7/24/2019 BEDAH Prostate Carcinoma

1/18

PROSTATE CARCINOMA

TERBANYAK SETELAH MELANOMA SKIN CANCER

TAHUN 2002 TERDIAGNOSA

189.000 KASUS

30.200 DIANTARANYA AKANMENINGGAL

TERDAPAT KECENDERUNGAN PENINGKATAN

KASUS

7/24/2019 BEDAH Prostate Carcinoma

2/18

PENYEBAB PENINGKATAN :

-BERTAMBAH LUAS PEMERIKSAAN SERUM PROSTATE

SPECIFIC AGENT (PSA)

KESADARAN MASYARAKAT

SCREENING YANG BERTAMBAH BANYAK

7/24/2019 BEDAH Prostate Carcinoma

3/18

7/24/2019 BEDAH Prostate Carcinoma

4/18

PEMERIKSAAN SEBELUM PSA :

DIGITAL RECTAL E!AMINATION

-GANGGUAN URINARY SYMPTOM :

URGENCY .

NOCTURIA

FRE"UENCY

HESITANCY

7/24/2019 BEDAH Prostate Carcinoma

5/18

GE#ALANYA SAMA DENGAN BPH (BENIGN PROS

TATE HYPERTROPHY )

-DITEMUI KASUS CANCER PROSTATE DENGAN

PSA TINGGI TETAPI PEMERIKSAAN PROSTATE NORMAL

-HANYA 20$ PENDERITA CANCER PROSTATE MEMILIKI

ABNORMAL DIGITAL RECTAL E!AMINATION

7/24/2019 BEDAH Prostate Carcinoma

6/18

KENAIKAN KADAR PSA TANDA DINI KELAINAN PROSTATE

BPH DAN CANCER PROSTATE PSA NAIK %

TETAPI KENAIKAN PADA CANCER LEBIH TINGGI

-KEADAAN LAIN YANG MENAIKKAN KADAR PSA%

PROSTATE INFLAMATION DAN PERINEAL TRAUMA

7/24/2019 BEDAH Prostate Carcinoma

7/18

7/24/2019 BEDAH Prostate Carcinoma

8/18

KADAR NORMAL PSA

-( &0 ' &9 ) *+, : ( 0 ' 2.- ) ,/

-(-0 ' -9 ) *+, : ( 0 ' 3.- ) ,/

-( 0 ' 9 ) *+, : ( 0 ' &.- ) ,/

-(0 ' 9 ) *+, : ( 0 ' .- ) ,/

7/24/2019 BEDAH Prostate Carcinoma

9/18

PROSTATE BIOPSI STANDARD PEMERIKSAAN

TRANSRECTAL BIOPSI

SIMPLE OFFICE

TANPA SEDASI ATAUPUN ANALGESIA

-BILA HASIL BIOPSI CARCINOMA

E4ALUATION ATAU CLINICAL STAGING

E!TEND OF SPREAD

7/24/2019 BEDAH Prostate Carcinoma

10/18

FAKTOR YANG DIPERTIMBANGKAN UNTUK TERAPI :

GENERAL MEDICAL CONDITION% AGE%

HISTOLOGIC GRADE (GLEASON SCORE)

PRETREATMENT PSA 4ALUE

DAN FAKTOR FAKTOR LAIN

7/24/2019 BEDAH Prostate Carcinoma

11/18

7/24/2019 BEDAH Prostate Carcinoma

12/18

TREATMENT OPTION :

-SURGERY

-

RADIATION

-HORMONAL THERAPY

-CHEMOTHERAPY

-5ACTHFUL 5AITING

7/24/2019 BEDAH Prostate Carcinoma

13/18

CONTOH KASUS SCREENING :

DIAGNOSE EARLY CANCER BEFORE THE ONSET OF SYMPTOM

&- YEARS OLD FAMILY HISTORY ( 6 )

-0 YEARS OLD USIA PEMERIKSAAN

-2 TEST : PSA BLOOD TEST

DRE (DIGITAL RECTAL E!AM)

7/24/2019 BEDAH Prostate Carcinoma

14/18

. DIGITAL RECTAL E!AM (DRE)

SI7E% SHAPE% SYMMETRY AND CONSISTENCY

CANCEROUS : IRREGULARLY ENLARGE AND HARD

. PROSTATE SPECIFIC ANTIGEN (PSA) TEST

SIMPLE BLOOD TEST LE4EL OF PSA (PROTEIN)

. COUNCELING

7/24/2019 BEDAH Prostate Carcinoma

15/18

7/24/2019 BEDAH Prostate Carcinoma

16/18

7/24/2019 BEDAH Prostate Carcinoma

17/18

TREATMENT BASE ON :

AGE OF PATIENT

PSA LE4ELBIOPSY LE4EL

STAGE OF DESEASE

TREATMENT OPTION :

SURGERY

RADIATION

HORMONAL THERAPY

CHEMOTHERAPY

5ATCHFULL 5AITING

7/24/2019 BEDAH Prostate Carcinoma

18/18