Chapter 091 Benign and Malignant Diseases of the Prostate (Part 1) pps
Chapter 091. Benign and Malignant Diseases of the Prostate (Part 1) pps
... Internal Medicine > Chapter 91. Benign and Malignant Diseases of the Prostate Benign and Malignant Diseases of the Prostate: Introduction Benign and malignant changes in the prostate increase ... prospective randomized trials. The paradox of management is that although the disease remains the second leading Chapter 091. Benign and Malignant Diseases of the Prostate (Part 1) Harrison's ... Autopsies of men in the eighth decade of life show hyperplastic changes in >90% and malignant changes in >70% of individuals. The high prevalence of these diseases among the elderly, who often...
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Chapter 091. Benign and Malignant Diseases of the Prostate (Part 2) pot
... these Chapter 091. Benign and Malignant Diseases of the Prostate (Part 2) Diagnosis and Treatment by Clinical State The disease continuum—from the appearance of a preneoplastic and invasive ... history of prostate cancer, testing is advised to begin at age 45. The American Urologic Association recommendations are similar, with a proviso that the risks and benefits of the performance of these ... trial. The prostate cancer detection rate was 18.4% (803 of 4364) in the finasteride group and 24.4% (1147 of 4692) in the placebo group. Early concerns that the cancers detected in the finasteride...
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Chapter 091. Benign and Malignant Diseases of the Prostate (Part 3) docx
... palpable, and of these, 70% are pathologically organ-confined. The Chapter 091. Benign and Malignant Diseases of the Prostate (Part 3) The PSA criteria used to recommend a diagnostic prostate ... biopsy. Each core of the biopsy is examined for the presence of cancer, and the amount of cancer is quantified based on the length of the tumor within the core and the percentage of the core involved. ... evolved over time. The goal is to increase the sensitivity of the test for younger men more likely to die of the disease and to reduce the frequency of detecting cancers of low malignant potential...
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Chapter 091. Benign and Malignant Diseases of the Prostate (Part 4) potx
... confined to the gland (T2), and those that have extended outside the gland (T3 and T4) (Table 91 -1). DRE alone is inaccurate with respect to the extent of the disease within the gland, the presence ... Chapter 091. Benign and Malignant Diseases of the Prostate (Part 4) Pathology The noninvasive proliferation of epithelial cells within ducts is termed prostatic intraepithelial neoplasia. ... absence of capsular invasion, involvement of seminal vesicles, and extension of disease to lymph nodes. Because of the inadequacy of DRE for staging, the staging system was modified to include the...
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Chapter 091. Benign and Malignant Diseases of the Prostate (Part 5) pot
... Chapter 091. Benign and Malignant Diseases of the Prostate (Part 5) TRUS is the imaging technique most frequently used to assess the primary tumor, but its chief use is directing prostate ... Comparison of outcomes of various forms of therapy is limited by the lack of prospective trials, referral bias, and differences in the outcomes combination of the initial T stage, Gleason score, and ... 47% and impotence rates range from 25 to 89%. Part of the variability relates to how the complication is defined and whether the patient or physician is reporting the event. The time of the...
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Chapter 091. Benign and Malignant Diseases of the Prostate (Part 6) docx
... intensity-modulated radiation therapy Chapter 091. Benign and Malignant Diseases of the Prostate (Part 6) Radical Prostatectomy The goal of radical prostatectomy is to excise the cancer completely ... disruption of the vascular supply and not the nerve fibers. Neoadjuvant hormone therapy has also been studied in combination with radiation therapy. The aim is to decrease the size of the prostate and, ... patients who received >70 Gy. The frequency of erectile dysfunction is related to the quality of erections pretreatment, the dose administered, and the time of assessment. Postradiation erectile...
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Chapter 091. Benign and Malignant Diseases of the Prostate (Part 7) potx
... disease had spread outside of the area of the prostate bed and is unlikely to be controlled with radiation therapy. disease. The practice evolved from studies of predominantly elderly men ... undergone surgery, prostatectomy for patients who had undergone radiation therapy. The decision to recommend radiation therapy after prostatectomy is often made on the basis of the pathologic findings ... evidence of disease on scan. For these patients the central issue is whether the rise in PSA results from persistent disease in the primary site, systemic disease, or both. In theory, disease in the...
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Chapter 091. Benign and Malignant Diseases of the Prostate (Part 8) docx
... Chapter 091. Benign and Malignant Diseases of the Prostate (Part 8) For patients with a rising PSA after radiation therapy, salvage prostatectomy can be considered if the disease ... hormone and follicle-stimulating hormone followed by a downregulation of receptors in the pituitary gland, which effects a chemical castration. They were approved on the basis of randomized ... included the Gleason grade of the primary tumor, time to recurrence, and PSA doubling times. For those with Gleason grade ≥8 tumors, the probability of metastatic progression was 37, 51, and 71%...
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Chapter 091. Benign and Malignant Diseases of the Prostate (Part 9) pdf
... Chapter 091. Benign and Malignant Diseases of the Prostate (Part 9) Antiandrogens Nonsteroidal antiandrogens such as flutamide, bicalutamide, and nilutamide block the binding of androgens ... quality of life. Combined androgen blockade the administration of an antiandrogen plus a GnRH analogue or surgical orchiectomy—was designed to inhibit both testicular and adrenal androgens at the ... initially to block the flare that results from GnRH analogue administration. They have also been studied as monotherapy and as part of a combined androgen blockade (also called maximal androgen blockade)....
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Chapter 091. Benign and Malignant Diseases of the Prostate (Part 11) pdf
... bedtime) act by relaxing the smooth muscle of the bladder neck and increasing peak urinary flow rates. No data show that these agents influence the progression of the disease. Surgical approaches ... removal of the gland via a retropubic, suprapubic, or perineal approach. Also utilized are TULIP (transurethral ultrasound-guided laser-induced prostatectomy), stents, and hyperthermia. Further ... and to assess the urinary outflow tract before surgery. Imaging of the upper tracts is advised for patients with hematuria, a history of calculi, or prior urinary tract problems. Medical therapies...
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