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Is It Cancer The Pathology of Prostate Cancer

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					Is It Cancer? The
Pathology of Prostate Cancer

  Richard E. Safrin, M.D.
  Department of Pathology
  Alvarado Hospital Medical Center
  San Diego, California



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I. Prostate Gland
   A. Part of the urinary system
   B. Part of the genital system




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II. The Normal Gland
  A. Weight—approximately 20 grams (one ounce)
  B. Two main types of tissue
     1. Glands
     2. Stroma
     3. A connective tissue capsule in theory
     surrounds the entire organ, similar to wrapping
     an object in thin wrapping paper.


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III. Diseases of the Prostate
A. Inflammation
B. Benign enlargement: benigin prostatic
   hyperplasia (BPH)
C. Malignant enlargement: cancer, or carcinoma,
   or adenocarcinoma
   1.   The most common form of cancer in men
   2.   250,000 new cases per year in USA
   3.   The second leading cause of cancer death in men
   4.   Racial Differences
   5.   Causes

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DIAGNOSIS OF PROSTATE CANCER

  A. Physical Examination
  B. Prostate Specific Antigen (PSA)
  C. Prostate Biopsy
       1. Tissue processing and staining
       2. Microscopic Examination by pathologist
              a. Architecture
              b. Cytology


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bph




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normal




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bph




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Cancer




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Once it is diagnosed as prostate
cancer, what else can the pathologist
say about it?
 • Grading—how abnormal the cancer looks
   when viewed through the microscope.
   The Gleason system is now standard

 • Staging—how extensive the cancer is
   anatomically
   • Is it confined to the prostate gland?
   • Has it spread to lymph nodes or beyond
     (lungs, bones, brain, etc.)
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Once it is diagnosed as prostate
cancer, what else can the pathologist
say about it?
 • Grading—how abnormal the cancer looks
   when viewed through the microscope.
   The Gleason system is now standard

 • Staging—how extensive the cancer is
   anatomically
   • Is it confined to the prostate gland?
   • Has it spread to lymph nodes or beyond
     (lungs, bones, brain, etc.)
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Enough pictures, already

Any more questions?
(EXCEPT about DNA ploidy!)




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