This slide deck is about Prostate cancer. It is amongst the leading cause of cancer deaths in adult males. This slide deck will provide you with necessary information regarding the symptoms, risk, diagnosis, and possible treatment of prostate cancer. I hope the readers find this slide deck useful & informative

1. Prepared by:
Dr. Ankita Purkite
Prepared for:
Turacoz healthcare solutions
PROSTATE CANCER

2. Table of Contents:
Facts about Prostate cancer
What is Prostate cancer?
What is Prostate and what does it do?
Who gets Prostate cancer?
Symptoms of Prostate cancer
Types of Prostate cancer
Screening of Prostate cancer
Diagnosis of Prostate cancer
Staging & Grading of the cancer
Treatment of Prostate Cancer
Conclusion

3. FACTS ABOUT PROSTATE CANCER !

4. What is Prostate and what does it do?
• The prostate gland is a small gland about the size of a walnut.
• It sits at the base of the bladder and in front of the rectum (back passage).
• The tube that drains urine from the bladder (urethra) runs down through the
Centre of the prostate gland, letting urine flow out of the body through the penis.
• The prostate produces a fluid that mixes with sperm (from the testicles) to make
semen. The fluid is kept in a tube-shaped gland that sits behind the bladder. This
gland is called the seminal vesicle.
• The prostate also produces a protein called prostate-specific antigen (PSA). This
helps to make semen more watery. A blood test can measure PSA. This is called a
PSA test. Doctors use it to help diagnose different prostate problems, including
cancer.
Reference: https://www.cancer.ie

5. Diagram of prostate gland
Source: https://www.macmillan.org.uk

6. What is prostate cancer?
• Prostate cancer is
when the cells of
your prostate gland
grow in an abnormal
way to form a lump
(tumor).
Source: https://www.cancer.ie/cancer-information-
and-support/cancer-types/prostate-cancer

7. Who gets prostate cancer?
These risk factors can increase the chance of developing prostate
cancer:
Age: The risk increases with age. It usually affects men over 50.
Nearly 2 in every 3 prostate cancers are diagnosed in men over 65.
Family history: Your risk is higher if you have a brother or father
with the disease. It is also higher if your relative developed prostate
cancer at a younger age or if you have more than one relative with
the disease.
The 2 genes identified as increase risk are the BRCA1 and BRCA2
genes. Men with BRCA2 are twice as likely to develop prostate
cancer.
Race: Afro-Caribbean men are at a higher risk of developing
prostate cancer.
Reference: https://www.cdc.gov/

8. How to reduce the risk of prostate cancer?
The most important things you can do to reduce your risk is:
• Lose weight
• Eat a healthy diet
• Be physically active
• Know your family history and have a discussion with your GP about the screening tests available.
Reference: www.cancer.ie

9. Symptoms of Prostate Cancer:
• Difficulty or pain urinating
• Increased need to urinate,
particularly at night
• Blood in urine or semen
• Trouble getting an erection
• Pain with ejaculation
• Loss of bladder or bowel control
• Pain in the hips, spine or ribs
• Weakness in the legs or feet
Reference: https://www.cdc.gov/
Pic source: http://digjamaica.com/m/

10. Awareness can save lives !
• The month of September has been
designated as National Prostate Cancer
Awareness Month to bring attention to
this very common form of cancer that
affects so many men.
• Prostate cancer is the most commonly
diagnosed form of cancer in men and is
the second leading cancer-related cause
of death in men.
• It is important to know the symptoms and
ask for help as prostate cancer can be
treated if diagnosed early.

11. Who should get a screening test done?
The doctor may suggest screening tests at certain ages:
•At age 50 for men of average risk
•At age 45 for men at high risk, including black men and
men who have a close relative diagnosed
with prostate cancer before age 65
•At age 40 for men who have more than one close relative
with a prostate cancer diagnosis before age 65
Reference: https://www.cdc.gov/

12. Tests for screening:
1. PSA test:
A blood test called a prostate specific antigen (PSA) test
measures the level of PSA in the blood. PSA is a substance
made by the prostate. The levels of PSA in the blood can
be higher in men who have prostate cancer. The PSA level
may also be elevated in other conditions that affect the
prostate.
2. Digital rectal exam (DRE):
In this test, the doctor will briefly insert a gloved finger
into your rectum(back passage) to feel for lumps as that
could be early signs of a tumor.
Reference: https://www.cdc.gov/

13. Types of Prostate cancer
• Adenocarcinoma
These cancers develop in the gland cells that line the prostate gland. They are the most common type of
prostate cancer.
• Transitional cell (or urothelial) cancer
Transitional cell cancer of the prostate starts in the cells that line the tube carrying urine to the outside of
the body (the urethra). This type of cancer usually starts in the bladder and spreads into the prostate.
• Squamous cell cancer
These cancers develop from flat cells that cover the prostate. They tend to grow and spread more quickly
than adenocarcinoma of the prostate.
• Small cell prostate cancer
Small cell prostate cancer is made up of small round cells. It’s a type of neuroendocrine cancer.
• Other rare forms - Sarcoma, Neuroendocrine tumors.
• Reference: https://www.pcf.org/

14. Diagnosis of Prostate Cancer
Types of tests done to diagnosis:
• PSA test
The amount of PSA in your blood is measured in nanograms of PSA per milliliter of blood (ng/ml).
If you're aged 50 to 69, raised PSA is 3ng/ml or higher. A raised PSA level in your blood may be a sign of
prostate cancer, but PSA levels can also be raised in other conditions too.
• MRI scan
If there is a raised PSA level, the doctor may refer you to hospital for an MRI scan of your prostate.
• Other tests are done to diagnose advanced level of Prostate cancer:
 MRI scan
 PET scan
 CT scan
 Isotope bone scan.

15. Prostatic Biopsy
• A biopsy is a procedure that can be used to diagnose prostate cancer and it’s a
confirmative test for prostate cancer.
• A biopsy is when a small piece of tissue is removed from the prostate and looked at
under a microscope to see if there are cancer cells.
• A Gleason score is determined when the biopsy tissue is looked at under the
microscope.
• If there is a cancer, the score indicates how likely it is to spread. The score ranges from 2
to 10. The lower the score, the less likely it is that the cancer will spread.
Reference: https://www.pcf.org/

16. Staging & Grading of Prostate cancer
• Staging means finding out how big the cancer is and if it has spread to
other parts of your body. Staging will help your doctor to plan the best
treatment for you.
• There are different ways to describe the stages of cancer. The TNM staging
system refers to:
 The size of the tumor (T)
If there is cancer in your lymph nodes (N)
If the cancer has spread to other parts of your body (M for metastasis)
Reference :https://www.cancer.ie/

17. Staging & Grading
Tumour (T) – How big is the tumor?
 T1 - The tumour is within your prostate gland. It is too small to be felt during a rectal
exam.
 T2 - The tumour is still within your prostate gland. It is large enough to be felt during a
rectal exam.
 T3 - The tumour can be felt throughout your prostate, and may have broken through the
outer layer of the prostate.
 T4 - The tumour has spread to organs outside your prostate gland.
Reference: https://www.cancer.ie/

18. Staging & Grading
Node (N) – Are the lymph nodes affected or not?
 N - Cancer is present in the lymph nodes
 N0 - No cancer in the lymph nodes
 N1- Cancer has spread to 1 or more of the lymph nodes
Metastasis (M) – has it spread outside the prostate?
 M- The cancer has spread to lymph nodes and/or other organs,
commonly bones.
 M0 - The cancer has not spread.
Reference: https://www.cancer.ie/

19. Treatment of Prostate cancer:
1. Active surveillance
2. Surgery (radical prostatectomy)
3. External beam radiotherapy
4. Hormone therapy
5. Watchful waiting
6. Brachytherapy (internal radiotherapy)

20. Active surveillance
This is a treatment option for low-risk prostate cancer.
The patient is asked to have regular tests to check changes in the cancer.
The following are the tests :
• PSA blood tests every few months at the start, and then every 6 months
after a couple of years.
• Regular digital rectal exam (where the doctor examines your prostate
gland through your rectum (back passage)).
• MRI scan.
• Prostate biopsies (taking samples of prostate tissue).
Reference: https://www.cancer.ie/

21. Surgery
• Robot-assisted laparoscopic prostatectomy (robotic surgery): This
operation is a type of keyhole surgery but with the use of a computer and
robotic arms to help to remove the prostate.
• Open prostatectomy: Open surgery means removing your prostate through
a cut in the wall of your abdomen between your belly button and pubic
bone (Retro pubic prostatectomy)or through a cut between your scrotum
and back passage(Radical perineal prostatectomy)
• Laparoscopic prostatectomy: With keyhole surgery, small cuts are made in
your abdomen so that special instruments can remove your prostate.
Reference: https://www.cancer.ie/

22. External beam radiotherapy
There are two types of external beam radiotherapy:
1. 3D conformal radiotherapy (3D-CRT)
With 3D-CRT, the radiation beams match the shape of the prostate as closely as possible. This aims to avoid
damaging the healthy tissue surrounding it, reducing the risk of side effects.
2. Intensity modulated radiotherapy (IMRT)
With IMRT, the radiation beams are matched precisely to the size, shape and position of the prostate. The
strength of the radiation beams can also be controlled so that different areas get a different dose. This
means a higher dose of radiation can be given to the prostate, without causing too much damage to the
surrounding tissue. The risk of side effects is usually lower with IMRT than with 3D-CRT.
Reference: http://www.myprostate.ie/

23. Hormone therapy
 Hormone therapy works by stopping the hormone testosterone from reaching prostate cancer cells.
 Testosterone controls how the prostate gland grows and develops. It also controls male characteristics, such
as erections, muscle strength, and the growth of the penis and testicles.
 Hormone therapy is an option for many men with advanced prostate cancer and offered as a lifelong
treatment. It can control the cancer and manage symptoms such as bone pain.
 Types of hormone therapy:
1. LHRH agonists
Luteinising hormone-releasing hormone (LHRH) agonists. These work by stopping messages (called Luteinising
Hormone) from the pituitary, a part of the brain, that tell the testicles to make the testosterone hormone
which prostate cancer cells need to keep growing.
They can only be given by injection. Some of the common LHRH agonists are:
• Goserelin (Zoladex)
• Leuprorelin acetate (Prostap)
• Triptorelin (Decapeptyl or Gonapeptyl).

24. Hormone therapy
2. Gonadotrophin releasing hormone (GnRH) blocker.
It works by blocking slightly different messages from the brain that tell the testicles to produce testosterone.
You have it by injection just under the skin of the abdomen once a month.
3. Tablets to block the effects of testosterone
Anti-androgens stop testosterone hormone from reaching the prostate cancer cells. They’re taken as a
tablet.
They are less likely to cause sexual problems and bone thinning than other types of hormone therapy.
There are several anti-androgens, including:
• bicalutamide (Casodex)
• flutamide
• cyproterone acetate (Androcur)
4. If your cancer is no longer responding as well to one type of hormone therapy, it may still respond to other
types of chemotherapy such as such as abiraterone (Zytiga®) and enzalutamide (Xtandi®).
References: http://www.myprostate.ie/

25. Watchful waiting
• An option for men with health
issues that make other treatments
unsuitable. You will have PSA tests
and sometimes DRE tests.
• If there are no signs of the cancer
growing it’s safe to continue with
watchful waiting.
Reference :https://www.cancer.ie/

26. Brachytherapy
• Brachytherapy is a type of radiotherapy,
which uses tiny radioactive pellets or
seeds put inside your prostate.
• The seeds release radiation slowly over a
number of months. The radiation destroys
prostate cancer cells. The seeds are not
removed and the radiation fades away
over time.
• The aim of brachytherapy is to fully cure
the prostate cancer.
Reference :https://www.cancer.ie/

27. CONCLUSION :
• After the treatment is over, you will still need to go back to hospital for regular check-ups once it is
over. This is called follow-up.
• The follow-up will involve having PSA blood tests, and maybe DRE tests.
• If the cancer symptoms come back, your doctor will advise you about other treatment options.
• It can take some time to come to terms with a cancer diagnosis, even after your treatment has
ended. Read about feelings after treatment and where to get
support.(https://www.cancer.ie/cancer-information-and-support/cancer-support/coping-with-
cancer/information-for-survivors/feelings-after-treatment)

28. Thank You