This lesson will increase your knowledge of concepts covered in the following TEKS for biology:

1. This lesson will increase your knowledge of concepts covered in the following TEKS for biology: 3.a – Analyze, review, and critique scientific explanations 3.c – Evaluate impact of research on scientific thought, society, and the environment 10.a – Interpret the functions of systems in organisms 10.b – Compare the interrelationships of organ systems to each other and to the body as a whole 11.a – Identify and describe the relationships between internal feedback mechanisms in the maintenance of homeostasis 11.b – Investigate and identify how organisms respond to external stimuli 11.c – Analyze the importance of nutrition, environmental conditions, and physical exercise on health

2. Previous LessonMenopause and Hormone Replacement Therapy

3. QUESTION: During a tubal ligation, a piece of each Fallopian tube is removed. Why would this result in sterility?

4. Tubal ligation blocks movement of egg down the Fallopian tube and movement of sperm up the Fallopian tube Based on: S. Mader's Inquiry Into Life, Wm. C. Brown Publishers

5. QUESTION: RU486 (abortion pill) blocks the effects of progesterone. Why does this result in loss of the implanted embryo? Based Time, June 14, 1993

6. Hormonal Regulation of Ovarian and Uterine Cycles Without progesterone, the endometrium is not maintained, breaks down, and is lost from the body Based on Mader, S., Inquiry,Wm. C. Brown Publishers

7. QUESTION: What study tested the hypotheses about the effects of HRT and what do scientists call this type of design?

8. Women’s Health Initiative • Study began in 1993 and was to last 15 years • Involved 67,000 in three random clinical trials (Dietary Modification, Calcium/vitamin D supplements, and HRT) • HRT involved 16,000 women to assess the pros and cons of estrogen-progestin therapy HRT study was stopped in July 2002

9. Two-group experimental design Test the health effects of HRT CONTROL GROUP EXPERIMENTAL GROUP Did not receive HRT Received HRT Was given placebo Estrogen and Progestin Record results Record results Compare and analyze the test results Report on experimental design, test results, and conclusions drawn from results

10. QUESTION: Women who have complete hysterectomies can experience the symptoms of menopause. Why can they be treated with estrogen alone? The ovaries, fallopian tubes and uterus are removed during a complete hysterectomy

11. Without a uterus, a woman cannot get uterine cancer and, theoretically, can take estrogen only (without progestin) to reduce menopausal effects

12. Prostate Cancer Today’s Lesson

13. Overview of Lesson • Male reproductive system • Problem of enlarged prostate • Prostate cancer • Detection • Treatment • Dilemma for older men

14. Pathway of Sperm Seminiferous tubules in testes Stored in epididymis Vas deferens Urethra • Accessory Glands • Seminal vesicles • Prostate gland • Bulbourethral glands

15. Testicle Based on: Mader, S., Inquiry Into Life, McGraw-Hill

16. Male Anatomy Based on: Mader,S., Inquiry Into Life, Wm. C. Brown Publishers

17. Accessory Glands • Seminal vesicles • nourishment for sperm • Prostate gland • Acidic solution which stimulates ATP production of the sperm • Bulbourethral glands (Cowper’s) • lubricating fluid that is alkaline and neutralizes the acid environment of the penile urethra

18. Semen • Millions of sperm • Fluid from seminal vesicles • Fluid from prostate gland • Fluid from bulbourethral glands

19. Male Hormones Based on: Mader, S., Inquiry Into Life, McGraw-Hill

20. Negative Feedback & Homeostasis Overview Negative feedback effect of testosterone is the prime homeostatic mechanism maintaining male characteristics at a constant level Hypothalamus Pituitary Testes Male sexuality Releasing hormone (GnRH) LH & FSH Negative Feedback Sperm Testosterone

21. What is known about the effects of overriding the homeostasis of the male hormonal system and taking too much testosterone? Testosterone Effects

22. Overview of Lesson • Male reproductive system • Problem of enlarged prostate • Prostate cancer • Detection • Treatment • Dilemma for older men

23. Enlarged Prostate Normal Prostate Based on : Harvard Family Health Guide, 1999 -Size of walnut until about 50 years old-Urethra open -After 50, can enlarge to size of lemon-Urethra squeezed

24. Enlarged Prostate Based on: Mayo Clinic Health Letter, April 2001 • Constricts urethra • Dilates bladder • Dilates ureters • Causes discomfort Based on: Harvard Health Letter, December 1987

25. Transurethral Resection of the Prostate Based on : Harvard Family Health Guide, 1999

26. Overview of Lesson • Male reproductive system • Problem of enlarged prostate • Prostate cancer • Detection • Treatment • Dilemma for older men

27. Spread of Prostate Cancer Based on : Harvard Family Health Guide, 1999 Prostate cancer kills if the cells leave the prostate area and spread throughout the body

28. What changes in a prostate cell would lead to metastatic prostate cancer? Cellular Changes

29. Prostate Cancer Risk • Second most common cancer in males (after skin cancer) • Lifetime risk of 1-in-6 of being diagnosed with prostate cancer • Men over 50 years • Gene variants + family history = 9x risk • African-American higher mortality risk • Veterans exposed to Agent Orange higher risk

30. PROSTATE CANCER:more prevalent than deadly Based on: Mayo Clinic Health Letter, April, 1994

31. Overview of Lesson • Male reproductive system • Problem of enlarged prostate • Prostate cancer • Detection • Treatment • Dilemma for older men

32. Goal is to detect prostate cancer in the earliest stage of the disease May take 10 years to go from A to D Based on: Mayo Clinic Health Letter, April 1985

33. Detection of Prostate Cancer • Digital rectal exam • PSA test • prostate specific antigen

34. Digital Rectal Exam • Start annual exams when 40 years old • Physician feeling for marble sized tumor Based on: Mayo Clinic Health Letter, April 1985

35. Stages of Prostate Cancer Digital Rectal Exam May take 10 years to go from A to D Based on: Mayo Clinic Health Letter, April 1985

36. PSA Levels by Age PSA Test • Detects an enzyme (prostate specific antigen) made by the prostate • PSA increases with age in healthy men • PSA increases dramatically with prostate cancer but can also increase with ejaculation, hair growth drugs or an enlarged prostate • Only detects 80% of prostate cancers Based on: Time, April 1, 1996

37. Needle Biopsy for Prostate Cancer • Biopsy gun inserted through anus • Needles shot into prostate from rectum • 6 to 18 samples taken • Attempting to detect cancer in stage A • Analysis of cancer spread and cell type Based on: Mayo Clinic Health Letter, April, 1985

38. NEW CASES OF PROSTATE CANCER(per 100,000 population) Based on: Mayo Clinic Health Letter, November 1998

39. New Cases vs. Deaths 2007 Deaths New cases

40. Overview of Lesson • Male reproductive system • Problem of enlarged prostate • Prostate cancer • Detection • Treatment • Dilemma for older men

41. Prostate Surgery • Radical • Prostatectomy • Nerve-Sparing • Prostatectomy Based on: U.S. News and World Report, May 22, 2000

42. Side Effects of Surgeries • Incontinence (most men eventually regain control of bladder function) • Impotence (most men never regain normal sexual function)

43. Radiation Treatments Radiation Seed Implants Based on: U.S. News and World Report, May 22, 2000 Based on: U.S. News and World Report, May 22, 2000

44. Side Effects of Radiation • Less recovery time • Can impair sexual • function • May not eliminate all • tumor cells • Surgery is not possible • after radiation

45. Hormone Therapy • Drugs eliminate or block • testosterone production by • testes • Used when cancer has spread • beyond the prostate

46. Side Effects of Hormone Therapy • Can impair sexual function • Does not eliminate tumor cells

47. Overview of Lesson • Male reproductive system • Problem of enlarged prostate • Prostate cancer • Detection • Treatment • Dilemma for older men

48. INVASIVE CANCER RATES BY AGE Probability of developing invasive prostate cancer in the following age groups Based on: Newsweek, June 16, 2003

49. Total 1999 prostate cancer deaths by age group (estimated) Based on: U.S. News and World Report, May 22, 2000

50. The Dilemma • 80% of men in their 80s probably have some prostate cancer cells when they die • Prostate cancer may spread slowly, taking 10 years or more to be life threatening • If prostate cancer is detected when 80 years old, life expectancy may be shorter than the time required for the spread of prostate cancer • One approach is “watchful waiting” • Hormone therapy (surgical or chemical castration)