Prostate cancer power point presentation

prostate cancer power point presentation

1. Osama Aldweik Prostate Cancer Al- Quds university Dr. Mahmoud Allan Yahya Ghannam

2. Prostate Cancer Prostate cancer is one of the most common types of cancer in men. Prostate cancer usually grows slowly and initially remains con f ined to the prostate gland, where it may not cause serious harm . 3

3. Epidemiology

4. Risk factors • - Advanced age (> 50 years) • - Family history • - African- American descent • - Genetic disposition (e.g., BRCA2 , Lynch syndrome) • - Dietary factors: high intake of saturated fat, well- done meats, and calcium 8

5. Methods of spread

6. Symptoms Typically asymptomatic - Early prostate cancers detected during screening tests. • • Patients may present with features of complicated lower urinary tract symptoms (LUTS), including: - Urinary retention ◦ ◦ ◦ Hematuria Incontinence Flank pain (due to hydronephrosis) Advanced prostate cancer can manifest with: ◦ Constitutional symptoms: fatigue, loss of appetite, unintentional weight loss ◦ Features of metastatic disease; examples include: ▪ ▪ ▪ Bone pain (due to bone metastasis, especially in the lumbosacral spine) Neurological de f icits (e.g., due to vertebral fracture causing spinal cord compression) Lymphedema (caused by obstructing metastases in the lymph nodes) 9

7. Diagnostic Parameters Prostate- Speci f ic Antigen: is a protein produced by the prostate gland. is an organ-speci f ic marker. It is not cancer-speci f ic All men have a small amount of PSA in their blood, and it increases with age. Prostate cancer can increase the production of PSA, also benign conditions PSA level should usually be below 2.5 ng/mL Mostly PSA levels up to 4.0 ng/mL Total PSA levels ▪ ▪ ▪ PSA < 2.5 ng /mL: Prostate cancer is unlikely. PSA 2.5–4 ng /mL: Prostate cancer is possible in symptomatic patients. ▪ ▪ PSA > 10 ng /mL: > 50% chance of prostate cancer ▪ 1- PSA (Prostate- Specific Antigen) !!A PSA level ≤ 4 ng /mL does not exclude prostate cancer! Psa poorly specific for prostate cancer PSR ratio : Free psa /total psa <25% more likely to be cancer >25% less likely PSA density:total psa /prostate volume PSA 4–10 ng /mL (moderately elevated PSA): ∼ 25% chance of prostate cancer PSA velocity: changing PSA level over time Type y > o u r t e x t 0.8 ng more likely to be. Cancer <0.8 less likely Do not calculate if the patient uses 5a reductase inhibitors like finastiride

8. 2- Digital rectal examination (DRE) A DRE should be performed in individuals with elevated serum PSA features suggestive of prostate cancer include: ◦ ◦ ◦ 11 Localized indurated nodules on an otherwise smooth surface Prostatomegaly , lobar asymmetry Hard nontender nodules

9. 3- MRI and CT Scan: To access the extension into the bladder and lymph nodes for staging the cancer and to evaluate bone metastasis.

10. 4- Transrectal ultrasound of the prostate predominantly used to guide prostate biopsy if there is clinical suspicion of prostate cancer

11. 4- Biopsy: This aid in the diagnosis and help to determine the Gleason score. The samples of tissue from the biopsy are studied in a laboratory. If cancerous cells are found, they can be studied further to see how quickly the cancer will spread. lower the score, the less likely the cancer will spread: A Gleason score of <7 means the cancer is unlikely to spread. A Gleason score of =7 means there is a moderate chance of the cancer spreading. A Gleason score of >7 means there is a signi f icant chance the cancer will spread

12. Staging TNM T: Tumor. T3: Tumor spread out side the capsule of the prostate . T4 : Tumor spread to the surrounding structures . T1 : Tumor not felt by PR exam. & not seen by imaging . T2 : Tumor localized to the prostate felt by PR exam. or seen by imaging.

13. Treatment The treatment of prostate cancer can vary based on the stage and aggressiveness of the cancer. Common treatment options include: 1. Active Surveillance : For low- risk cases, monitoring the cancer's progression with scheduled DRE, PSA, prostate biopsies, and mpMRI

14. ▪ ▪ Gonadotropin-releasing antagonist (e.g., degarelix) GnRH receptor antagonist (e.g., relugolix) ◦ * Surgical castration : bilateral orchiectomy • ◦ ◦ ◦ ◦ ◦ Adverse effects Incre a sed risk of osteoporosis a nd fr a ctures Sexu a l dysfunction: loss of libido, erectile dysfunction Ch a nge in body im a ge: gynecom a sti a , weight g a in, decre a sed penile a nd testicul a r size - Ch a nge in body composition: incre a sed body f a t, decre a sed muscle m a ss Incre a sed c a rdiov a scul a r a nd met a bolic risk Anemi a 2. Hormonal Therapy This can help suppress the growth of cancer cells by reducing the levels of male hormones (androgens). Androgen deprivation therapy (ADT) *Medical castration : decreases pituitary stimulation of androgen production by the testes - Gonadotropin-releasing hormone (GnRH) agonists (e.g., leuprolide) Should be administared with anti androgens to prevent flares

15. Androgen synthesis inhibitors and androgen receptor antagonists • Indication : Addition to ADT in locally advanced and metastatic prostate cancer • *Androgen synthesis inhibitors ◦ - Mechanism of action: inhibition of CYP17 gene products → inhibits androgen synthesis in the adrenal glands, testis, and tumor tissue ◦ - Commonly used agent: abiraterone ◦ ▪ ▪ Speci f ic adverse effects: Increased production of mineralocorticoids: hypertension, hypokalemia, cardiac arrhythmias Inhibition of glucocorticoid production: adrenal insuf f iciency so (Glucocorticoids should be co-administered to avoid adrenal insuf f iciency.) • *Androgen receptor antagonists (antiandrogen therapy) ◦ Mechanism of action: displaces androgens from androgen receptors ◦ Commonly used agents: apalutamide and enzalutamide (second-generation antiandrogens) 2. Hormonal Therapy

16. Treatmen t 3. Radiation Therapy: External beam radiation or brachytherapy (internal radiation) can be used to target and destroy cancer cells After prostatectomy Life expectancy more. Than 10 years T1+T2 4. Surgery: Prostatectomy is the surgical removal of the prostate gland. This can be done through open surgery or minimally invasive procedures like laparoscopy or robotic- assisted surgery. 5. Chemotherapy: Sometimes used for advanced cases that don't respond to other treatments . 6. Management of bone health