Introduction of prostate cancer

Prostate, also known as prostate, bladder neck is located in the export of a cone-shaped gland organizations, around the urethra, surrounding the urethra from five leaves and formed a group of acinar gland, the secretion of fluid in the ejaculation with mixed semen urethra can be activated and the extension of the function of sperm motility. Prostate cancer is commonly found in men over the age of 50. In the United States second only to lung cancer and colorectal cancer is a common male cancer, Taiwan's average life expectancy rate was also increased and progress in screening and a significant increase in 86 years the incidence has risen ten of the seventh. 

 Prostate gland cells are due to deterioration and hyperplasia caused by, resulting in lesions of the reasons is not clear, likely to be: 

 1. Genetic factors: genes, when the relatives have prostate cancer when the disease has been changed to increase opportunities. 

 2. Hormonal factors: the majority of the prostate have to rely on male hormones to maintain the growth, so from a young age were castrated or testicular dysplasia disease does not occur. 

 3. Food and the Environment: carcinogens may have exhaust, cadmium, fertilizers, rubber and dyes, but also has reports and high-fat food-related. 

 4. Viruses and bacterial infections: the object of many, a high rate of sexually transmitted diseases, the chance of suffering from prostate cancer higher. 

 

 Early symptoms of prostate cancer and prostate hypertrophy almost nodular hyperplasia, early voiding difficulty or frequency of urine, occasional hematuria, urinary tract infection, urine and urine do not want to come out, urinating small diameter radio column, after solution is still down little drops of unfinished constantly. Easy bulging bladder often happen is not easy to explain or cystitis blood in urine. The latter often in patients with anemia, and easy to transfer to bone and bone pain. 

 Prostate cancer more than 95% for adenocarcinoma, the diagnosis of prostate cancer or to rely on the final pathology to complete. To ultrasound-guided systematic biopsy (in the prostate biopsy of the four different parts, each sampling site 2-3 times) for the malignancy of prostate cancer and tumor stage to provide accurate information. Ultrasound for the seminal vesicle and low ultrasonic wave reflection DRE nodules but can not touch the cancer tumor biopsy, is very helpful. Ultrasound for long in prostate transitional zone of deep cancer biopsy also provides accurate guidance. To ultrasound-guided automatic biopsy gun development, made it possible to fine-needle aspiration sampling of ways to use less and less. Because fine-needle aspiration specimens is too small, not readily available in pathological changes in the organizational structure in order to make a good grade or by installments. General can be divided into four phases: 

 A period 

 (T1) cancer cells in the transitional zone, and are due to benign prostatic hyperplasia surgical resection was found. A period is divided into: 

 A1 (T 1a) ─ 

 For well-differentiated or moderate degree of differentiation of cancer cells (Gleason score of 2-7), accounting for the resection of carcinoma of benign prostatic hyperplasia organizations 5%, or resection of benign prostatic hyperplasia tissues have less than three cells. 

 A2 (T1b) ─ 

 Are in the transitional zone of prostate cancer, but do not meet the definition of A1. 

 Recently, because prostate specific antigen (PSA) findings and transrectal ultrasound of the progress, more and more touching than a slice of cancer diagnosed. These cancers were found to be classified as current (T 1c). 

 Phase B 

 Cancer Cancer is defined as cancer is still within the prostate capsule, and in accordance with the size of cancer and in prostate site is divided into: 

 B1 ─ 

 Are in the prostate Cancer leaves about one leaf, by DRE touch, and a diameter <1.5>

 B2 ─ 

 Cancer in the are around the prostate can touch both lobes, and the diameter of> 1.5 cm. 

 C Phase 

 For violations of cancer cells into the prostate outside the organization. The most common violations for the seminal vesicle, prostate gland around the fat, urethra and bladder neck muscles. D on behalf of metastatic cancer lesions. 

 D period 

 Further divided into: 

 D1 ─ 

 For violations of the pelvic lymph nodes. 

 D2 ─ 

 For cancer cells to distant organs and bones. 

 

 And classification, the current most widely used is the Gleason grading system, it is divided into cells according to grade levels 1-5 months, "1" for the differentiation of the best, "5" for the differentiation of the worst. Scoring of the tumor from the internal election of the entire gland cancer in most series the majority of poor differentiation and sub-divide the majority of bad series, whichever is the sum of the scores that is yes. In accordance with the system ,2-4 is divided into well-differentiated, 5-7 into the middle degree of differentiation into serious ,8-10 poorly differentiated. 

 

 Because usually no symptoms of early prostate cancer, doctors currently make DRE, measurement of serum prostate specific antigen (PSA) concentration, the merger of two test results, judged to be a high-risk groups, they make by rectal ultrasound and systematic biopsy to obtain the pathological diagnosis.

Prostate cancer treatments, including radical resection of the prostate, radiation therapy, hormone therapy or immunotherapy and gene therapy. Variability because of prostate cancer treatment also makes it diversifying can never active treatment to surgical resection. Different treatment modalities based on patient's age and physical condition of cancer cells and tumor progression based on the stage. In addition the hospital equipment and physician's preferences also need to be taken into account. 

 1. 

 For confined to the prostate cancer treatment intramembranous outsourcing (T1 or T2), is based on extensive resection of the prostate or radiation therapy. Two methods of long-term survival rate was 80-90%. 

 2. 

 For prostate cancer outside the capsule has been through, or in surgically resected specimens found in prostate cancer cells have violations around the patient, based on radiation therapy alone or combined with hormone therapy. 

 3. 

 Transfer has occurred for the treatment of prostate cancer is hormonal therapy. Orchiectomy which is the most simple and effective method. Other rule of the hormone of chemical agents while prices have more side effects Aung and disadvantage. Partial transfer of bone lesions can be a separate trip to the local radiation therapy to alleviate the suffering of patients 

 Surgery may be perineal, retropubic and the sacral make radical prostate surgery, including prostate, seminal vesicle and bladder neck resection is required. General recommendation is suitable for surgery patients, its expected life expectancy for more than a decade. Surgical complications include urinary incontinence, sexual dysfunction, such as wound infection. 

 In addition, early prostate cancer cure rates of up to 80 ~ 90%, while regular DRE and blood Detect prostate specific antigen (PSA), can be early detection of this cancer.