前列腺癌

定义

前列腺癌 is a disease in which 癌症 starts in the 前列腺. 男性的前列腺是一个核桃大小的腺体. 它包围着尿道 the tube that carries urine (pee) out of the body.

Most prostate 癌症s grow slowly, but some grow and spread fast.

前列腺癌

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原因

癌症 happens when cells in the body divide without control or order. 如果细胞保持 分裂形成大量的组织. 这些被称为生长或肿瘤. 如果肿瘤是 它被称为恶性肿瘤. Tumors can invade nearby 组织 and spread to other 身体部位.

前列腺癌的确切病因尚不清楚. 这很可能是由于基因和 环境.

风险因素

前列腺癌 is more common in men who are aged 65 and older. 它在黑人中也更常见. 其他增加风险的因素 是:

• Family members with prostate 癌症—especially in a father or brother
• 肥胖
• 高脂肪饮食
• 某些基因改变
• Exposure to certain chemicals, such as Agent Orange

症状

Early prostate 癌症 often does not cause symptoms. 当 出现症状时，可能是:

• 排尿问题，例如:
• 勃起问题
• 射精疼痛
• 血尿或精液中的血
• Frequent pain or stiffness in the lower back, hips, or upper thighs

的se symptoms may also be caused by other conditions, such as 良性前列腺增生(BPH)或其他 感染. People with these symptoms should see a doctor right away.

诊断

许多前列腺癌是通过 前列腺特异性抗原 (PSA)筛选. 它可以提前发现癌症 症状出现.

前列腺癌 may also be found after 症状出现. 的 医生会询问症状和过去的健康状况. 会做身体和直肠检查. 的 doctor can feel an enlarged prostate through the wall of the rectum. 血液和尿液 tests may be done to rule out other things that cause increased prostate size.

A sample of the prostate will be removed and tested with a 活组织检查. 这将证实癌症. 的图片 the prostate and area can show the size of the growth. 测试可能包括:

• Transrectal超声波
• 骨盆 核磁共振成像扫描
• 腹部 盆腔CT扫描
• 前列腺癌–specific membrane antigen based PET/CT scan (PSMA PET/CT)

Test results will be used to find details of the 癌症. 这 includes the type, stage, and grade of the 癌症. 分期用于指导治疗. 前列腺癌分为1到4级. 一期癌症只影响到附近的组织. Stage 4 癌症 has spread to other 身体部位. 分级显示癌症的发展速度 是否有可能生长和扩散.

治疗

治疗 varies depending on the stage and grade of prostate 癌症. 治疗包括:

观察等待

手术

可能需要的手术类型包括:

• 骨盆 lymphadenectomy—removal of pelvis lymph nodes to see if they have 癌症
• Radical prostatectomy—removal of the prostate using
• 经尿道膀胱切除术 前列腺癌)—removal of part of the prostate with an instrument inserted through the urethra (may be done to ease symptoms)

Side effects of prostate 癌症 surgery may be 勃起功能障碍,问题 控制尿流 or 凳子 (屎). 手术 methods may help reduce these risks for some. 他们 可能包括:

• 神经保留手术
• 机器人手术
• 腹腔镜手术

放射治疗

Radiation therapy can kill 癌症 cells and shrink tumors. 例子有:

• Conformal 辐射 therapy— saves nearby tissue from the harmful effects of 辐射.
• 调强放射治疗 (IMRT)—delivers higher doses of 辐射 to the tumor and lower doses to nearby 组织.
• Radiopharmaceuticals—drugs with radioactivity are injected into a vein to:

激素疗法

Hormone therapy may be used if prostate 癌症 has spread—or 治疗后返回. 的 goal is to lower the levels of male hormones called 雄激素. 主要的雄激素是睾酮. 降低雄激素水平会导致 使前列腺癌缩小或减缓其生长.

睾丸切除术 手术是切除睾丸吗. It 可以帮助控制荷尔蒙吗. 睾丸产生雄激素.

其他治疗方案

其他选择包括:

• Cryosurgery—癌症 cells are frozen and destroyed. 它可以用于低风险， early stage 癌症 for those who cannot have surgery or 辐射.
• Immunotherapy—的se drugs build the immune system to help fight 癌症 cells. 它们可能包括疫苗或注射.
• Targeted therapies—Attack 癌症 cells and help spare healthy cells.
• High-intensity focused ultrasound—A probe inserted through the rectum destroys 癌细胞与超声能量.
• 化学治疗(化疗)-主要用于缓解 symptoms in 癌症 that has spread outside the prostate. 化疗可能也有帮助 激素疗法.

预防

为了降低患前列腺癌的风险:

• 吃一 健康的饮食 那就是:

参考文献

• 前列腺癌. 美国癌症协会网站. 可用 在:http://www.癌症.org/癌症/prostate-癌症.html.
• 前列腺癌. EBSCO力学网站. 可以在: http://www.力学.com/condition/prostate-癌症.
• 前列腺癌筛查. EBSCO力学网站. 可用 在:http://www.力学.com/预防/prostate-癌症-screening.
• 前列腺癌的诊断和分期. EBSCO力学 网站. 可以在: http://www.力学.com/evaluation/prostate-癌症-diagnosis-and-staging.
• Schaeffer E, Srinivas S, Antonarakis ES等. 前列腺癌 癌症. 版本3. 2020. In: National Comprehensive 癌症 Network (NCCN) Clinical Practice Guidelines in Oncology (NCCN Guidelines). NCCN 2020年11月17日来自NCCN网站.