Search This Blog

Carcinoma of Prostate

  •  Most common cancer in men
  •  Second most common cause of cancer death in men
  •  Incidence increases with age
  •  Highest rate in African Americans
  • ill-defined, firm, yellow mass
  • Commonly arises in the posterior aspect of the peripheral zone

  • Adenocarcinoma
  • Gleason grading system

1.Local spread
  • Tends to grow upwards to involve seminal vesicles, bladder neck, trigone, lower end of ureter.
2. Hematogenous
  • Bone esp, pelvic bone and lower lumber vertebrae.( osteoblastic)
  • Femoral head, rib cage and skull are other common sites.
3. Lymphatic
  • Commonly goes to the obturator and pelvic lymph nodes
TNM Staging

1. T1a, T1b, T1c: incidentally found tumor.
T1a : tumor involving less than 5% of the resected specimen
T1b: Tm involving greater than 5% of the resected specimen
        T1c: impalpable tumor found following a raised PSA.

2. T2a: suspicious nodule on rectal examination confined within prostate capsule involving one lobe.
T2b: involves both lobes

3. T3: extends beyond the capsule
T3a: U/L or B/L extension
T3b: seminal vesicle extension

4. T4: tm which is fixed or invading adjacent structures other than seminal vesicles- rectum or pelvic side wall

Clinical Presentation

  • Often clinically silent
  • May present with lower back pain secondary to metastasis
  • Advanced localized disease may present with urinary tract obstruction or UTIs

  • Digital rectal exam (induration)
  • Serum PSA levels
  • Transrectal U/S and biopsy
  • Alkaline phosphatase elevated with metastasis
  • Bone scan

Local disease (T1 and T2):
 prostatectomy and/or external beam radiation
  • Metastatic disease (T3 and T4): B/L Orchidectomy
  • Estrogens or androgen receptor blockade (flutamide or leuprolide)
  • Monitor with PSA levels


  1. After reading your article I was amazed. I know that you explain it very well. And I hope that other readers will also experience how I feel after reading your article. kanker behandelen

  2. Interested in the best weight loss pill to use? If you want to lose weight and lose it fast, often times pills come into play. Lepto Connect supplement