Sections View Full Chapter Figures Tables Videos Annotate Full Chapter Figures Tables Videos Supplementary Content ++ 185 Malignant neoplasm of prostate233.4 Carcinoma in situ of prostate ++ C61 Malignant neoplasm of prostateD07.5 Carcinoma in situ of prostate ++ 4C: Impaired muscle performance6B: Impaired aerobic capacity/endurance associated with deconditioning +++ Description ++ Cancer begins in prostate glandWraps around the urethra98% of prostatic tumors are adenocarcinomas1Aggressive and slow-growing forms +++ Essentials of Diagnosis ++ Prostate Specific Antigen (PSA) screensNeedle biopsyGleason grade to assess risk of cancer spreadingThe Gleason scale assigns cancer cells a score from 1 to 10, by combining the two most common patterns of cells to give a total score (i.e., 3 + 4 = grade 7)These scores are broken down into three main levelsGleason score of 4 or less = low-grade (well differentiated)Gleason score between 4 and 7 = intermediate grade (moderately differentiated)Gleason score between 8 and 10 = high-grade (poorly differentiated)ABCD stages of prostate cancerStage A: Cancer found when not suspected or due to a high PSA levelStage B: Cancer found due to abnormal digital rectal exam and is held in the prostateStage C: Cancer that has spread to the tissues outside of the prostateStage D: Cancer that has spread to the lymph nodes or bone +++ General Considerations ++ Prostate wraps around the urethra causing urination issuesEnlarged prostate does not increase risk of cancerVegetarians have a lower rate of prostate cancer +++ Demographics ++ Most frequently diagnosed visceral malignancy in American menIncreased risk forAfrican-American menIndividuals with a brother or father with prostate cancerMen older than 60 years of ageSecond most common cause of male death from cancer +++ Signs and Symptoms ++ May be asymptomatic until late stagesNeed to urinate frequently, especially at nightDifficulty urinating, slow startDecreased force in the stream of urineLeakage of urine after urinationBlood in urineBlood in semenPainful ejaculationSwelling in legsPain or stiffness in the lower back, hips, or upper thighsSciaticaBone pain (if cancer has spread)Chemotherapy side effectsNauseaVomitingDiarrheaAlopeciaMouth soresConjunctivitisUlcersLeukopeniaAnemiaThrombocytopeniaHeadachesDizzinessInfertilityPeripheral neuropathiesRadiation side effectsFatigueSecondary neoplasmIntegumentary compromise (burns)Radiation fibrosis +++ Functional Implications ++ IncontinenceSexual dysfunction +++ Possible Contributing Causes ++ AndrogensGeneticsXenotropic murine leukemia virus-related virus (XMRV)Exposure to agent orangeAlcohol abuseExposure to cadmiumHigh animal fat dietsFamilial history +++ Differential Diagnoses ++ Benign prostatic hyperplasia (BPH)CalculiUrinary tract infection (UTI)Sacral dysfunctionLumbar spine radiculopathyProstatic cystsProstatic tuberculosisProstatitis +++ Laboratory Tests ++ PSA ScreenReverse transcription-polymerase ... Your Access profile is currently affiliated with [InstitutionA] and is in the process of switching affiliations to [InstitutionB]. Please select how you would like to proceed. Keep the current affiliation with [InstitutionA] and continue with the Access profile sign in process Switch affiliation to [InstitutionB] and continue with the Access profile sign in process Get Free Access Through Your Institution Learn how to see if your library subscribes to McGraw Hill Medical products. Subscribe: Institutional or Individual Sign In Error: Incorrect UserName or Password Username Error: Please enter User Name Password Error: Please enter Password Sign in Forgot Password? Forgot Username? Sign in via OpenAthens Sign in via Shibboleth You already have access! Please proceed to your institution's subscription. Create a free profile for additional features.