Prostate cancer mostly occurs in people over 60 years old. With the increase of age, the incidence rate also increases, which may be related to the imbalance of sex hormones.
Prostate cancer can be divided into three types according to its clinical manifestations. The first type is called "latent type", and the tumor is latent and inactive. The focus is static for a long time, with neither local spread nor distant metastasis, which has little clinical significance. The second type is called clinical type, which is characterized by enlarged prostate and urinary tract obstruction, similar to prostatic hypertrophy. The third type is called "hidden type", which is the most dangerous type. Because the primary tumor is small and does not cause symptoms, it is easy to have distant metastasis (such as cancer cells invading the spine, pelvis, liver and lungs). ), so it is easy to delay diagnosis and treatment.
Putting a rubber finger cuff on the finger for anal examination is the main method to diagnose prostate cancer (if the patient with urinary retention needs catheterization to empty the bladder before anal finger examination). Sometimes early localized tumor nodules can be felt, which are hard and inelastic. If it continues to progress, it will become a lump with uneven surface and unclear surrounding boundaries. The sulcus of the prostate disappeared and the bilateral lobes increased asymmetrically. If prostate cancer has invaded the prostate capsule, the prostate will lose its normal shape. The patient's urine or prostate secretion is examined by cytology, and if tumor cells are found, the diagnosis can be made.
Anal finger examination of early prostate cancer is sometimes difficult to distinguish from inflammatory granuloma, tuberculosis, calculus and chronic prostatitis. If you want to make a further diagnosis, you can biopsy the prostate through perineum or anus, and if necessary, you can expose the prostate surgically. If we take pathological specimens under direct vision, such as seminal vesicle radiography, we can see that the ejaculatory duct is deformed and displaced, and the contrast agent in the seminal vesicle is filled with defects. X-ray films of spine, pelvis and chest can find metastatic lesions. At present, isotope scanning is very helpful to diagnose bone metastasis. If advanced prostate cancer invades urethra and bladder, cystoscopy or cystourethrography can be used to make a definite diagnosis. Take venous blood to check serum acid phosphatase. If it rises, it means that prostate cancer may have metastasized.
Treatment principle For early prostate cancer (stage I and II, the lesion is confined to the prostate capsule) under 70 years old, radical prostatectomy should be tried, but only about 65,438+00% can really do this operation. Most patients have been confirmed to have metastasis of adjacent organs or far away when they are diagnosed, so they can only be treated without radical treatment. Non-radical treatment includes antiandrogen therapy, chemotherapy and radiotherapy. Stage III (lesions invading prostate capsule, such as bladder and urethra) and stage IV (lesions metastasizing to spine, pelvis, liver and lung). ) or patients with poor general condition who cannot tolerate radical surgery and antiandrogen therapy (including bilateral orchiectomy and estrogen, etc.). ) can inhibit the development of tumor, and make more than half of patients get better, improve the general condition, shrink the tumor and relieve dysuria. Chemotherapy and radiotherapy are suitable for patients whose androgen therapy is ineffective or whose condition gets worse after improvement. Chemotherapy, such as cyclophosphamide, vincristine and 5- fluorouracil, has a certain effect, and the combination is better than the single drug.