Question

Jon Doe a 60-year-old male, was diagnosed with prostate carcinoma 15 months ago. At that time, he underwent a radical prostatectomy and was found to have disease confined to the prostate. Before surgery, his prostate specific antigen (PSA) was 25 ng/ml (normal <3.0). At a regular follow-up exam Mr. Doe's only complaint was mild backache, which he attributed to strain. His PSA was found to be 100 mg/ml and a CT scan of the pelvis showed a number of enlarged lymph nodes consistent with metastatic prostate cancer. A bone scan revealed blastic lesions in the lumbar region of the spine. Mr. Doe was otherwise asymptomatic and his only other medical problems are 15-year history of essential hypertension and evidence of early congestive heart failure. 1. What are Mr. Doe's risk factors for prostate cancer? 2. List the clinical manifestations Mr. Doe might exhibit in the course of his cancer. What is the pathophysiology behind each clinical manifestation?

Answer 1

1.Risk Factors

*Age

*Lifestyle changes

*Dietary habits

*Genetic factors

*Race and ethnicity

The risk of prostate cancer increased with age after 50 years.Mr.Doe is having 60 years.

2.Clinical manifestations

Usually patients will be asymptomatic in early stages.Some patients may experience,

*Pain in the pelvic region

* Decreased force of urine

*Dribbling of urine

*Heamaturia

* Pelvic pain

*Bone pain etc.

*Erectile dysfunction

PATHOPHYSIOLOGY

Prostate gland cells mutated into cancer cells

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Cancer cells begin to multiply

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Spread to surrounding prostate tissue and forming tumour

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Changes in the gland ➡️ urinary dysfunction such as Heamaturia, dribbling of urine, decreased force of urine.

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Tumour grow large and invaded nearby structure ➡️affects vas deferens➡️erectile dysfunction

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Metastasis to other organs through blood and lymphatic system

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Clinical manifestations such as bone pain,pelvic pain etc