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

• Weightapproximately 20 grams (one ounce)
• 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
• The most common form of cancer in men
• 250,000 new cases per year in USA
• The second leading cause of cancer death in men
• Racial Differences
• 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?

• Gradinghow abnormal the cancer looks when viewed
  through the microscope.
• The Gleason system is now standard
• Staginghow 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?

• Gradinghow abnormal the cancer looks when viewed
  through the microscope.
• The Gleason system is now standard
• Staginghow 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!)