INTRODUCTION TO UROLOGIC ONCOLOGY Prof Dr Faruk Yencilek
- Slides: 15
INTRODUCTION TO UROLOGIC ONCOLOGY Prof. Dr. Faruk Yencilek
PROSTATE CANCER Most frequently diagnosed cancer (USA) Number 1 in cancer related male mortality Incidence increases with age: ◦ <40 ◦ 40 -59 ◦ 60 -79 1/10, 000 1/100 1/8 Life-time P Ca. Risk of a 50 - yo male: ◦ Latent (autopsy): 40% ◦ Clinic: 9. 5% ◦ Death: 2. 9%
Many cancers can remain latent and do not threaten the patient’s life. However, becomes symptomatic in some patients, and kills the patient if left untreated Wide spectrum in the biological behaviour of the disease makes it difficult to make a decision on patient basis.
Risk factors: Presence of P Ca. in family is a risk factor! ◦ 1. Degree 1 relative 2 -fold 2 relatives 5 -fold 3 relatives 11 -fold ◦ Annual PSA follow-up must start at age of 40.
Diet Geography - life style Race P Ca. incidence same in autopsies Clinic P Ca incidence different – Low in Asian race ◦ Diet may not start cancer, but may affect the progress of cancer.
Fat: May affect androgen level Causes the formation of free radicals Fatty acid metabolites can be carcinogenic Polyunsaturated linoleic acid in red meat
Diet Soy – isoflavon ◦ Genistein – EGFR inhibition; P Ca cell inhibition. Lycopene ◦ Carotenoid, tomatoes, antioxidant Selenium ◦ In antioxidant glutathion peroksidase Vitamin E (alpha-tocopherol) ◦ Antioxidant Green tea (polyphenols)
Pathology Gleason scoring system ◦ Glandular pattern; not cytologic features ◦ Example: Gleason 3+4: 7
Clinical suspicion Abnormal serum PSA value Suspicious digital rectal examination To diagnose TRUS guided biopsy Standard 12 cores Bx (-) and still suspicious re-biopsy
Prostate Specific Antigen (PSA) Enzyme (serine protease) Secreted from prostatic epithelial cells Liquidification of semen Prostate specific, not prostate cancer !! What is abnormal? ◦ 4, 0 2, 5 ng/ml.
Staging TNM staging is based on DRE findings. To obtain more detailed information, inform the patient and plan the treatment: ◦ Biopsy findings ◦ Nomograms ◦ Radiologic imaging methods
TREATMENT Classic treatment altenatives stage by stage Individualied treatment
Localized P Ca. Surveillance Radical prostatectomy ◦ Open surgery ◦ Laparoscopic prostatectomy ◦ Robotic surgery Radiation therapy ◦ External beam Rx ◦ Brachytherapy
Locally Advanced Disease Neoadjuvant hormonal treatment + Radiation therapy
Metastatic Disease Hormonal Treatment
- Dr faruk yencilek
- Emt chapter 18 gastrointestinal and urologic emergencies
- Faruk kenç
- Ganimet seç
- Bizim memleket indir
- Faruk sari
- Faruk gözübüyük
- Divan fenerbahçe faruk ilgaz tesisleri
- Texte argumentatif développement
- Unc hematology oncology fellows
- 3rd annual immuno oncology bd&l and investment forum
- Steelhead oncology
- Kusum viswanathan
- Oncology haematology helpline triage tool
- Ons pep
- Impact of nf1pn