Diseases and Disorders

Prostate Cancer

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INTRODUCTION

DRG Category: 713

Mean LOS: 4.1 days

Description SURGICAL: Transurethral Prostatectomy with CC or Major CC

DRG Category: 715

Mean LOS: 6.3 days

Description MEDICAL: Other Male Reproductive System Operating Room Procedure for Malignancy with CC or Major CC

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Prostate cancer is the most common type of cancer in men and the second leading cause of death among men in the United States. The American Cancer Society estimated that, in 2008, there were 200,000 new cases of prostate cancer and approximately 30,000 deaths from the disease. Overall, 1 in 6 men are diagnosed with prostate cancer and 1 in 33 die from this disease. The 5-year survival rate is 99%. Prostate cancer may begin with a condition called prostatic intraepithelial neoplasia (PIN), which can develop in men in their 20s. In this condition, there are microscopic changes in the size and shape of the prostate gland cells. The more abnormal the cells look, the more likely that cancer is present. It has been noted that 50% of men have PIN by the time they are 50 years old.

Adenocarcinomas compose 99% of the prostate cancers. They most frequently begin in the outer portion of the posterior lobe in the glandular cells of the prostate gland. Local spread occurs to the seminal vesicles, bladder, and peritoneum. Prostate cancer metastasizes to other sites via the hematologic and lymphatic systems, following a fairly predictable pattern. The pelvic and perivesicular lymph nodes and bones of the pelvis, sacrum, and lumbar spine are usually the first areas to be affected. Metastasis to other organs usually occurs late in the course of the disease, with the lungs, liver, and kidneys being most frequently involved.

Although the recommendation is controversial, the American Cancer Society now advises screening for prostate cancer in asymptomatic men beginning at age 40. American Cancer Society guidelines include an annual digital rectal examination beginning at age 40 and annual serum prostate-specific antigen (PSA) testing beginning at age 50.

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