With the development of urbanization in China, the living standards of residents have been rising.Prostate cancer cases are on the rise, as
With the development of urbanization in China, the living standards of residents have been rising.
Prostate cancer cases are on the rise, as in our hospital admissions, cases of prostate cancer, from the year of digits, now every month more than two digits of the number of cases, the incidence rate of growth is amazing, but we have to face the reality.
In our hospital from 1989 began to carry out radical resection of prostate cancer, in recent years, has completed the transformation from open surgery to endoscopic surgery, effectively overcomes the bleeding or complications such as urinary incontinence, combined with a comprehensive treatment, the maximum extend the patient's life.
But in daily work, often found with patients, family members often can not communicate adequately, and led to some patients into a dead end treatment. So, close up this article.
1, the rejection of prostate puncture:
In abnormal PSA, rectal examination and imaging examination revealed palpable nodule nodules, which are needed for prostate biopsy indications, and in the follow-up treatment, the need for health insurance for special diseases, will also be a pathological report as the only basis, this routine prostate puncture, in hospital under the condition of risk has dropped markedly. We have hundreds of thousands of patients with prostate cancer every year.
(1) encountered a case of advanced prostate cancer, said to be from the PSA5.6ng/ml, began to observe, observed for 7 years, has been observed at the time of treatment, bone metastasis has been very obvious at more than and 200. Asked the family, why only observe and not deal with? The family said that every three months, looking for an expert to do anal examination, saying there is no thing, there is no treatment. If done in a timely manner, clear, and may be more early treatment.
(2) some cases are thought to be advanced, so do not puncture: such as the discovery of elevated PSA, or metastasis. So do not puncture. But there will always be clinically misdiagnosed, PSA also showed increased inflammation; other types of cancer in the prostate can also transfer performance. Without obtaining the puncture to obtain the pathological diagnosis, it may lead to treatment bias, but can not evaluate the therapeutic effect.
(3) thought that the age is big, or the body is bad, do not puncture: in fact, there is no puncture to get the pathological report, the future of treatment may be blind.
2, dependence on endocrine therapy
Prostate cancer, except for low-risk cases (active monitoring indications of 1 very low risk patients, PSA < 10, GS < 6 positive biopsy index less than or equal to 3, T1c-2a biopsy specimens of each clinical tumor is less than or equal to 50% of prostate cancer. 2 clinical T1a patients with well differentiated or moderately advanced prostate cancer, with a life expectancy of less than 10 years. Such diseases should be followed closely by PSA, TURS, or prostate biopsy. 3 T1c-2a patients with benign or moderately differentiated prostate cancer, with a life expectancy of less than 10 years Or, always in progress. The progress of endocrine therapy can not completely control the cancer, not to mention the endocrine treatment of prostate cancer may lose efficacy after treatment in 2 years or so, and turned to endocrine therapy of refractory prostate cancer, long-term treatment of patients is bad.
3, irregular endocrine therapy
Many patients, because of symptom control or for other reasons, the use of irregular endocrine therapy, so the effect is very poor.
4, the trust of radical surgery
Radical surgery, part of the solution to the case, but to lymph node metastasis or invasion prominent capsule, seminal vesicle, radical resection is not omnipotent, also need further treatment, this kind of cases such as adjuvant endocrine therapy or salvage radiotherapy.
5, after the treatment of biochemical recurrence
In clinical practice, often encounter some patients in the testis after resection in biochemical relapse into non hormone dependent, some doctors recommend the use of Zoladex, enantone like medicine, actually this is often ineffective, because these drugs only in the testis, after orchiectomy, these drugs have been lost place, but because of misunderstanding the doctor, let the patient and to use the results.
Because of the high incidence of biochemical recurrence, it is now recommended for intermittent endocrine therapy, but must be under the guidance of a specialist.
6, radical operation status: because the radical operation of master doctor's not too popular, so some patients don't contact to do radical surgery doctors, which led to the treatment of deviation.
Talk about, may also be biased, welcome to discuss.