Please confirm topic selection

Are you sure you want to trigger topic in your Anconeus AI algorithm?

Please confirm action

You are done for today with this topic.

Would you like to start learning session with this topic items scheduled for future?

Updated: Dec 27 2021

Prostate Cancer

  • Snapshot
    • A 58-year-old man presents to his primary care physician for an annual examination. He does not have any acute complaints and feels otherwise healthy. He has a past medical history of hypertension that is adequately controlled with lisinopril. Family history is remarkable for prostate cancer in his father. Digital rectal examination is notable for an asymmetric, nodular prostate. Prostate-specific antigen level is elevated at 15 ng/mL.
  • Introduction
    • Overview
      • malignancy arising from the prostate
        • most prostate cancers are adenocarcinomas
          • arises most commonly in the posterior lobe (peripheral zone)
  • Epidemiology
    • Incidence
      • most common cancer in men
      • more common in older men (> 65 years of age)
    • Risk factors
      • increasing age
      • family history
      • black race
  • Presentation
    • Symptoms
      • asymptomatic in most cases
      • lower urinary tract symptoms
        • e.g., urinary retention
    • Physical exam
      • digital rectal exam (DRE)
        • prostate nodules, induration, or asymmetry
  • Studies
    • Serum labs
      • prostate-specific antigen (PSA)
        • not specific for malignancy (e.g., can be elevated in benign prostatic hyperplasia)
    • Invasive studies
      • biopsy
        • indication
          • confirms the diagnosis and important for pathologic staging
            • provides a Gleason grade
  • Differential
    • Benign prostate hyperplasia
      • differentiating factors
        • symmetric enlargment and firmness of the prostate
  • Treatment
    • Treatment dependent on pathological features, metastasis, and the patient's life expectancy
      • e.g., if patient is already on maintenance GnRH therapy, external beam radiation therapy is used to treat symptomatic metastasis
  • Complications
    • Obstructive uropathy
    • Metastatic spinal cord compression
      • prostate cancer can metastasize to the spine, causing epidural spinal cord compression
        • if metastatic spinal cord compression is suspected or confirmed in a patient with neurologic deficits, initial management includes administration of high-dose steroids to reduce edema and inflammation
        • in patients with suspected spinal cord compression but no neurologic deficits, steroid therapy may not be necessary
        • if neoplastic spinal cord compression is suspected, work-up includes:
          • MRI is first-line imaging modality
          • CT myelography is second-line imaging modality, for patients with contraindications to MRI
1 of 0
1 of 4
Private Note

Attach Treatment Poll
Treatment poll is required to gain more useful feedback from members.
Please enter Question Text
Please enter at least 2 unique options
Please enter at least 2 unique options
Please enter at least 2 unique options