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Prostate cancer
Prostate cancer radiotherapy is conducted in what way?
Indications for radiation therapy for prostate cancer include clinical stages T1 to T4, M0 to M1. M0-stage prostate cancer patients undergo radiation therapy techniques including external beam radiation and brachytherapy. External beam radiation techniques comprise conventional radiation therapy, three-dimensional conformal radiation therapy, and intensity-modulated radiation therapy. Permanent seed implantation is used only for the treatment of early-stage localized prostate cancer with a good prognosis. External radiation therapy is divided into three categories based on therapeutic objectives: curative, adjuvant, and palliative radiation therapy.
How long can one live after prostate cancer has spread to the bones?
Bone metastasis is the most common site of metastasis for prostate cancer. If a patient with prostate cancer develops bone metastasis, it means that the cancer is no longer in its early stages and has progressed to a more advanced stage. However, unlike other cancers with a higher degree of malignancy, if the tumor is highly sensitive to hormone therapy, with standardized treatment, the patient's survival time can be significantly extended.
Endocrine therapy after radical prostatectomy for prostate cancer
Endocrine therapy after radical prostatectomy for prostate cancer is equivalent to adjuvant endocrine therapy for prostate cancer. Its purpose is to treat residual lesions, positive residual lymph nodes, and microscopic metastatic foci, thereby improving long-term survival rates. Currently, the indications for adjuvant endocrine therapy are based on postoperative pathology-positive results, positive lymph nodes post-surgery, and postoperative pathology confirmation of stage T3 or T4, but with high-risk factors. According to major guidelines, the duration of adjuvant endocrine therapy should be at least eighteen months.
The difference between benign prostatic hyperplasia and prostate cancer.
Prostatic hyperplasia and prostate cancer are sometimes very difficult to distinguish clinically, as both diseases occur in elderly men, can cause lower urinary tract symptoms, and lead to elevated PSA levels. However, prostatic hyperplasia generally has a longer medical history, whereas prostate cancer has a shorter history and progresses more quickly. During a digital rectal exam for prostatic hyperplasia, the gland appears enlarged and the surface is smooth. In contrast, during a prostate exam, the gland may show irregular enlargement, a rough surface, and the tumor feels firm. When these two are difficult to distinguish, considering a prostate biopsy may be advisable.
Typical symptoms of prostate cancer
Early-stage prostate patients often do not exhibit significant clinical symptoms. However, when the prostate cancer tumor invades the surrounding tissues and structures, it can cause corresponding clinical manifestations such as urinary tract irritation and urinary obstruction. Symptoms include difficulty urinating or frequent urination, painful urination, and even urinary incontinence, perineal pain, and sciatica. Bone metastasis is a common site of metastasis in prostate cancer patients, causing pain in the affected area and even pathological fractures.
What are the symptoms of bone metastasis from prostate cancer?
Bone metastasis is the most common site of metastasis for prostate cancer, with the lumbar vertebrae being the most common site. Eighty percent of bone metastases in prostate cancer are osteoblastic changes. The main symptoms caused by bone metastasis are bone pain, pathological fractures, anemia, and if the spinal cord is compressed, it can cause paralysis of the lower limbs, weakness, incontinence, and other symptoms.
androgen deprivation therapy for prostate cancer
Androgen deprivation therapy for prostate cancer includes surgical castration, which can quickly and continuously reduce levels to very low levels. The second is medical castration, which involves the use of analogs of luteinizing hormone-releasing hormone. Currently available products include leuprolide, goserelin, and triptorelin. Third, estrogen therapy, with diethylstilbestrol being the most common estrogen treatment. Surgical castration, medical castration, or estrogen therapy offer similar progression-free survival rates in patients with tumor-related outcomes.
Commonly used drugs for endocrine treatment of prostate cancer
The purpose of endocrine therapy for prostate cancer is to reduce the concentration of androgens in the body, inhibit the synthesis of androgens originating from the adrenal glands, inhibit the conversion of testosterone to dihydrotestosterone, or block the binding of androgens to their receptors, thereby inhibiting or controlling the growth of prostate cancer cells. The medications include a luteinizing hormone-releasing hormone analogue, with representative drugs being leuprorelin, goserelin, and triptorelin. There is also an androgen-blocking drug, including steroidal drugs with representative drugs like cyproterone acetate, and non-steroidal drugs with representative drugs like bicalutamide and flutamide. Additionally, there are estrogens, with the most common being diethylstilbestrol.