PROSTATE CANCER

A diagnosis
(1) clinical diagnosis
1. Early symptoms may developed symptoms of advanced prostate hyperplasia with a similar obstructive symptoms. Because cancer metastasis to the bone, lumbosacral pain, sciatica, nerve paralysis, accompanied by weight loss, fatigue, loss of appetite and other systemic symptoms.
2. Digital rectal examination is a rock-hard prostate nodule, its boundaries unclear, mass sizes, or a few millimeters or large and fixed.
3. Laboratory ACP, AKP increase in transfers. PSA, PAP in the diagnosis of prostate cancer is a certain sense.
4. Ultrasound imaging examination revealed the prostate hypoechoic lesions. See X-ray examination of the bone changes that increased density of the shadow, we can see that osteolytic lesions transfer or mixed; THE chest lung metastases can be found. CT and MRI scans of the prostate that can be changed, occupying lesions and metastases. ECT earlier than X-ray found bone metastatic lesions.
5. Prostate Needle aspiration biopsy of the prostate can be diagnosed as a method used 6:00 puncture biopsy system.
More clinical staging method is not yet unified. Ts are commonly used phased improvement of law and TNM staging.
1. Improved staging of ts
A: Most of incubation. Clinical found no tumors, prostate digital rectal examination without change, found only in the examination of tumor cells and tumor cells in good, normal serum acid phosphatase.
A1 period: only confined to the prostate tumor lesions within one to two small regions.
A2 period: multiple tumor foci were still confined to the prostate.
B: Tumor confined to the prostate, but the digital rectal examination can be touched. The digital rectal examination can be divided into the following two.
B1 period: tumor nodules confined to the side of the prostate with less than 1.5 cm in diameter.
B2: tumor involvement Hitotsuba above or greater than 1.5 cm in diameter, but not over-coated. Normal serum acid phosphatase.
Stage C: Most violations have prostate cancer, benign prostatic capsule penetration violations spermatheca, bladder neck and pelvic bilateral or other pelvic organs, there is no transfer. Serum phosphorus acid normal or elevated enzyme.
C1 period: no cancer and seminal vesicle invasion.
XC2 period: seminal vesicle involvement or other pelvic organs.
D: Clinical and pathological have transferred. 2 / 3 cases of elevated serum acid phosphatase.
D1 period: pelvic lymph node metastasis in the aortic bifurcation.
D2 period: aortic bifurcation more lymph nodes and other organs and bone metastasis.
2.1974 Initiative, the International Union of TNM staging
The primary tumor (T) phases:
Tx: occasionally cancer (carcinoma in situ)
T0: the original tumor was found.
T1: tumor of the prostate 1 / 2 below normal size gland.
T2: tumor of the prostate 1 / 2 or 1 / 2 above, nor increase gland.
T3: tumor confined to the gland, but gland increases.
T4: the gland tumor,.
Regional lymph nodes (N) phases:
Nx: lymph nodes situation can not be estimated.
N0: No change lymph nodes.
N1: local lymph nodes deformation.
N2: can be fixed palpable abdominal lymph nodes.
Distant metastasis (M) stages:
M0: no transfer.
M1: metastasis.
Vaccine: Only bone metastases.
FDA: other parts of the transfer, with or without bone metastases.
2, differential diagnosis
1. Prostate tuberculosis prostate sclerosis, it is similar with prostate cancer. But younger patients, reproductive system other organs, such as the seminal vesicle, vas deferens, epididymis tuberculous lesion or urinary tuberculosis symptoms, such as frequency, urgency, novel urethral secretions, blood and sperm. Tuberculosis prostate nodule for local infiltration, texture than they. Urine, prostatic fluid, semen with red, IL. X-ray shadow sometimes visible calcification prostate, prostate biopsy pathology typical TB change.
2. Prostate stone for stone prostate digital rectal examination, ahead of prostate, palpable calculus of a hard twist of the flu. Pelvic X-ray shadow of stone that the prostate; Ultrasonography showed that the prostate area with the light acoustic shadow.
3. Nonspecific granulomatous disease prostatitis nodules developed rapidly, with peak-like protrusions, hard and soft mixed, but resilient. The treatment of antibiotics and anti-inflammatory medication 1-2 months sclerosis smaller. Hard Festival prostate biopsy, endoscopic rich in non-caseating granulomas, full of epithelioid cells, foam cells, around lymphocytes, plasma cells, eosinophils, the gland often rupture expansion, with inflammatory cells.
4. Prostate nodular hyperplasia prostate showed diffuse increased, smooth surface, there are nodules flu; PSA general in the normal range; Prostate ultrasonography increased its points-in uniform, prostate capsule for reflection, clearly limits its surrounding tissue.
5. The incidence of prostate sarcoma with high youth, children accounted for 1 / 3; Condition rapid development, shorter duration. Digital rectal examination prostate enlargement, but flexible texture, soft as cystic more with lung, liver, bone metastasis and other clinical symptoms.

Prostate cancer - healthy elderly men occult killer <BR> Zhao After various inspections, the results, he appeared prostate cancer patients with bone metastasis. That is prostate cancer the cancer had metastasized to the bone, the bone caused pain and lead to a strong movement disorders.
Prostate cancer is the world's sixth largest malignancy. In the United States, the incidence rate of prostate cancer, a malignancy Habitat men, second only to lung cancer mortality, accounting for second place, each six older Americans out of a person suffering from prostate cancer. With the aging of our population, the incidence of prostate cancer is increasing year by year, its impact on the health of older men are increasingly apparent. Shanghai, the incidence of prostate cancer in 1985 was 2.6/10 10,000 by the year 2000 increased to 7.7/10 million, is expected in 2005 will reach 10/10 10,000. Similar to the situation in Beijing, in 1985 the incidence rate was 2. 38/16 10000, 1985 ~ 1995, the City of prostate cancer incidence increased by 2.3 times, is also expected to achieve a 10/10 10,000.
Bone metastases of prostate cancer is the main performance <BR> advanced prostate cancer is the most vulnerable to the malignant bone metastasis, more than 80% of patients with prostate cancer bone metastases will happen. Metastatic bone lesions can be found at Ilium, vertebrae, ribs, skull and proximal long bones, mostly in the avascular bone axis rich site. The most common prostate cancer is the first clinical manifestation of bone metastasis is the bone pain. Sustained pain, and often affect patients with anorexia and daily rhythm of life, so patients increasingly emaciated, the misery. Secondly, because the bones were 1.1 points to tumor cells "eat", the bone metastasis was prone to pathologic fracture. If tumor cells of the patient spinal vertebrae, then vertebral collapse will lead to the symptoms of spinal cord compression by, it makes treatment more difficult.
Bone metastases of prostate cancer treatment is a comprehensive treatment of early prostate cancer often <BR> male androgen treatment resistance is sensitive. But with the development of disease, treatment of androgen resistance will gradually lose their role, but also the development of prostate cancer has advanced. Fortunately, the disease Although Zhao advanced prostate cancer, but resistance to androgen therapy is sensitive. Through oral drugs and the necessary surgical intervention, he fell to a certain androgen levels. In order to alleviate the symptoms of bone pain, the doctors gave him a main component of the use of bisphosphonates for the special drug. With drug drop by drop in the importation of Mr. Zhao, bone pain from the torture he gone step by step, gradually smile in the face of Mr. Zhao spacious. Three weeks later, Mr. Zhao calmly walked out the door of the hospital.
Bone metastases of prostate cancer treatment in addition to the above-mentioned endocrine therapy (androgen treatment resistance), bisphosphonates in the treatment, under different conditions also can be used chemotherapy, the radiation therapy, radiation therapy within radionuclide therapy and various integrated applications. Another more advanced treatment, such as immune therapy and gene therapy, is still in the pilot stage, clinical application of small, but has a very broad application prospects.
Urology doctors Suggestions <BR> majority of prostate cancer patients with bone metastasis, because of a certain feeling of headaches body to the hospital and found the orthopedic treatment. But unfortunately, at this time of prostate cancer has developed to the advanced. Therefore, the importance of early detection of prostate cancer.
The generally accepted clinical effective early detection of prostate cancer is the digital rectal examination and examination of the serum concentration of P SA. Digital rectal examination can be found in prostate cancer nodules, carefully rectal examination for prostate cancer early diagnosis and staging are of important significance. If that is found suspicious nodules, it would need to further prostate biopsy, about 70% of the patients could be diagnosed. PSA is a prostate cancer-specific serum indicators, generally less than normal abnormal. If higher than the target, this will cause doctors attention. Men over the age of 45, preferably every three months to six months to see a urology clinic, do a detailed inspection of prostate related.