Prostate Cancer: Presented To Dr. Fawad Rasool by
Prostate Cancer: Presented To Dr. Fawad Rasool by
Prostate Cancer: Presented To Dr. Fawad Rasool by
METASTATIC
SPREAD
Hematogenous Lymphatic
Local extension
dissemination drainage
Pathophysiology
Hematogenous
Lymphatic drainage visceral involvement
dissemination
• Lymph node metastases • Skeletal metastases from • lung, liver, brain, and
are more common in hematogenous spread adrenal glands are the
patients with large, are the most common most common sites of
undifferentiated tumors sites of distant spread. visceral involvement,
that invade the seminal • Sites of bone although these organs
vesicles. involvement include the are usually not involved
• The pelvic and lumbar spine, proximal initially.
abdominal lymph node femurs, pelvis, thoracic
groups are the most spine, ribs, sternum, skull,
common sites of lymph and humerus.
node involvement
TREATMENT
To decrease morbidity and mortality
caused by prostate cancer.
methods
• Brachytherapy:
• Permanent implantation of radioactive beads of
145 Gy Iodine or 124 Gy of Palladium. It is usually
• Luteinizing Hormone-
Releasing Hormone
Agonists
Pharmacological • Gonadotropin-Releasing
Therapy Hormone Antagonists
• Anti-Androgens
• Combined Androgen
Blockade
• Chemotherapy
Drugs include leuprolide acetate,
leuprolide depot, leuprolide implant,
triptorelin depot, triptorelin implant,
goserlin acetate implant.
Administered as a SC
injection every 28 days.
Drugs include Monotherapy is no
flutamide, longer
bicalutamide, recommended
nilutamide, due to decreased
enzalutamide. efficacy.
3.Anti-
Androgens Antiandrogens are
indicated for Adverse effects
advanced include
prostate cancer gynecomastia,
only when loss of libido, LFT
combined with abnormalities, GI
LHRH agonists or disturbances.
orchieotomy.
4.Combined Androgen Blockade
Also referred as maximal androgen deprivation or total
androgen blockade.