Diagnosis by Biopsy the Gold Standard

Biopsy represents the gold standard of prostate cancer diagnosis. There is no better proof of the presence of a cancer than the histologic evidence. It is clear that the incidence of PCa is influenced by the method of prostate sampling. The real incidence of prostate cancer is unknown, as is the natural history concerning size and location within the prostate. In a small series of radical cystoprostatectomy specimens, removed for urothelial carcinoma, small volume prostate cancers were found in...

Latent Carcinoma

Perhaps one of the most commonly accepted paradigms of the prostatic cancer literature relates to the worldwide incidence of latent prostatic cancer. Specifically, it is commonly believed that the incidence of latent and small prostate cancers in Asian countries is the same as that for men living in Western countries, despite the large differences in clinical incidence and mortality rates that have been observed. Latent prostate cancer is defined as those carcinomas that are clinically...

The Classic Three Prostate Specific Antigen Digital Rectal Examination Transrectal Ultrasonography

Various diagnostic modalities are discussed below, starting with the classic three PSA, DRE, and TRUS. Most early detection efforts focused on these modalities, and each of them was at some time thought to be useful as an independent screening tool. In these studies, younger age was excluded from analysis, based on the clinical presentation of prostate cancer. Age, however turned out to be a valuable tool, especially in relation to PSA, and will be discussed in the section on prostate volume...

Free to Total PSA Ratio

One of the more recent PSA derivatives is the comparison of unbound free PSA to the total amount of PSA in the serum. The PSA can exist as free PSA and as PSA bound to Od-antichymotrypsin ACT or a2-macroglobulin A2M .43'44 The PSA bound to A2M PSA-A2M is anti-genically shielded and not measurable by any PSA assay. The PSA-ACT complex, however, is immunoreactively unique and can be measured in the serum as a separate moiety. As a result, it is possible to compare the amount of free PSA to the...

Racial Ethnic Epidemiologic Statistics

The clinical incidence of prostate cancer reported by the American Cancer Society in 1997 was 66 higher among African American men than among Caucasian men.9 In the past, the clinical incidence of prostate cancer has ranged from 30 to 50 higher among African Americans than among Caucasians. Also, there have been variations among the two groups in the lifetime risk of being diag nosed with prostate cancer. In 1993, 1 of 11 African Americans was diagnosed with prostate cancer compared to 1 of 9...

Info

Versus traditional age-adjusted and original normal PSA value. Versus traditional age-adjusted and original normal PSA value. The same authors applied an ANN to the Prostate Cancer Awareness Week PCAW screening database to predict the presence of cancer in 1500 men who had an abnormal DRE or PSA.8 All men underwent prostate biopsy and 25 were ultimately proven to have cancer. The ANN was trained using the 39 clinical and demographic variables and the known outcome. The ANN gave a sensitivity...

Androgen Receptor GGC Repeats

In addition to containing a polymorphic CAG repeat in the transactivation domain, exon one of the androgen receptor also contains a polymorphic GGC repeat. The GGC repeat encodes for a variable number of glycines and is located approximately 1.1 kilobases 3' of the CAG repeat. The variable GGC repeat 4 to 24 triplets follows an invariant GGT 3GGG GGT 2 repeat that also encodes for six consecutive glycines. The median and mean GGC repeat length are both approximately 16.9,10 Unpublished...

Gross Anatomy

The gross and microscopic anatomy of the human4,20-22 and rodent23-28 prostates have been described in detail and will be covered only briefly here. The gross anatomy of the human prostate is best described as a zonal arrangement consisting of the peripheral zone 70 to o , central zone 20 to 25 , transitional zone 5 to , and the periurethral zones approximately 1 Figure 14-2 .20,24,27 For a comparison of the original lobular nomenclature of prostatic anatomy with that of the currently used...

Susan R Marengo PhD

This chapter focuses on the normal physiology of the human prostate and its regulation. Because of the pronounced interspecies variation in the types of accessory sex glands present and the constitution of their secretions, this review cannot be considered a review of general prostatic physiology that can be extrapolated to other species. Since the rodent model rats and mice has been utilized extensively as a model for investigation of prostatic physiology and pathology, these species will be...

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