General Information
The Yale Genitourinary Pathology Program encompasses the entire spectrum
of diagnostic services on biopsies and resections from the prostate,
bladder, and genitourinary tract.
The service provides specialized
expertise in the pathologic diagnosis of prostate, bladder, and testicular
cancer; assessment of immunotherapy of bladder cancer; and hormone
therapy of prostate lesions, interstitial cystitis, and infertility.
The goal is to provide outstanding service to clinicians and patients
through accurate diagnosis, quick turnaround time, and frequent
personal communication.
Prostate Cancer
Prostate cancer continues to be the most frequently occurring
malignancy (aside from skin cancers), representing about 29% of all
new cancer cases in American men. One out of every six men is at lifetime
risk for prostate cancer.
African-Americans have the highest rates
of prostate cancer. They are more than twice as likely to be diagnosed
with prostate cancer and have a mortality rate more than double that
of white males. Asian men have the lowest incidence of prostate cancer.
However, research shows that as Asian men immigrate to the United
States, the rates of prostate cancer rise to levels almost identical
to those
of white Americans.
The risk for prostate cancer increases with age,
with men over the age of 65 at highest risk. At the age of 50,
a man has a 42% chance of developing prostate cancer but only a 2.9%
chance
of dying of the disease.
Frequently Asked Questions
What are the symptoms of prostate cancer?
Although prostate cancer often does not cause physical symptoms,
the most frequent are related to the urinary tract (urinary hesitancy,
decreased stream force, urinary incontinence). Metastasis to bone
can result in bone pain.
Is it serious?
Prostate cancer can be relatively harmless or extremely aggressive.
Some prostate tumors are slow growing, causing few clinical symptoms.
In these cases, a patient will often die with prostate cancer rather
than from prostate cancer. Aggressive tumors spread rapidly to the
lymph nodes, other organs, and especially bone. All male mammals have
a prostate, but only humans and dogs are known to develop prostate
cancer.
How is it diagnosed?
Doctors diagnose prostate cancer through physical examinations, laboratory
tests, imaging technologies and analysis of tissue samples. The most
common diagnostic technique is the digital rectal exam (DRE), in which
a physician inserts a gloved finger in the rectum to assess the texture
and size of the rear portion of the gland. The PSA test, which became
widely used in the early 1990s, measures levels of an enzyme (Prostate
Specific Antigen, or PSA) produced by the prostate. Doctors also use
ultrasound technology to visualize the organ and biopsies to study
prostate tissue samples under a microscope.
The biopsy is critical for the diagnosis of prostate cancer. The
pathologist’s
role in diagnosis involves examination of the prostate tissue for the
presence or absence of carcinoma. If prostate carcinoma is present,
a Gleason score is assigned, indicating a higher or lower grade carcinoma,
which will assist the primary physician in determining treatment.
How is it treated?
A variety of treatments are available for cancer of the prostate,
including hormone therapy, chemotherapy, radiation therapy, and
surgery. Such
treatments are tailored to the particular patient.
People
Demetrios
Braddock, M.D., Ph.D. is Assistant Professor of Pathology.
Clinical interests: urologic pathology and hematopathology.
Marguerite
Pinto, M.D., is Assistant Professor of Pathology and Attending
Pathologist, Bridgeport Hospital. Clinical interests: genitourinary,
gynecologic, and breast pathology; cytopathology, including fine needle
aspiration (FNA).
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