Speaker: David DeBrota
A review of the anatomy, physiology, and pathology of the prostate gland, with a special focus on prostate cancer.
David DeBrota is a general internal medicine physician who spent the majority of his career developing drugs at Eli Lilly and Company. He has served on the Scientech BOD and presented at meetings on 3 previous occasions.
Program: The Prostrate. Speaker: Dave Debrota, MD, internal medicine and drug development with Eli Lilly, Scientech Club member
Introduced By: Bill Halsema
Attendance: NESC: 102 Zoom: 32
Guest(s): Sandy Hurt, Ben Blakly, Donna Holl, Frank Crossland, Alan Rebea,
Scribe: Alan Schmidt
Editor: Bill Elliott
Talk’s Zoom recording found at: https://www.scientechclubvideos.org/zoom/01052026.mp4
His program provided a review of the anatomy, physiology, and pathology of the prostate gland, with a special focus on prostate cancer.
The prostate is a muscular gland inside a fibrous capsule in the male penis. The physiology of the prostate is for nutritional support and delivery of sperm. Prostate tissue is glandular cells and fibromuscular stroma. The prostate nerve tissue is shared with the bladder, seminal vesicles, the vas deferens, and the penis. The blood supply is shared with the bladder. Women almost never get prostate cancer in their rudimentary tissue in this area of their urethra. PSA is a Prostate Specific Antigen blood test that can indicate prostate cancer, with PSA<4 being low risk. For those in their 70s PSA 6.5 warrants additional investigation. A prostate biopsy can be performed to identify prostate cancer or bone scintigraphy nuclear medicine imaging. Digital rectal exams to check for prostate cancer are not as common since the more sensitive PSA test or PSMA prostate-specific membrane antigen test. Prostate cancer can spread to the lymph nodes and cause leg swelling. Prostate cancer is a type of adenocarcinoma for secretory cells lining organs such as the lung, breast, or the prostate. The usual age for prostate cancer diagnosis is 65 to 69 with 1/8 of the men being diagnosed during their lifetime and 2 to 3 out of a hundred dying from it. After prostate cancer diagnosis, watchful waiting with sequential PSA testing can be continued indefinitely up to the decision for treatment.
Symptoms of prostate cancer include blood in the urine, bone pain, unintended weight loss, erectile dysfunction, and painful ejaculation, but early on it is often asymptomatic. The prostate tends to get bigger with age. Benign Prostatic Hyperplasia BPH with an enlarged prostate, a common cause of lower urinary tract obstruction, is not prostate cancer.
In stage four metastatic, advanced prostate cancer, it has spread to distant organs; the five-year survival rate is only 10 to 30%. Cell patterns determine the cancer’s aggressiveness and likelihood of spreading with scores above Gleason 8 being high risk.
In general, a healthy lifestyle (diet, exercise, etc.) is thought to reduce risk of prostate cancer. Smoking is a risk factor for more aggressive prostate cancer. Lose weight if you are obese.
In the future, oncolytic virus therapy may modify adenovirus, infect tumor cells, and cause them to self-destruct. Maybe a single dose will cure a cancer patient. Adoptive cell therapy can use chimeric Antigen Receptor equipped with T-Cells (CAR-T) to divide and conquer. Natural Killer cells (NKs) and tumor infiltrating lymphocytes (TILs) can also be enhanced and reinfused in patients. Doing gene sequencing may choose an ideal therapy for you.
Dave Debrota
