1 / 11

Pathology of Prostate - Cancer

prostatic cancer.

vmshashi
Download Presentation

Pathology of Prostate - Cancer

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. Shashidhar Venkatesh Murthy A/Prof & Head of Pathology College of Medicine & Dentistry CLINICAL PATHOLOGY The foundation of clinical medicine. BPH4: Urinary Tract Dis: Prostate Cancer

  2. 3 Prostatic Cancer: Introduction  Adenocarcinoma, Most common male cancer, elderly (>50y),  But second common cause of cancer death in males. (next to lung)  Many prostatic carcinomas are small and clinically insignificant.  If tested, seen in many elderly dying of other causes* (incidental Ca)  But some are rapidly fatal, no specific test to detect early*  Population screening of PSA – controversial, now discouraged***  % of free PSA to total PSA is lower in men with prostate cancer.

  3. 4 Adeno-Ca Prostate Gross: 1. Irregular, stony hard 2. Peripheral / posterior BPH Cancer

  4. 5 Prostatic Cancer: Etiopathogenesis  Etiology: ?Androgens, genes (ETS, PTEN) & ?env / diet. (Not BPH)  PSA* proteolytic enzyme, liquefies semen. Not cancer specific. Normal Serum PSA < 4.0ng/L.  in Prostate damage / malignancy.  Lower in non malignant but significant overlap*.  Patients (54%) lacking both PTEN & ETV had ‘good prognosis’ (85.5% alive at 11 years)* - localized cancer without killing…! *BJC  Pathogenesis: Dysplasia  PIN  cancer. Loss of double layer in Ca PIN: Prostatic Intraepithelial Neoplasia

  5. 7 Prostatic Cancer: Microscopy Normal Gross: Hard, gritty / stoney Cancer Normal Cancer Microscopy: 1. Pleomorphic cells 2. Single layer glands 3. No secretions.

  6. 8 Prostatic Ca: Gleason Scoring: 1 Gleason Scoring: (note limitations*) 1. Biopsy microscopy study. 2. Two prominent areas. 3. Add the values. (2 10 max) 4. E.g. 3 + 4 = 7 2 5 Glands

  7. 9 Prostate Cancer: Summary  Staging: Stage-1 90% 5 year survival to Stage-4 10% survival. Summary:  Adenocarcinoma, Commonest men cancer.  Two clinical types: good & bad prognosis.  Many cancers are small, non palpable (DRE), asymptomatic discovered on needle biopsy following raised PSA level***.  20 to 40% of localised prostate cancer have normal PSA value.  PSA is useful but imperfect marker*  Progressive increase in PSA is more useful in monitoring.  Low grade, localized cancers best managed by wait & watch.

More Related