Prostate Cancer Treatment Options

Written by Zhou Zi Hua
Oncology
Updated on September 23, 2024
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How is prostate cancer treated? The choice of treatment plan should be based on a comprehensive consideration of the patient's clinical stage, age, overall health, and expected lifespan. For example, in the early stages of prostate cancer, one can choose postoperative radical radiotherapy after prostatectomy. For locally advanced prostate cancer, radiotherapy, intensified radiotherapy combined with endocrine therapy can be chosen. For metastatic prostate cancer, endocrine therapy is mainly used, and chemotherapy can be adopted for those who are ineffective or fail endocrine therapy.

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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.

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Is vomiting in prostate cancer due to metastasis to the liver?

Patients with prostate cancer may experience vomiting due to the metastasis of the disease to the liver, causing damage to liver function. However, vomiting could also be caused by other reasons, such as the metastasis of prostate cancer to the peritoneum of the abdominal cavity. Clinically, this can lead to cancerous intestinal obstruction, with symptoms commonly including vomiting, abdominal pain, bloating, reduced bowel movements and gas, or cessation of bowel movements and gas. When prostate cancer metastasizes to the brain, the increased intracranial pressure can also cause symptoms such as vomiting, headache, swelling of the optic disc, hemiplegia, and aphasia. Additionally, some prostate cancer patients may experience vomiting due to toxic side effects from treatments such as chemotherapy and targeted therapy.

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What causes prostate cancer?

The causes of prostate cancer are not yet very clear. Its occurrence may be related to gonorrhea of the prostate, or viral and chlamydial infections of the prostate, as well as the intensity of sexual activity and the influence of hormones, which may have some connection to the development of prostate cancer. Additionally, a high-fat diet and some occupational factors, such as excessive exposure to chromium, may also be related to the onset of prostate cancer.

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Pathological classification of prostate cancer

The classification of precancerous lesions of prostate cancer is divided into two categories: intraductal carcinoma of the prostate and atypical adenomatous hyperplasia. Among these, the relationship between intraductal carcinoma of the prostate and prostate cancer is the closest. Intraductal carcinoma of the prostate is currently recognized as a precancerous lesion of prostate cancer, while atypical adenomatous hyperplasia has not been proven to be a precancerous lesion of prostate cancer according to current evidence. However, the biological behavior of this atypical adenomatous hyperplasia is not very clear yet, so it should be closely monitored. The histological classification of prostate cancer mainly includes the majority of acinar adenocarcinoma and a small amount of ductal adenocarcinoma, with acinar adenocarcinoma being a highly invasive malignant tumor.

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Written by Zhou Zi Hua
Oncology
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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.