carcinoma, prostatic cancer, the English abbreviation for the PCa) is the most common male reproductive system cancer, the incidence increased with age, the incidence of significant regional differences in Europe and North America is higher. It is reported that after lung cancer, cancer deaths in men is the second. Our previous low incidence, but because of the aging population, the incidence has increased in recent years, prostate cancer and because of the continuous improvement of diagnostic methods, such as acidic phosphorus acid enzyme radioimmunoassay, prostate removal of lactic acid catalase determination, transrectal ultrasound imaging, CT examination and prostate needle improvements, etc., to make early diagnosis of prostate cancer, but also the incidence of prostate cancer has increased.
cause pathological
not yet identified the cause of prostate cancer may be related to genetic, environmental, sex hormones and so on. Prostate androgen secretion by testosterone nine-one regulation, gonadotropin luteinizing hormone play an indirect role. Were never young castrate prostate cancer.
98% for adenocarcinoma of prostate cancer, often shrink from the peripheral part of the prostate occurs, mostly multifocal.
prostate cancer metastasis in three ways:
? to nearby tissue or adjacent organs infiltration, the first invasion, and both sides of the leaves, worn envelope, to the ampulla of the vas deferens, seminal vesicles, bladder neck and urethra;
? lymphatic metastasis to the bones of the body can be inside and outside the para-aortic lymph nodes;
? The most common blood transfer to the pelvis, spine and femur. Severe pain, pathologic fractures can occur. Can also be transferred to the liver, lungs, chest 1 film, adrenal gland, brain and other organs.
prostate cancer classification
(1) latent prostate cancer: is not in his lifetime signs and symptoms of prostate disease, autopsy after death by pathological examination revealed the primary Pok in the prostate gland cancer. Latent prostate cancer can occur in any part, but the central area and peripheral area more common, and often well-differentiated adenocarcinoma. The incidence of foreign reports of 15% to 50%. Research Institute of China?s Bei Yida reported urinary latent prostate cancer incidence
V was 34%. Statistics Pok studies have shown that the incidence of prostate cancer may be related to potential environmental and genetic factors.
(2) incidental prostate cancer: clinical to the main symptoms of benign prostatic hyperplasia, prostatic hyperplasia in the removal of tissue, tissue Pok examination revealed prostate cancer. The performance of their organizations Pok better-differentiated adenocarcinoma, with mesh-like tubular adenocarcinoma and adenocarcinoma, a small number of poorly differentiated adenocarcinoma, incidental prostate cancer in foreign countries the incidence rate of 10% to 30%. China reported incidence of 5% or so.
(3) occult prostate cancer: patients with no signs and symptoms of prostate disease, but in the lymph node biopsy specimens or Guchuan pathological examination confirmed the curb prostate cancer. After a prostate biopsy can be further confirmed. These patients the serum prostate-specific antigen (PSA) and prostatic acid phosphorus acid, enzyme levels increased. PSA and biopsy done (or) PAP immunohistochemical staining were positive.
(4) clinical prostate cancer: clinical examination (palpation, ultrasound, CT or MRI, etc.) in the diagnosis of prostate cancer, and after a biopsy. Can also be increased in patients with serum PSA and PAP to assist in diagnosis. Most patients anus door DRE palpable prostate nodules, nodules of prostate ultrasound examinations showed irregular shape, uneven echo and echo low.
clinical manifestations of prostate cancer vary widely, and the tumor type. Latent, occult are no local symptoms. Type of local symptoms and clinical benign prostatic hyperplasia is similar.
early asymptomatic. When the cancer causing bladder neck and posterior urethral obstruction can occur when symptoms, hematuria fewer symptoms of some patients to transfer treatment, the performance of low back pain, sciatica. So the men of unknown primary tumor metastatic cancer, prostate cancer should be excluded.
bladder neck and urethral invasion, there are inflammatory symptoms of urethral stricture, urinary frequency, urgency, dysuria, hematuria, and dysuria.
patients with symptoms of chronic wasting, weight loss, weakness, anemia.
at an early stage, the patient and without any features. As the disease progresses, patients may notice that the following conditions:
1, urinary frequency, urgency
2, urinary retention
3, spicy feeling when urinating
4, is difficult to form a flow
5, hematuria
6, painful urination
7, bone pain
has to prostate patients with advanced cancer may also complex with the following conditions:
1, bone marrow depression disorder
2, osteoma transfer
3, paraneoplastic syndrome
4, high in calcium
5, pain
6, high uric acid
7, pleural leakage
8, leg swelling
prostate cancer can be divided into three types: ? clinical symptoms with benign prostatic hyperplasia; ? cover type, the tumor is small, does not cause obstruction and clinical symptoms, physical examination, or there may be a result of metastatic disease (such as the pelvis, spine, etc.) symptoms was found; ? latent, only in the tissue pathological examination found.
prostate cancer is often without clinical symptoms start only in the physical examination rectal examination prostate nodule prostate cancer began in the prostate peripheral zone easily palpable urinary retention and hematuria may be accompanied by the cancer caused by benign prostatic hyperplasia dysuria and hematuria is often a considerable number of advanced clinical prostate cancer, benign prostatic hyperplasia is found in pathological examination of surgical specimens there are also many cases of medical treatment for symptoms of the transfer of clinical diagnosis of prostate
method:
? digital rectal examination: find hard nodules, the correct rate of 80%;
? transrectal needle biopsy of the prostate or perineal incision is more accurate;
? serum acid determination of phosphorus acid enzymes: can be significantly increased.
? B ultrasound, isotope scanning: the prostate has changed.
? X line: urethrography urethral bladder neck displacement; spine, pelvis, femur, sternum deterrence film, see destruction of metastatic bone lesions.
early diagnosis of prostate cancer because prostate cancer
occurred in the posterior lobe, early and asymptomatic, even if there is discomfort, but also enough to cause the patient?s attention, so early diagnosis made it difficult to . Once there is a clear clinical symptoms, often already advanced disease, poor prognosis. Can be seen, early detection of prostate cancer is very important. Especially for prostatitis, BPH patients, recurrent diseases, great care should be changes in condition, to prevent cancer. Prostate cancer patients often appear in the early increase in urinary frequency and nocturia, dysuria, flow thinning, urine prolonged, painful urination, and urinary retention and other symptoms, the same with benign prostatic hyperplasia, whereby it is difficult to diagnose prostate cancer, mainly rely on digital rectal examination diagnosis.
digital rectal examination in early diagnosis of prostate cancer is extremely important, the accuracy rate of up to 50% -70%. Many Pok advocated in prostate cancer-prone areas, middle-aged men on a regular basis for digital rectal examination, many patients will get the chance of early diagnosis and cure.
necessary, doctors can take perineal, rectal biopsy, taking biopsy, the diagnosis of
correct rate of 70% -80%. Also massage the prostate through the rectum, prostate fluid examination fee, the positive rate of 90% or more. Most cases can thus be confirmed.
diagnosed with advanced prostate cancer
(1) advanced prostate cancer, mainly for the lower urinary tract obstructive symptoms, or with hematuria and urinary retention. The most prominent symptom is pain, bone metastasis, pelvic area or lumbosacral pain. Signs are mainly localized prostate induration, lump, its hard texture, loss of normal playing sexy and fixed glands around the hardware change, state of confusion.
(2) X ray shows bone iliac bone was to change the shadow of bone density, trabecular bone disappeared.
(3) angiography showed prostate enlargement the bladder, urethra damage or jagged.
(4) the prostate gland imaging showed damage, duct obstruction, irregular increases and so on.
(5) cystoscopy is invasive cancer can clear the urethra or bladder.
(6) prostate cancer cells at the available positive results.
(7) availability of positive biopsy results.
(8) acid phosphorus acid serum enzymes, serum bone alkaline acidic phosphorus acid, phosphorus acid, enzymes and enzyme determination in bone metastases can be increased.
basic treatment options for prostate cancer
present, according to the staging of prostate cancer, treatment options used are as follows:
A1 term treatment of benign prostatic hyperplasia when the accidental discovery of cancer , lesions limited to, the majority of well-differentiated, the majority of patients in stable condition, develops slowly, only about 1% likely to die of cancer. As the prognosis is good, generally do not advocate the immediate line of radical prostate surgery or radiotherapy, endocrine therapy. Be regular follow-up, the line digital rectal examination and B-ultrasound, and serum acid phosphorus acid enzymes. Can be treated with medicine to control their development.
A1 period without treatment 35% of patients may have tumors that progress, and should therefore be considered radical resection of the prostate or radiation therapy.
B1 majority of well differentiated tumors, but surgery found that 5% -20% of patients had lymph node metastasis occurs, it should be radical resection of the prostate cancer, radical cancer-free survival after 15 years 50% -70%.
B2 period of about 50% of patients the tumor has violated the seminal vesicle, while 25% -35% of cases with lymph node metastasis, it should be held before cancer radical surgery and pelvic lymph node dissection, orchiectomy, endocrine therapy, radiotherapy and radiotherapy within the organization. B2 stage 15 years after radical surgery for cancer-free survival rate was 25%. C phase of treatment is no unified opinion, so when the treatment is difficult, the majority of pelvic lymph nodes had metastases. Methods commonly used treatment following Ji: ? the frail elderly, patients with poor general condition, suitable for in vitro expansion of the scope of radiotherapy. ? endocrine therapy (including double orchiectomy), the degradation process was conducted after in vitro expansion of the scope of radical surgery for prostate cancer radiation therapy and in combination. ? organization radiotherapy and radiation in vitro, for those without lymph node metastasis and distant metastasis, and the general condition is better.
D term endocrine, chemotherapy and immunotherapy based on the D0, D1 phase can be implemented for pelvic lymph node dissection, early use of endocrine therapy prolong survival time of tumor, 5-year survival rate of 30%.
prostate cancer ultrasonography
men prostate cancer is common, typical of prostate cancer, ultrasound showed:
(1) increased prostate volume, left-right asymmetry , form inconsistent.
(2) rough thickened capsule, continuous bright line break has damaged the local level is unclear.
(3) heterogeneous internal echo, there may be irregular focal hypoechoic areas, and may be associated with bright points of light group, may have sound attenuation. Lesions often appear in the posterior lobe or left lateral lobe, internal and external membrane structure ill-defined.
(4) to adjacent tissue, in the seminal vesicle, bladder, rectum, bladder or rectum fossa exploration and tumor echo, or irregular thickening of the bladder neck, broke into the bladder.
(5) the performance of lower urinary tract obstruction, bladder neck and prostate cancers after urethral obstruction, hydronephrosis occurs. Trabecular changes in the bladder mucosa, showing residual urine.
early symptoms of voiding dysfunction
dysuria, urinary flow thinning or skew, or urine flow bifurcation, prolongation of urine, urinary frequency, urgency, dysuria, urine not the flu, severe urinary dribbling, and urinary retention.
waist pain, sacral, hip, hip pain, pelvis, sciatica is a common, severe unbearable.
shift in prostate cancer symptoms
people, the transfer is very common. About 1 / 3 or 2 / 3 of the initial medical treatment of patients with lymph node when the transfer occurred in the internal iliac, external iliac, waist, groin and other parts. Can cause swollen lymph nodes and the corresponding parts of the lower limb swelling.
symptoms
pain affects as diet, sleep and spirit, the long-suffering, body condition increasing weakness, weight loss, fatigue, anemia, cachexia, or renal failure.
the daily care of prostate cancer
1. do prevention, early diagnosis and treatment, so that elderly men to understand and master the knowledge about prostate cancer, early detection of abnormal urination, seek immediate medical attention , a clear diagnosis and early treatment.
2. surgery or conservative treatment, all doctors should be asked to do, take medication, injections.
3. a reasonable diet and pay attention to appropriate activities to enhance physical fitness, help to restore.
prevention of prostate disease, another way is to diet. First, you must reduce the deterrence to take Bao and fat, because it is considered to have increased incidence of prostate cancer in the wind Yan. Second, eat more foods containing lycopene. Lycopene is an antioxidant, tomato, red is because it comes.
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Source: http://nikkaconsulting.com/prostate-cancer-of-prostatic/
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