Anatomy

ANATOMY AND PHYSIOLOGY

PROSTRATE CANCER

William, a 69-year-old retired male, went to his doctor, complaining of leg pain that started in his lower back, ran across the side of his thigh, and over the front of his knee. Next, he developed pain that radiated from his back to his front at the chest through the level of his nipples and also at the umbilicus.
A physical and laboratory test showed hard nodule on his prostate and an elevation in several of the blood tests. His PSA (prostate specific antigen), an enzyme secreted by normal prostate tissue (0-4 ng/ml) was 453. Alkaline phosphatase was also elevated at 156 U/L, an indication of bone involvement.
A bone scan was ordered to visualize the bone involvement. (This test uses a calcium analogue attached to a radioactive tag. A special scanner can pick up images of this radioactivity and create an anatomical picture of the skeletal system. The radiation shows up as black spots on the film.)
Usually prostate cancer’s growth is initially influenced by the presence of testosterone. If testosterone is removed by castration, the cancer will often shrink for some period of time before the remaining fraction of testosterone-independent cancer cells grow.
William was not interested in castration and asked if there was another form of treatment. He was treated with a single shot of a drug which is slowly released into the body over a three-month time period. Within that time the patient noticed marked relief in his pain.

1)What is William’s diagnosis?
answer
Metastatic prostatic cancer/ stage 4 cancer of the prostate gland
2)Why would the scan show bone abnormalities? What would cause it?
answer
Metastasis to the bone, causing the bone anomaly. Metastasis of the cancerous cells from the prostate gland via the hematogenous spread, seeding into bone tissue.
3)Which endocrine organs are responsible for serum calcium levels?
answer
Parathyroid glands and Chief cells of the thyroid gland.
4)Describe the feedback loop between the anterior pituitary and the production of testosterone in the testes.
answer
The feedback loop system does occur in males during spermatogenesis. When testosterone level rises, it acts on the anterior pituitary gland and the hypothalamus. This inhibits FSH, LH, and GnRH. There is then the production of inhibin hormone by the Sertoli cells at this time, and when the sperm count rises, the inhibin hormone gets released into the blood. When this happens, FSH and GnRH are inhibited, which slows down spermatogenesis. With a sperm count of 20 million per milliliter, the Sertoli cells will stop the release of the inhibin hormone, which will lead to an increase in sperm count.

William, a 69-year-old retired male, went to his doctor, complaining of leg pain that started in his lower back, ran across the side of his thigh, and over the front of his knee. Next, he developed pain that radiated from his back to his front at the chest through the level of his nipples and also at the umbilicus.

Posted in Reading mode.

Leave a Reply

Your email address will not be published. Required fields are marked *