
Prostate Cancer
Known Symptoms
- Early-stage: Often asymptomatic.
- Locally advanced: Lower urinary tract symptoms (LUTS): hesitancy, weak stream, nocturia, urgency.
Hematuria or hematospermia. - Metastatic disease:
Bone pain (especially back/hips), pathological fractures. Weight loss, anemia, lower extremity edema (from nodal involvement). - Red flags: Acute urinary retention, renal failure (from obstruction). Neurological symptoms (e.g., cord compression from vertebral metastases).
Known Causes
- Etiology:
- Age (risk increases significantly after 50). Family history and genetic factors (e.g., BRCA1/2 mutations, Lynch syndrome). Race (higher incidence and mortality in African American men).
- Lifestyle factors (e.g., high-fat diet, obesity).
- Pathophysiology:
- Androgen-driven growth; progression often involves mutations in genes like PTEN, TP53, and ETS family fusions (e.g., TMPRSS2-ERG).
- Metastasis commonly occurs to bones (osteoblastic lesions) and lymph nodes.
Care
- Prevention:
- Smoking cessation, weight management, limited alcohol.
- Screening in high-risk individuals (e.g., BRCA carriers) with MRI/EUS and CA19-9.
- Follow-up:
- CT imaging and CA19-9 monitoring every 3–6 months post-treatment.
- Focus on symptom management, nutritional support, and palliative care.
- Genetic counseling for family members of hereditary cases.
- Early-stage: Often asymptomatic.
- Locally advanced: Lower urinary tract symptoms (LUTS): hesitancy, weak stream, nocturia, urgency.
Hematuria or hematospermia. - Metastatic disease:
Bone pain (especially back/hips), pathological fractures. Weight loss, anemia, lower extremity edema (from nodal involvement). - Red flags: Acute urinary retention, renal failure (from obstruction). Neurological symptoms (e.g., cord compression from vertebral metastases).
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