CO SCI 136 Lecture Notes - Lecture 12: Benign Prostatic Hyperplasia, Tnm Staging System, Bone Metastasis
Document Summary
The second leading cause of cancer death in men (after lung cancer). Most are adenocarcinomas arising in peripheral zone of the prostate. Adenocarcinoma (>95%): often multifocal; arising in peripheral prostate. Urothelial carcinoma of the prostate (4. 5%): associated with uc of bladder: does not follow tnm staging, not hormone-responsive. The exact aetiology is unknown; suggested aetiological factors: Increased testosterone: conflicting evidence on hormonal influence as a direct cause. Adenocarcinoma: malignant proliferation of prostatic glands arising in peripheral zone. Lymphatic spread to regional nodes: obturator > iliac > presacral/para-aortic. Hematogenous dissemination occurs early: sclerotic bony lesions. Black ethnicity; north american / northwest european descent. May present with nocturia or obstructive symptoms e. g. hesitancy, poor stream, terminal dribbling. May rarely be associated with: palpable lymph nodes / lymphoedema (due to obstructing metastases, constitutional symptoms (e. g. weight loss/anorexia, lethargy, back/bone pain (due to bone metastases) Digital rectal examination (dre) may reveal hard irregular (asymmetrical) nodule or diffuse dense induration involving one or both lobes.
