 ?