Knowledge of prostate cancer

【Overview】

Prostate cancer is the male reproductive system common malignant tumor. The prostate is located below the bladder, a chestnut-shaped gland, with the middle through the urethra. It is a fluid secreted by sperm nutrition is an integral part of semen. Prostate cancer, genitourinary system tumors account for about 4%. Old age in men is more common forms of cancer. Almost all prostate cancer occurs in the lateral prostate, showing latent slow-growing, therefore, cancer is very small without any clinical manifestations. And benign prostate enlargement and prostatitis produce similar symptoms and cancer. Prostate cancer may be related to age, high-fat, vasectomies, genetic factors, smoking, contact with heavy metals, inappropriate and sexually transmitted diseases related to sexual life.

Clinical manifestations 【】

Early symptoms: difficulty urinating, was progressive to begin thinning is only urine-line, future development of voiding difficulty in urinating effort, the last line of performance for not a drop of urine; urinary frequency, urgency, hematuria; urination, pain or burning sensation; the lower back, upper thighs or pelvic pain at a row.


Late symptoms: bone marrow suppression disease, osteoma transfer, paraneoplastic syndrome, a high calcium, pain, high uric acid, pleural leakage, leg swelling.

【Treatment】

Prostate cancer treatment, mainly surgery, hormone therapy, chemotherapy, radiotherapy and immune therapy. The specific choice of what method should be based on patient's age, body conditions, the local scope of cancer and the transfer of the case may be.

(1) Surgical treatment:

1) radical prostatectomy, and its scope, including the prostate gland and the prostate capsule;

2) pelvic lymph node dissection;

3), transurethral resection of the prostate is mainly used to lift the bladder neck obstruction.

(2) Radiation therapy: Using radiation treatment of prostate cancer has been more than 60 years of history, mainly in the following methods:

1) In vitro radiation therapy;

2) The organization radiotherapy, this approach often associated with radical prostatectomy or pelvic lymph node dissection in conjunction;

3) total body irradiation: a certain extent, ease the pain of bone metastasis and reduce the local lesion development.

Prostate cancer is the disease-prone elderly men. In Europe and the United States is male cancer mortality. According to statistics, in Northern Europe the incidence of prostate cancer, accounting for male carcinoma first. In the United States the incidence of prostate cancer after lung cancer, malignant carcinoma ranks second in men. Although the incidence rate in China is lower than the European and American countries, but recent statistics, its incidence on the rise.


Prostate Tuberculosis

Prostate TB is the male reproductive system the highest incidence of tuberculosis in common diseases, but also a common urinary tract following the incidence of tuberculosis.

Prostate cancer is the male reproductive system, a common malignant tumor. Our incidence rate is lower than the Western countries, but over the past 20 years, an upward trend. The incidence of prostate cancer with age in parallel, according to foreign statistics, men under 50 years of age rarely; 50-60 years of age accounted for the incidence of prostate cancer l / 3; 70 over the age of about 1 / 2; 80 years old and about 3 / 4 .

The cause of prostate cancer has not yet entirely clear, a large number of clinical data suggest that with the sex hormone related. May be the body of estrogen and androgen imbalance, especially in male hormones. Studies have found that sexual activity the higher population, higher incidence of prostate cancer, while in the Koo-nine patients after resection of very rare; in patients with cirrhosis, the liver of a reduced ability to inactivate estrogen, estrogen hormone levels rise, so the incidence of prostate cancer is not high. There is also data indicate that environmental pollution, gonococcal infection, prostate hyperplasia, excessive coffee and alcohol drinking were also related to the occurrence of prostate cancer.

Prostate cancer mostly occurs in the posterior lobe, but also occasionally on both sides of leaf disease. Prostate cancer is mainly adenocarcinoma, accounting for about 97%, while the squamous cell carcinoma is rare. Prostate cancer at an early stage, can have no symptoms, when the tumor grew up to make the development of the prostate gland increases to a certain size, as well as bladder neck obstruction occurs when the symptoms. At this point there are frequent urination, urgency, slow urine flow, difficulty urinating, or even urinary retention and other symptoms, a few patients have symptoms of hematuria or transfer occurs. When oppression or violation of the surrounding lymph nodes or blood vessels, then may appear lower extremity edema, may occur with bone metastasis, low back pain, lower limb paralysis.

Prostate digital rectal examination is an effective method of diagnosis of prostate cancer. Because this occurred in prostate cancer after many kinds of leaves and both sides of the leaf edge, hard texture of the Ministry of lesions, so digital rectal nodules reach potential energy. Diagnosis of prostate cancer refers to the performance of the gland increased, nodule hard, uneven, the central sulcus disappeared, glands fixed, and sometimes invading the intestinal wall. Such as men over 45 years of age to do digital rectal examination screening, early detection of prostate cancer can improve the cure rate can be. To imply that the review found an induration in the prostate, regardless of their distribution area, highlighting in the glandular or not, whether the rules should be thought of the possibility of the disease.

Malignant prostate cancer, a higher degree of apparent early stage of local infiltration and lymph node metastasis, tumor often violations of seminal vesicle and bilateral Penbi, very few violations of the rectum. Along the pelvic lymph node metastasis to nearby lymph nodes, and then transferred to a secluded, the skeleton total, abdominal aortic, mediastinal lymph nodes, as well as supraclavicular lymph nodes. Prostate cancer metastasis to the bone can also be blood, the most common is the pelvis, lumbar spine, femur and ribs. Road from the blood can also be transferred to the lungs, liver, kidney, brain and other organs.

Early detection of prostate cancer if diagnosed early, you can achieve better therapeutic effect. Commonly used in clinical examination are: (1) ultrasound examination. (2) X-ray imaging examination. (3) radionuclide scan. (4) CT examination. (5) MRI. (6) in urine and prostatic fluid cytology. (7) acid phosphatase (PAP) measured. (8) prostate-specific antigen (PSA) measurement. (9) syrup protein (r-Sm) determination. (10) prostate biopsy.

Prostate Cancer

Prostate cancer is the United States over the age of 50 the most common male malignancy by 10 years of age, the incidence of each increase. The United States each year is about 209.9 thousand new cases of people (1997 estimate). Prostatic sarcoma rare, mainly in children. Undifferentiated prostate cancer, squamous cell carcinoma and transitional cell carcinoma can also be found, but poor performance commonly used control methods. hormonal influence and the occurrence of certain of the cancer, but sarcoma, undifferentiated carcinoma, squamous cell carcinoma and transitional cell carcinoma is almost certainly unrelated to .

Prostate cancer is usually adenoid, compared with the normal histological structure similar to the prostate. Is characterized by small-cell hyperplasia and large nucleoli. According to the structure of classification, common Gleason score, the main (most popular) classification (1 ~ 5) with secondary (sub-popular) classification (1 ~ 5); thus can be divided into from 2 (well differentiated) to 10 (poorly differentiated). phased in Table 233-1.

Symptoms, signs and diagnosis

Slow general development of prostate cancer may be asymptomatic. Diseases can occur with advanced bladder outlet obstruction, or ureteral obstruction symptoms or hematuria. Transferred to the pelvis, ribs and vertebrae can cause pain. Locally advanced prostate cancer can be expressed as spread to the seminal vesicle of induration, glands fixed to the side.

Abnormal digital rectal examination, transrectal ultrasound (TRUS) showed hypoechoic lesions or serum prostate-specific antigen (PSA) should be suspected elevated levels of prostate cancer. However, the histological diagnosis be confirmed, the most commonly used is the transrectal ultra - sound under the guidance of transrectal biopsy, biopsy can be carried out without anesthesia. there is a nerve-week diagnosis of lymphatic invasion. Occasionally, suspicion from the surgical removal of a benign enlarged prostate tissue found in malignant transformation can be diagnosed prostate cancer.

Prostate cancer often cause osteoblast bone metastasis. In the presence of a hard stone-like, when the prostate bone scan or X-ray examination found that often have diagnostic significance.

TRUS can be used for tumor staging. In particular, to provide against the tumor through capsule and seminal vesicle of information. Roy test (an enzyme method) was found elevated serum acid phosphatase and cancer metastasis, especially lymph node metastasis. This Enzymes in benign prostatic hyperplasia (prostate massage force increased slightly after), multiple myeloma, Gaucher disease and hemolytic anemia may also be increased. Research and Application of RT-PCR was used to detect circulating prostate cancer cells in the staging and estimate the prognosis in value.

Although the acid phosphatase and prostate-specific antigen (PSA) levels decreased after treatment, relapse, when elevated, PSA is to monitor tumor response to treatment progress and the most sensitive indicators. However, due to PSA in 30% ~ 50% patients with benign prostatic hyperplasia (based on prostate size and degree of obstruction) and 25% ~ 92% of prostate cancer (based on tumor size) were moderately elevated, therefore early detection and disease staging of yet to be evaluated. PSA levels were significantly elevated prompt tumor extracapsular spread or metastasize. Update the determination of the ratio of free antigen and antigen-binding way to reduce the number of non-cancer patient's biopsy.

Palpable during digital rectal examination and a stone-like lumps or nodules of malignant prostate tips must be consistent with granulomatous prostatitis, prostate stones, or other less common prostate disease phase identification. But a normal digital rectal examination and prostate cancer can not be excluded swollen.

Many patients may receive long-term local control, even cure. But it can be affected by many factors, such as administration of tumor grade, stage and pre-treatment PSA levels, even in the clinically-localized prostate cancer patients. Tumor level is low, limited to in organ survival rate of patients within the substance and non-prostate cancer quite the same age group. some elderly patients with localized prostate cancer, especially in well-differentiated and may not need treatment (for example, to be observed), because the risk of death for other reasons More than prostate cancer. However, most patients a choice of radical prostatectomy or radiotherapy.

For younger patients, radical prostatectomy may be the best, enjoy a long life expectancy, their risk of incontinence is minimal (about 2%). About 50% of patients to maintain erectile function (eg, at least be able to retain a nerve plexus). radiotherapy may have similar results, especially in the pre-treatment of patients with low PSA levels. The standard external radiation therapy is usually in the 7 weeks to give 70Gy (7000rad) of exposures. three-dimensional technology to safely increase the exposure up to 80Gy (8000rad), preliminary data indicate that a higher rate of local control. interstitial irradiation (implantation of radioactive seeds) whether it has the same effect yet to be evaluated.

Asymptomatic localized prostate cancer or late metastasis of patients with hormone therapy, radiation therapy combined with or without secondary benefit. Hormone therapy is rarely used exogenous estrogen, it is a cardiovascular and thromboembolic risk of complications. Pairs of lateral orchiectomy or luteinizing hormone-releasing hormone stimulants make a similar decline in serum testosterone.

Some patients with anti-androgen was added to the total androgen blockade useful. Symptomatic patients with bone metastasis, local radiation therapy is often palliative in nature. Hormone invalid there is no standard treatment for prostate cancer; under study by cytotoxic drugs and biological agents may have palliative effects and prolong survival. but they alone than the superiority of corticosteroids has not been confirmed.


Prostate cancer, non-governmental secret

Prescription a

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Function: Yiqi kidney, Qi Sanjie.

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Light diet to prevent prostate cancer

The incidence of prostate cancer, the factors are complex, currently known risk factors including age, race, heredity, diet, vasectomy, smoking, obesity and other prostate diseases and so on.

Age: occurs mainly in older men

Prostate cancer occurs mainly in older men, reported in the United States has a group of men over the age of 50 autopsy about 30% of prostate cancer over the age of 80 was as high as 50%.

Genetics: family history, please note that

A family history of prostate cancer, men, the incidence of prostate cancer will likely increase significantly.

Dietary factors: controlling total calorie intake

In the risk factors, the most significant is the prevention of prostate cancer induced by dietary factors. Studies have shown that excessive intake of fatty foods may increase the prevalence of prostate cancer, while a class soy protein diet to reduce its incidence.

San Francisco's Chinese and Japanese immigrants prostate cancer incidence rate is 3-7 times of their own people, of which a very important factor is fatty food people eat more than their own. Because fat intake too much will lead to increased cholesterol synthesis, and further lead to the synthesis of cholesterol-based androgen increase, in the testosterone androgens increase the rate of incidence of prostate cancer, an important factor. Now that the total number of calories of fat in the diet the proportion of 10% -20% better.

Asian countries, a lower incidence of prostate cancer with soy proteins are more related to food intake. Because these foods are rich in phytoestrogens, its chemical structure similar to estrogen in humans, to a certain degree of inhibition of androgen-related. Of course, the dietary factors that induce prostate cancer is far more than this. For example, the catechins in green tea or fresh vegetables and fruits in vitamin E and selenium and other ingredients, can inhibit the occurrence of prostate cancer.

Prevention of prostate cancer diet be summed up in five points: First, the total calories of food in the proportion of fat, less than 20%; 2 is a daily intake of 20-40 grams of soy foods; third, 200 micrograms of selenium per day; Fourth, 400-800 international units of vitamin E per day; 5 is a multi-drink green tea. Three of them, 42 can also be used often to eat fresh vegetables and fruits instead.

Other: Please moderate exercise

Despite the small number of studies suggest that people who accept vasectomy prostate cancer rate will be higher, but most of the studies do not support this view. There is also a study of benign prostatic hyperplasia, obesity, lack of exercise, smoking, radiation, or sexually transmitted virus that may increase the incidence of prostate cancer. Relevant risk factors in older men need to be vigilant, get rid of bad eating and living habits, regular exercise may have on prostate cancer prevention makes sense.