Prostate Cancer

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Prostate Cancer by Mind Map: Prostate Cancer

1. Etiology

1.1. Genetics

1.1.1. 8q24 region on chromosome 8 that are associated with increased risk of prostate cancer.

1.1.2. Gene alterations on chromosome 1, chromosome 17, and the X chromosome have been found in some patients with a family history of prostate cancer. The HPC1 (hereditary prostate cancer 1) gene and the PCAP (predisposing for cancer of the prostate) gene are on chromosome 1, while the human prostate cancer gene is on the X chromosome.

1.1.3. BRCA-2 mutations increase the risk for prostate cancer that is more aggressive and develops at a younger age.

1.2. Diet

1.3. Hormones

2. Treatment

2.1. Surgery

2.1.1. Radical retropubic prostatectomy

2.1.2. Radical perineal prostatectomy

2.2. Radiation

2.3. Cryotherapy

2.4. Hormone Therapy

2.5. Chemotherapy

2.6. Vaccine Therapy

2.6.1. Sipuleucel-T (Provenge)

3. Common Findings

3.1. Urinary complaints or retention Back pain Hematuria

3.2. Advanced Findings

3.2.1. Cancer cachexia Bony tenderness Lower-extremity lymphedema or deep venous thrombosis Adenopathy Overdistended bladder due to outlet obstruction

4. Risk Factors

4.1. Age

4.1.1. Prostate cancer is rare in men younger than 40, but the chance of having prostate cancer rises rapidly after age 50. About 6 in 10 cases of prostate cancer are found in men older than 65.

4.2. Race/ethnicity

4.2.1. Prostate cancer occurs more often in African-American men and in Caribbean men of African ancestry than in men of other races. African-American men are also more than twice as likely to die of prostate cancer as white men.

4.3. Gene changes

4.3.1. -Inherited mutations of the BRCA1 or BRCA2 genes raise the risk may increase prostate cancer risk in some men. -Men with Lynch syndrome (also known as hereditary non-polyposis colorectal cancer, or HNPCC), a condition caused by inherited gene changes, have an increased risk for a number of cancers, including prostate cancer.

5. Diagnostic Tests

5.1. Elevated prostate-specific antigen (PSA) level

5.1.1. -No PSA level guarantees the absence of prostate cancer. -The risk of disease increases as the PSA level increases, from about 8% with PSA levels of ≤1.0 ng/mL to about 25% with PSA levels of 4-10 ng/mL and over 50% for levels over 10 ng/mL

5.2. Abnormal digital rectal examination (DRE) findings

5.2.1. -DRE is examiner-dependent, and serial examinations over time are best. -Most patients diagnosed with prostate cancer have normal DRE results but abnormal PSA readings.

5.3. Biopsy

5.3.1. -Biopsy establishes the diagnosis -False-negative results often occur, so multiple biopsies may be needed before prostate cancer is detected

5.4. Screening

5.4.1. -50 years of age for men at average risk who have at least a 10-year life expectancy -40 or 45 years of age for African Americans and men who have had a first-degree relative diagnosed with prostate cancer before age 65 years -40 years of age for men with several first-degree relatives who had prostate cancer at an early age

6. Causative Factors

6.1. Diet: Obesity

6.2. Gene Mutation

6.2.1. BRCA 1 and BRCA