Biology of Disease

Figure 17.33Diagrams illustrating (A) the normal

appearance of the prostate gland and (B) a rectal

examination of a cancerous prostate gland.

SPECIFIC TYPES OF CANCERS

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A)

B)

Prostate

gland

Prostate

cancer

Anus

Bladder

Vas deferens

Urethra

Seminal

vesicle

Ejaculatory

duct

tests because above normal levels of PSA are found in conditions other than
cancer, for example in urinary infections. Following referral, additional tests
undertaken to determine the extent of the problem include an isotopic scan of
bones and an MRI or CT scan. Biopsies of the prostate are obtained by passing
a needle through the rectum into the prostate, aided by an ultrasound scan.

Prostate cancers are commonly graded using the Gleason system which scores
the cancer according to the growth pattern and the arrangement of the cancer
cells within the prostate. The higher the score, the more likely the tumor is to
spread. The tumors are staged as shown in Table 17.9 and Figure 17.34.

Treatment for prostate cancer

The treatment for prostate cancer is determined by the grade and stage of
the tumor, including metastasis, the age and health of the patient and the
concentration of PSA in the blood. The range of treatments for early prostate
cancer includes surgical removal of the prostate gland or prostatectomy,
radiation therapy, hormonal therapy, or combinations of any or all of these.
Chemotherapy is rarely used to treat prostate cancer. Depending on the age
of the patient, an early stage cancer may not require treatment, but may be
actively monitored until treatment is needed. Prostate cancers often grow
slowly and the treatments, which have considerable side effects, should