The prostate gland Incidence of Prostate Cancer and

The prostate gland

Incidence of Prostate Cancer and Prostate Cancer Deaths, Based on Annual Predictions

Risk Factors Associated with Prostate Cancer • Probable risk factors - Age - Race - Genetic • Possible risk factors - Environmental - Occupational - Diet - Hormonal

Clinical Presentation

DIAGNOSIS • • Digital rectal examination (DRE) Prostate specific antigen (PSA) Transrectal ultrasonography (TRUS) Prostate biopsy

Digital rectal examination (DRE)

Serum PSA in Untreated Patients with Prostatic Cancer Stage A 1 A 2 B 1 B 2 C D 1 D 2 Mean (ng/ml) 5. 1 7. 96 5. 64 14. 25 32. 46 51. 46 410. 00 Percentage above normal 45 69 75 78 75 93 97

Prostate specific antigen (PSA) • คาปกตของ serum PSA - 4 ng/m. L (Hybritech) - 2. 8 ng/m. L (Yang Pros-check) • ������ BPH ������ Prostate Cancer ������� biopsy ����� simple prostatectomy �����

PSA Age-Spacific reference range Age (year) PSA (ng/ml) 40 -49 50 -59 60 -69 70 -79 2. 5 3. 5 4. 5 6. 5

Treatment • Watchful waiting • Surgery and Radiation therapy • Hormonal therapy - Luteinizing Hormone-Releasing Hormone Agonists - Antiandrogens - Combined Hormonal Blockade • Chemotherapy

Hormone Therapy

Antiandrogens

EVALUATION OF THERAPEUTIC OUTCOMES • tumor size, involved lymph nodes, and tumor markers such as PSA • PSA level is checked every 6 months for the first 5 years

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