USMLE® Step 1 style questions USMLE
A 63-year-old man comes to the office because of nocturnal back pain that is not relieved by rest or change in position. He was diagnosed with localized prostate cancer 6 months ago and was started on long-acting gonadotropin releasing hormone (GnRH) agonist after refusal of surgical prostatectomy and radiation therapy. Further evaluation confirms the diagnosis of metastatic prostate adenocarcinoma. A decision to start flutamide is made to help relieve pain and decrease the size of the tumor. Which of the following best describes the mechanism of action of this agent?
Prostate cancer, usually refers to prostate adenocarcinoma, where adeno- means gland and carcinoma refers to uncontrolled growth of cells - so prostate cancer is a tumor or growth that originates in the prostate gland.
Only males are born with a prostate, so this condition only affects males and not females.
And that part of the urethra is called the prostatic urethra.
Beneath this layer, the prostate can be divided into a few zones.
The peripheral zone, which is the outermost posterior section, is the largest of the zone and contain about 70% of the prostate’s glandular tissue.
Moving inward, the next section is the central zone which contains about 25% of the glandular tissue as well as the ejaculatory ducts that join with the prostatic urethra.
Last, is the transitional zone, which contains around 5% of the glandular tissue as well as a portion of the prostatic urethra.
The transitional zone gets its name because it contains transitional cells which are also found in the bladder.
The transitional zone undergoes hyperplasia, or an increase in the number of cells, in a large percentage of older men, and that often leads to compression of the urethra.
This is called benign prostatic hyperplasia and is often considered a normal part of aging.
Sitting within that basement membrane, is a ring of cube-shaped basal cells as well as a few neuroendocrine cells interspersed throughout.
Finally, there’s an inner ring of luminal columnar cells, which are within the lumen or center of the gland.
The androgens include testosterone, which is produced by the testicles, androstenedione and dehydroepiandrosterone which are produced by the adrenal glands, and dihydrotestosterone, which is made from testosterone by the prostate itself.
Some risk factors for a genetic mutation include old age, obesity, and a high fat-low fiber diet.
Prostate cancer is a type of cancer that develops in the prostate, a gland in the male reproductive system. It usually arises in the posterior lobe of the prostate and can spread to other parts of the body, particularly the bones and lymph nodes. Symptoms include difficulty urinating, blood in the urine, weight loss, and pain in the pelvis during urination. Treatment may involve a combination of chemotherapy, radiotherapy, hormonal therapy, and surgery.