What are we going to talk
Anatomy of prostate
Very basic histology!
How prostate cancer starts and spreads
Epidemiology and risk factors
Presenting symptoms and signs
Investigations and Management
Name 5 main anatomical relations of the prostate
Pelvic floor (apex)
From which cells do prostate cancers arise?
What types of cancers arise in the prostate?
Normal glands and stroma
Where does prostate cancer
How does prostate cancer
Commonly to bone
What percentage of 80 yr old men have prostate ca?
From 50-80% in autopsy studies!
Prevalence from autopsy studies
Why did incidence rise in 1990’s?
Probably secondary to PSA testing!
Name 2 endogenous and 2 exogenous
aetiological factors for prostate ca
Age, race, genetics, hormone levels
Diet: high fat (inc risk), omega 3, selenium,
vitA, soya (dec risk)
Vasectomy (+1.56 RR)
Name 2 general and 2 specific presenting features for
Spread to other
Name 5 clinical tests or investigations for a
patient with suspected prostate ca
Bloods: FBC, U+E, Ca, G+S, PSA
Imaging: CXR, USS, CT, MRI, bone scan
Invasive: TRUS biopsy
Note 10% are incidental on TURP for BPH
What are the principles of management of a
patient with prostate cancer?
“Die with not from”, Watchful waiting, palliation
Hormonal treatment, Radiotherapy
Medical therapy is targeted at all parts of the
LHRH, anti-androgens or complete blockade, oestrogens,
some men opt for orchidectomy (eunochs don’t get prostate
cancer or lap), TURP for LUTS
What have we talked about?
Epidemiology, Aetiology and Risk Factors
Clinical Presentation and investigations
Basics of Management