Medical Faculty

Of
University Prima Indonesia

BLOC XVI (ONCOLOGY &

GERONTOLOGY)

Group 8

Group 8

ACHMAD FAWZI MURZANI

ALEXANDER ANGKASA
ALHOI LESLEY DAVIDSON
APRIANI KRISTA WITER LAIA
CICILIA ROSALYN SITORUS
CHINTYA ARISHA
DITRA KONEKSI WAOMA
DIWIL
FITRI RAHMAH JUWITA
HAAFIZH ISKANDAR
MENAS ASPI LOI
RIO
RICHARD GUNAWAN
WILDA HAYATI

Scenario 3

A man aged 59 years came to the doctor's

office with complaints of urinary disorders
since 4 months ago. Straining when urinating
should only be urine out. The evenings are
always willing to awaken if you want to pee.
Family history of his father died a year ago
after suffering Ca prostate. On examination
compos
mentis
common
sensorium,
temperature 37 degrees Celsius, blood
pressure of 140/90 mmHg, HR 64x / min, and
RR 20x / min. On rectal examination of the
prostate common tuse palpable, hard
consistency and uneven surfaces. What
happens in this patient?

Clarification of Term
1. Rectal tuse: Physical examination done by
striking the rectum to detect
abnormalities in the rectum area.

Define the problem

1. A man aged 59 years came to the doctor's
office with complaints of urinary disorders
since 4 months ago. Straining when
urinating should only be urine out. The
evenings are always willing to awaken if you
want to pee. Family history of his father died
a year ago after suffering Ca prostate.
2. On rectal examination of the prostate
common tuse palpable, hard consistency
and uneven surfaces.

Analysis of the Problems

1. - The possibility of urinary tract
obstruction
- Possible genetic factors
- Possible factors of age
2. Possible signs of malignancy

Tentative Conclusion
Men aged 59 years suspected
possibility of prostate cancer

the

Learning Objective
1. Definition, etiology, epidemiology and risk
factors for prostate cancer
2. Pathophysiology and clinical symptoms of
prostate cancer
3. Diagnosis and differential diagnosis of
prostate cancer
4. Management and prevention of prostate
cancer
5. Complications and prognosis of prostate
cancer

1. DEFINITION, ETIOLOGY,
EPIDEMIOLOGY and RISK
FACTORS for PROSTATE CANCER
Definiton
Ca Prostate is a malignant tumor that
grows in prostate.
Most prostate cancers grow very slowly
but it is a malignant cancer, and the
cancer can spread to other parts of the
body, especially the bones and lymph
nodes.

Etiology and risk factors

The exact cause of prostate cancer is not known for certain, but there are
some risk factors that cause a person to suffer from prostate cancer.
Risk Factor
1. AGE
Rarely in men under 40 years of age
Generally occurs in those aged> 50 years
2. Genetic predisposition
Chances increased to 5x if father and brother also suffered.
. 3. Effect of hormonal
Testosterone hormone thought to be involved in the development and
growth of prostate cancer.
. 4. Diet
. High-fat Diet, milk of animals, red meat and liver, Increased risk of
prostate cancer
. 5. Races
Prostate cancer is more many nations suffered by African-Americans who
were black than white people.

6. LIFESTYLE
Smoking, Drinking alcohol, obesity, physical activity /
exercise less also increase the incidence of prostate
cancer.
7. ENVIRONMENT
Exposure to various chemicals, especially cadmium which
there are many in the electric appliance and the battery is
closely related to the incidence of prostate cancer.
8. INFECTION
In 2005
Prostatitis Sexually Transmitted Diseases and increase the
risk of prostate cancer such as gonorrhea and Human
papilloma virus
In 2006
Research shows a link between a retrovirus, xenotropic
MuLV-Related virus (XMR) with prostate cancer

Epidemiology
Prostate cancer is the most common malignancy in
men and may be beyond lung cancer as a cause of
cancer death most.
Attacking patients aged over 50 years, including:
30% on 70-80 years
75% on > 80 years
Many common in continental Europe and the United
States ranks second malignant tumor.
Mostly in black people and white people in new
zealand and sweden, but in china is not often found.
United states has 14 deaths per 100,000 men per
year compared with 22 for sweden and 2 for japan
According to the CDC in 2008, the united states (new)
214.633 : diagnosis of prostate ca
28.471 : died

2. PATHOPHYSIOLOGY and CLINICAL SYMPTOMS of

PROSTATE CANCER

MANIFESTATIONS OF CANCER PROSTATE

May be asimptomatic.
Nocturia
Incontonentia urine
Hematuria
Dripping
Dysuria
Other manifestation:
Hematospermia
Pain
Rectum pain
Blood in stool ,etc.

3. DIAGNOSIS and DIFFERENTIAL DIAGNOSIS of

PROSTATE CANCER

Anamnesis
difficult urination
Pain during urination
Bleeding during urination
Hard erection or sustain an erection
Difficult defecation
Continuous pain in the lower back, pelvis or
upper thighs in
Frequent urination at night
Urine dripping or not strong enough
family history

physical examination
rectal toucher
supporting investigation
PSA test
PCA3 test
Urinalysis
Biopsy
Transrectal ultrasonography
MRI
Bone Scan
differential diagnosis
Benign prostate hypertrophy (BPH)
prostatitis

4. MANAGEMENT and PREVENTION

of PROSTATE CANCER
MANAGEMENT
Actions taken against prostate cancer
patients depends
on the stage, life expectancy, and the
degree of
differentiation.
a. Observation
b. radical prostatectomy
c. Radiation
d. hormonal therapy

PREVENTION
1. American Cancer Society (ACS) recommends Digital
Rectal Exam examination (DRE) to check the prostate
gland is done once a year in men beginning at age 40
years.
2. The new inspection instructions issued by the ACS
recommends examination of the levels of prostate
specific antigen (PSA) every year once in men aged 50
years and older.
3. Choosing a healthy diet filled with fruits and vegetables.
Avoid high-fat foods and centered on choosing a variety
of fruits, vegetables and grains. One nutrient that is
consistently associated with the prevention of prostate Ca
is licopene, which apat found in tomatoes.
4. Exercise routine
5. Maintaining an ideal body weight
6. Abstain from cigarettes
7. Increasing healthy lifestyle

5. COMPLICATIONS and PROGNOSIS

of PROSTATE CANCER
COMPLICATIONS
1. Metatasis place of or to any other organ
2. Erectile Dysfunction
3. Urinary incontinence
4. Bladder stone
5. Retention urine
6. Epididymitis
7. Hidronefrosis
8. Pyelonephritis
9. Kidney failure
10.Haemorhoid, hernia, prolapse of the rectum DUE
straining

Prognosis
1. To stage a well-differentiated, without
metastases can live a long time, if
extensive lesions diradioterapi 5-year
survival can reach about 85%
2. Patients with stage B 20-25% of lymph
node metastases, 5-year survival
decreased obviously.
3. Stage C and D estrogen therapy
effectiveness of about 60-80%.

FINAL CONCLUSION

THANK YOU