Q. Which of the following statements regarding carcinoma of the prostate is true?
a. It has a higher incidence among American blacks than other American ethnic groups
b. A single microscopic focus of prostate cancer discovered on transurethral resection of the prostate
(TURP) is an indication for radical prostatectomy
c. It arises initially in the gland’s central portion
d. It commonly produces osteoclastic bony metastases
e. Screening for prostate-specific antigen, although easily done, offers no advantage over simple rectal examination in the detection of the disease
One of the most frequent causes of male cancer deaths, prostate cancer has an incidence of
ReplyDeletemore than 75,000 new cases per year in the United States. American blacks appear to have a 50% higher incidence and mortality. Prostate cancer (adenocarcinoma) arises initially in the periphery of the gland. Therefore, one
of the best screening tests is careful rectal examination. However, the use of screening for prostate-specific antigen (PSA) has increased the detection rate fourfold. Spread is by direct local extension and by lymphatic and vascular channels. The most common locations of distant metastases are in the axial skeleton with osteoblastic bony lesions. A single focus of disease discovered on TURP or simple prostatectomy is considered stage A1. Only 2% of patients have unsuspected nodes (i.e., only 2% 5- to 10-year mortality).
Therefore, no definitive therapy is required except possibly in patients less
than 60 years old. Follow-up should be undertaken and progression of disease
may be treated as necessary. Several foci or diffuse disease is considered stage A2 and surgery or radiation therapy is generally indicated.