Fast Five Quiz: Test Your Knowledge of Advanced Prostate Cancer

Bradley Schwartz, DO


November 16, 2017

Obliteration of the lateral sulcus or seminal vesical involvement found during rectal examination often indicates locally advanced disease. Physical examination findings of adenopathy, lower-extremity edema, and bony tenderness may indicate metastatic disease. Advanced prostate cancer results from any combination of lymphatic, blood, or contiguous local spread. Manifestations of metastatic and advanced disease may include the following:

  • Anemia

  • Bone marrow suppression

  • Weight loss

  • Pathologic fractures

  • Spinal cord compression

  • Pain

  • Hematuria

  • Ureteral and/or bladder outlet obstruction

  • Urinary retention

  • Chronic renal failure

  • Urinary incontinence

  • Symptoms related to bony or soft-tissue metastases

The Whitmore-Jewett classification of stages A-D is no longer widely used. Prostate cancer does not necessarily progress in a sequential manner.

Transitional cell carcinoma and sarcoma of the prostate are more common in men who have undergone previous pelvic radiation therapy for prostate cancer than in men who have not. Likewise, squamous cell carcinoma of the prostate may be observed in men treated with hormonal therapy. All of these can present as a large pelvic mass with or without metastases.

For more on the presentation of advanced prostate cancer, read here.


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