Urine testing can be uncovered malignant prostate cancer

University of Michigan researchers found that urine samples through the inspection, can be uncovered malignant, highly aggressive prostate cancer, looking forward to let the disease is not so serious in patients with prostate cancer suffer less points. The study is published in "Nature" (Nature) journals. 

 In Taiwan, men accounted for malignant prostate cancer ranking fifth in the urinary tract malignancies, the first prostate cancer are on. Prostate cancer patients, some patients with particular ferocity, tumor grade is also relatively high. The medical community has been hoping to find a method of early identification. 

 Some prostate tumors grow slowly, and patients often end up not die of cancer, but death due to other diseases. But some prostate tumors are also fierce and fast growing, these patients need treatment immediately. But the medical staff it is difficult to differentiate the difference between two types of tumors, so let some prostate cancer patients unnecessary surgery or chemotherapy treatment, patients often suffer. 

 The researchers found that, when the physical face of aggressive prostate cancer, the body will produce a small molecule called the "glue acid methyl Gan" (Sarcosine), the future of plastic acid methyl Gambari may be able to become a tumor marker, to allow medical staff more accurately grasp the condition. However, the U.S. admitted the University of Michigan researchers, the study is still an early stage, if there is a clear outcome to wait at least 5 years. 

 Researchers at the pathological examination of 262 samples, these samples are from organizations, blood or urine samples containing 1126 kinds of molecules. The researchers point out that when patients with a more malignant form of cancer, the samples can be found about 10 kinds of molecules, metabolites. One metabolite is plastic acid methyl Gan. Researchers have discovered that malignant tumors, cancer proliferation in patients with urine, tissue glue acid methyl Gambari has increased the trend. The study pointed out that plastic acid methyl Gambari may help cancer proliferation, the future of R & D of new drugs when the gel acid methyl Gambari might be classified as a potential therapeutic target.

-89 Strontium isotope therapy can effectively alleviate the complication of metastatic bone pain of prostate cancer

Prostate cancer in Western countries are leading the incidence of the first. Taiwan's informal survey urologist number of patients diagnosed with prostate cancer, the incidence per million population of about 16 people, average age of initial diagnosis of 67.8 years old. Per 100,000 population 40 to 45-year-old incidence of 0.23% over the age to 80 per 100,000 population to 32 percent higher, at 50 years of age the incidence rate of three times the mortality rate, age, the greater the mortality rate more high. Taiwan's Chinese and whites, the age of 50 men over the age of one third to one quarter have already latent prostate cancer. According to the Department of Health statistics, the number of deaths, the number of people die each year from prostate cancer has been increasing trend in the past nineteen years has increased fourfold. According to this increase in the ratio of view, the projection after a few decades Taiwan has at least a thousand people a year die of prostate cancer. 

     The treatment of advanced prostate cancer there is no magic formula, relying on orchiectomy and hormone replacement therapy can improve most of the patient's symptoms, but will eventually be transferred step by step toward the deterioration of one death. The early diagnosis of prostate cancer is therefore essential. 

     Traditional endocrine therapy by surgery or drug therapy alone can reach a few of the effects of castration of male hormones, including: (1) orchiectomy, (2) oral female hormone preparations, and (3) LHRH Analogues three subcutaneous treatment law, its clinical efficacy homogeneous approximation. Orchiectomy under local anesthesia in the implementation of 3-8 hours in the postoperative period can be Su-male serum concentration fell to castration, is the most traditional, fast and effective treatment method. However, patients have been psychologically castrated feelings, thereby affecting the degree of acceptance of this treatment. Although orchiectomy Another advantage of the merger in patients with severe pain of bone metastasis when orchiectomy can achieve rapid pain relief effect. 

     To sum up, in Taiwan, approximately every three to a quarter of the elderly contain latent prostate cancer, perhaps because of the past decade changes in environmental factors and life expectancy results of clinical prostate cancer incidence and in mortality has increased the trend of speed has become the most common male urinary system cancer. For the terminally ill can no cure, only by early diagnosis and early imposed prostate surgery or partial eradication of radiation, isotope control treatment in order to have radical treatment opportunities. 

 [Cancer metastatic bone pain] 

     The domestic top ten causes of death, cancer is still the number one adversary. Cancer of the high incidence of bone metastases, while the male rate of bone metastasis of prostate cancer up to 80%. Metastatic bone cancer patients, about 50-80% have bone pain symptoms, and many are drug treatment of pain difficult. Generally speaking, the more the spread of cancer, the patients on the higher probability of pain. Explore the cancer can be transferred to the bone by two ways. One for the infringement of sponge bone marrow cavity, one for the Hastelloy tube by periosteal bone dense part of violations. However, some 15% of patients did not see the transfer of pain would happen. Bone pain showed only in the non-terminal cancer and may occur at any given time. The reasons for the complexity of cancer pain, treatment methods of diversification, including the use of a variety of analgesic drugs, narcotic analgesics, systemic radiation therapy, and even surgical treatment and behavior therapy have. Its purpose is to make the patients were free of pain of suffering, improve quality of life, to live with dignity; to allow patients in a warm, non-painful circumstances, survive the rest of his life. 

 [How to help cancer metastatic bone pain?] 

     Ways analgesics, including traditional non-steroidal analgesics, narcotic analgesics, in vitro irradiation and radiation isotope control analgesic treatment of pain. The first two have to worry about the toxicity of drugs and addiction. To in vitro irradiation of extreme pain may cause bone marrow suppression, gastrointestinal discomfort, side effects such as hair loss. Radioisotope therapy until the last ten years has it begun to expand the use of. Easy to say that the advantages of isotope therapy generally have: 1. Comparison would not hurt the surrounding normal tissue; 2. Targeting specificity, and low toxicity characteristics. In fact the real mechanism of clinical pain is still studying in the medical community. As the radioisotope treatment, want to kill tumor cells is much higher than the required dose of analgesics doses, so the pain of cancer pain are palliative in nature and did not take too high doses. Pharmacy use this pre-treatment, need to be excluded such as nerve root compression, osteoarthritis, musculoskeletal lesions and tumor invasion of the possibility of soft tissue pain. Europe, the United States has opened many insurance are paid Strontium -89 therapy, and for a variety of cancer patients with metastatic bone pain giving the drug, hoping to alleviate or eliminate the disease of bone pain.

[Radioisotope strontium -89 brief introduction] 

     Strontium -89 therapy are the main indications for bone metastases of the cancer and bone pain, especially by the hormonal treatment of prostate cancer patients were invalid. The drug in patients with contraindications are the use of this drug before, and if serious bone marrow suppression, or event such as the number of neutrophil and platelet severely reduced, are not recommended to receive this treatment. This agent in the organization penetration distance of about 8-10mm, and the biological half-life of more than 50 days. Analgesic effect is often sustained 3-14 months. 

     Patients before treatment could be given a nuclear medicine bone scan to determine the location and number of bone metastases, patients of conventional blood test should also be noted that white cell count, platelet count or serum PSA concentration after treatment is also in need of regular blood tests every 4-8 weeks once only . -89 Strontium metabolism mainly through the kidney drained by a small number of bile discharged, the drug metabolites will be placed in a stool or urine, so patients after the toilet flush twice as long as many, or the event of any splash urine immediately wipe, you can prevent pollution. Staff must wash their hands after work, contamination of clothing is also required to clean and separate from other clothing. Furthermore Strontium -89 therapy spacing shall be separated for more than 3 months. This drug is a radioactive drug, can only be in hospitals by the nuclear medicine professionals use to give. Drugs in vivo injection first inside, and some patients will complain about aching bones, this is a temporary phenomenon, on behalf of the drug appears to enter the local site of bone metastasis, the role of happened. 

     Taking strontium -89, hematopoietic system will produce a small amount of inhibition, a slight reduction in white blood cells and platelets are predictable. Than the number of platelets before taking this medicine 10 to 40 percent slightly lower, but after a period of time be able to resume. By Strontium -89 discharged by the kidneys, if the seriousness of patients have renal dysfunction, use of this drug should be considered dangerous. 

   Strontium -89 release only pure beta particles, is a rather long half-life of 50.52 days for. Radiation and its only plastic or glass syringes barrier to achieve the effect of health care workers in contact with the patient need not worry about the radiation exposure injury, safety, fewer side effects. 

 [Medical expenses instead of savings] 

     Sr-98 in metastatic bone cancer pain has not yet included in the current domestic health insurance pay for items. However, according to the report of Canada, the use of Sr-89 to treat cancer patients with metastatic bone pain of their total medical costs an average of 16,570 yuan Canadian dollars. Without the use of Sr-89 therapy in patients with total medical costs an average of 23,688 yuan Canadian dollars. An average reduction in total medical costs 7118 yuan Canadian dollars (equivalent to approximately NT 14-160000 yuan on the spectrum), is indeed a big savings in costs. If we try to identify the original, because the use of Sr-98 after treatment relative to substantial reduction of the use of traditional non-steroidal analgesics, narcotic analgesics analgesic agents and in vitro irradiation of the cost. Therefore, the proposed National Health Insurance Bureau Sr-98 as soon as possible the transfer of bone cancer pain included in pay items. Nevertheless, substantial benefit not only required the transfer of bone cancer pain in patients suffering from pain, improve quality of life, and live in dignity. On the other hand can save a lot of medical expenses, control of the National Health Insurance Bureau is currently possible substantial losses. 

 [Looking] 

     Taipei Veterans General Hospital has completed nearly 110 cases of prostate cancer bone pain Strontium -89 therapy in clinical experience. Statistics show that strontium -89 treatment of metastatic bone pain remission rate of 65-70%, foreign experience around nearly 80%. Patients can reduce the pain and greatly enhance their quality of life. Observation shows that a small number of patients only minor rough white blood cell and platelet count decreased, there is no discomfort or other serious complications, one can be said to be very safe and effective treatment of metastatic bone pain. If necessary, patients can be re-treatment once every three months. Is a promotion of nuclear medicine isotope treatment. 

 [Conclusion] 

     Radioisotope Strontium -89 therapy prostate cancer metastasis bone pain, safety, fewer side effects. At present, the Court will continue to actively seek into the National Health Insurance project.

About prostate cancer

1. What is prostate cancer? 

 Prostate male urogenital system of an organ, is located below the bladder, rectum, urethra through which has, such as the size of chestnuts. Increases with age, the prostate gland with hyperplasia, the volume will grow. The prostate gland secretions are males constitute the main component of semen. 

 Are within the prostate gland because of the malignant cell proliferation caused by not only long in the prostate gland, may also be violations of the prostate surrounding the organization, or with the blood, lymphatic metastasis to other parts of the body. Take place most frequently in the general position of the prostate surrounding area, which is closer to that part of the rectum. 

 2. Prostate happened, what are the reasons? 

 Guarding adenocarcinoma occurred for unknown reasons. However, according to research shows that may be, and the following factors: 

 Genetic factors: blood in the person has prostate cancer, prostate cancer was the opportunity to comment on the high than the average person. 

 Hormonal factors: from a young age were castrated or testicular dysplasia do not have to. The vast majority of men have prostate cancer cell surface hormone receptors, loss of androgen stimulation of prostate cancer cells to shrink degradation. 

 Diet and environmental factors: food of saturated fatty acid content is too high, or cadmium in the environment are possible and related to the occurrence of prostate cancer. 

 Infection factors: potential and long-term, chronic bacterial, or virus infection. 

 3. What are the symptoms of prostate cancer? 

 Early symptoms of prostate cancer are not. Violations to the urethra when the prostate cancer, the patients will have urinary frequency, nocturia, urgency, urinary small urethral symptoms such as pain and hematuria, and benign prostatic hyperplasia similar symptoms. When prostate cancer metastasis to bone, such as lumbar spine bone, it will cause low back pain in neuralgia symptoms. 

 4. How can the diagnosis of prostate cancer? 

 First of all, the clinical history, family after inquiry, the most important thing is to do a physical examination DRE. Physicians with gloves, coated with the lubricant containing liquid anesthetic, followed by the index finger anus Add a patient's rectum to check the prostate. Prostate cancer early, when the DRE feels may only be a small lump. 

 Then two other important examination, blood tests for one prostate-specific antigen (PSA), another for transrectal ultrasound. When necessary, can puncture biopsy in order to make further pathological diagnosis. In establishing the diagnosis of prostate cancer, the doctor will arrange a number of checks in order to understand the scope of disease and extent of violations, such as chest X-ray examination, intravenous pyelography (IVP), computed tomography scan (CT-scan), and systemic such as bone scans. When necessary to do laparoscopic pelvic lymph node surgery, remove the lymph node biopsy to do to determine the extent of spread of cancer cells. 

 5. How staging of prostate cancer? 

 Localized prostate cancer according to infringe upon or to the extent of spread is divided into four phases: 

 A period: refers to the early days, there is no spread of cancer, DRE also feel less than Cancer. Patients due to benign prostatic hyperplasia surgery after resection of the prostate, pathological examination revealed that prostate cancer cells have the existence of the organization. 

 Phase B: the absence of the proliferation of cancer, DRE Cancer can touch. 

 C period: refers to prostate cancer have been violated to the prostate gland around the organization. 

 D period: that pelvic cavity have lymph nodes or other organs such as bone, has been the phenomenon of transfer. 

 6. How should the treatment of prostate cancer? 

 For early prostate cancer, if the patient is less than 70 years old, the best treatment are the eradication of prostate surgery. If the patients over 70 years old, then the merger of BPH symptoms can be considered transurethral resection of the prostate, plus the treatment of oral hormone preparations. Early or in part, the proliferation of prostate cancer, radiation therapy can also be used. Metastatic prostate cancer, treatment can be used Hall, or the use of drugs, will have radiation substances, to treat metastatic lesions. 

 7. Conclusion 

 Early prostate cancer, active treatment, the survival rate of prostate cancer patients and not be able to have the same. Prostate cancer patients after treatment, still need regular outpatient follow-up review, oral hormonal drug must be taken for life. Patients must be regularly checked blood prostate specific antigen concentration in order to detect early recurrence of prostate cancer, and the timely adjustment of treatment. At present, due to advances in medical technology and treatment of prostate cancer result is good, patients and medical personnel as long as the cooperation of the disease need not worry.

Prostate cancer-related vocabulary

Abdomen: one part of the body, including his pancreas, stomach, intestines, liver, gallbladder and other organs. 

 Adrenal gland: a pair of small glands, located above the kidneys. Renal gland secretion of hormones help control heart rate, blood pressure, body use food and other vital functions. 

 Anti-androgen: used to block the male sexual hormones or interfere with its function of manufacturing drugs. 

 Anus: the rectum is connected to the outside body openings. 

 Benign: not cancer; will not infringe on nearby organizations, or spread to other parts of the body. 

 Benign prostatic dysplasia: benign prostatic tissue (non-cancerous) in hyperplasia, will hinder the urethra and bladder, blocking the discharge of urine. Also known as benign prostatic hyperplasia. 

 Biological agents therapy: Using the body's immune system, directly or indirectly, to fight cancer or reduce the number of cancer therapy caused by side effects. Including immunotherapy, biological therapy and biological response modifier therapy. 

 Biopsy: removal of one tissue samples, with a microscope to check for cancer cells. Will be organized simply referred to as excision biopsy or core biopsy method; If we remove the whole tumor cells is referred to as excision of biopsy method; to needle to remove tissue samples or body fluids are known as acupuncture live biopsy or fine-needle aspiration method. 

 Bladder: the hollow organs stored urine. 

 Cancer: an unusual cell division uncontrolled disease. Cancer cells can be violated to a nearby organization or with the blood or lymphatic system spread to other parts of the body. 

 Chemical treatment: the use of anti-cancer drug therapy. 

 Clinical trial: patients about research projects. Each program is designed to find better ways to prevent, detect, diagnose or treat cancer and to answer scientific questions. 

 Cryosurgery: use of a device which can be frozen and could destroy the abnormal tissue therapy. 

 Bladder examination: Physician use of a lighting apparatus has depth urethra (the tube which can connect the bladder to outside the body) to view the bladder inspection. Can remove a piece of tissue samples under the microscope to check to determine whether the disease has existed. 

 Digital rectal examination: a cancer detection method. Doctors had to wear gloves lubrication to finger into the rectum, to feel abnormal region. 

 Do the climax: climax semen but did not shoot. 

 Ejaculation: the climax phase, when semen from the penis injection. 

 Estrogen: female hormones, promote the development of female sexuality and maintenance. 

 Radiation in vitro: the use of machinery from radiation exposure outside of the body. 

 Genito-urinary system: one part of the body, in the reproduction, manufacture of urine to exclude waste or both play an important role. 

 Classification: tumor classification are used to determine the cancer cells under a microscope to check the abnormal situation, and can speculate the growth of cancer cells may be the proliferation of speed and its trend. The system will be in accordance with the different types of cancer to classification. 

 Hormone therapy: the use of medicines impede access to certain special cells required for their growth hormone therapy. 

 Hormones: refers to glands in the body generated by chemical substances, usually in the blood circulating. Hormonal control of specific cells or organs function. 

 Imaging examination: to create the body of a site inspection of the images. 

 Impotence: an erection when sexual intercourse should not. 

 Incision: an operation when the physical wounds painting together. 

 Incontinence: the bladder can not control the outflow of urine. 

 Body radiation: one containing a small container of radioactive material directly into or near a tumor radiotherapy. 

 Tomography intravenous pyelography (IVP): kidney, ureter and bladder series of X-ray examination. The reagent was injected into veins, then in X-rays showing a video. 

 Local treatment: Cancer affects only or in the vicinity of cell therapy. 

 Hormone progesterone to promote: a very similar hormone luteinizing hormone secretion of substances, controlled the manufacture of hormones. However, the promotion of hormone progesterone on the body and luteinizing hormone secretion of various hormones. Promote the hormone progesterone will eventually reduce sex hormone secretion. 

 Lymph nodes: small bean-shaped organ shape. Along the lymphatic system lymphatic distribution. Save a lymph node lymph flow in to seize the body of the bacteria or cancer cells in the special. Groups of lymph nodes located in the armpits, groin, neck, chest, and abdomen. Also known as lymph glands. 

 Lymphatic system: The tissues and organs may be the manufacture, storage, carrying to fight infection and disease of white blood cells. This system includes the bone marrow, spleen, thymus and lymph nodes and lymph and white blood cells to provide the mobile network of piping systems, such as the distribution of tubes like blood vessels in the body of the organization. 

 Vicious: that is, cancer; will assault and damage the nearby organizations and spread to other parts of the body.

Internal Medicine Physician Oncology: specializes in treatment of cancer physicians. Cancer experts in each field on the different types of cancer treatment own specialization. Such as radiation oncology experts, are devoted to the treatment of cancer with radiation physicians. 

 Transfer: refers to a cancer cell from the body parts to another part of the proliferation and metastasis of tumor cells and tumor cells are initially the same. 

 Orchiectomy: surgery to remove one or both testicles. 

 Pathology expert: the use of microscopy to identify cells or tissues diseases physician. 

 Pelvic cavity: the lower parts of the abdomen, located between both sides of the hip. 

 Prognosis: the disease may be the result or process; recovery opportunities. 

 Prostate: a male reproductive system of glands, located just below the bladder. It surrounded the upper half of the urethra, bladder and urethra are emptying the pipeline urine. It creates thick liquid to form a part of semen. 

 Prostate-specific antigen (PSA): prostate cancer or benign prostatic hyperplasia patients with the blood of men may increase the content of the material. 

 Prostate resection: surgery to remove part or all of the prostate gland. Radical (or total) of the prostate resection is resection of the prostate gland and some surrounding tissue. 

 Prostatic acid phosphatase? (PAP): secreted by the prostate gland of an enzyme. Male prostate cancer patients may increase the volume. 

 Radiation Oncology physicians: specializing in the use of radiation therapy of cancer physicians. 

 Radiation therapy: the use of high-energy radiation to kill cancer cells of the therapy, the radiation may come from radioactive material in vitro or to be placed on a direct role in the vicinity of Cancer. Systemic radiation therapy is the use of radiation with material such as monoclonal antibodies which play a role in systemic circulation. 

 Rectum: Lower large intestine part of 8-10 inches. Rectum solid manure storage until it leaves the body through the anus. 

 Relapse: recurrence; cancer repeatedly in the same or other parts of the emergence. 

 Ease: the disappearance of disease symptoms, it can be temporary or permanent. 

 Risk factors: some may lead to diseases. 

 Scrotum: the body outside the skin containing the testes bladder. 

 Semen: the height of the liquid from the penis injection. Sperm are manufactured by the testicles and prostate sperm and other fluids produced by gonadal component. 

 Phases: via a series of test and inspection to know the extent of violations of cancer, especially whether it has spread to the original organ fat to other parts of the body. 

 Surgery: to repair or the removal of certain body parts or to discover whether there is any disease process. 

 Systemic therapy: the use of blood flow through the arrival and impact of systemic cancer substances go therapies to treat cancer. 

 Testis: a pair of oval glands, can produce sperm and male hormones. 

 Testosterone: male hormone, and promote the development of male sex characteristics and maintenance. 

 Transurethral prostate resection (TURP): the instrument from the urethra to remove the part into prostatic tissue surgical process. 

 Cancer: the excessive cell division resulting from the abnormal mass. Cancer of the normal function of the body useless. They can be benign or malignant (cancer) is. 

 Ultrasound: The sound waves rebound from organizations like the echo of the inspection was. 

 Urethra: bladder emptying urine from the pipeline. 

 Urologist: specializing in female urinary organs and male urinary and genital diseases physician. 

 Vasectomy: incision or injection will be tied to the delivery of sperm from the testicles of two tubes of surgical method.

Prostate cancer: causes and prevention

Prostate causes have not yet fully understood. Researchers are trying to understand the factors likely to cause prostate cancer. They know more of these risk factors will have more opportunities can be found for the prevention and treatment of this disease. 

 In the United States, prostate cancer occur in many men over the age of 55, patients with an average age of diagnosis is 72 years. Blacks suffer more prostate cancer than whites. In fact, American blacks are issued all over the world the best race of prostate cancer. Doctors were unable to explain why a person would get prostate cancer while others do not. But what's certain is that it does not contagious, no one from another infected person to the prostate. 

 Some studies have shown that, when the father or brother had been suffering from prostate cancer in men the risk of prostate cancer will increase. However, researchers unsure why some families have a higher probability of prostate cancer will be. 

 Scientists are studying the effects of diet. Some studies pointed out that the high-fat diet will increase the risk of prostate cancer, while the rich diet of vegetables and fruits can reduce the risk of suffering from prostate cancer, but these linkages have yet to be confirmed. 

 Researchers are studying whether vasectomy for men suffering from prostate cancer or increase the danger. Some studies have indicated that they may be associated, but other research on the do not agree with that statement. 

 Other studies show that farmers or workers in welding, plating or manufacturing the battery when exposed to the metal cadmium might increase the risk of prostate cancer risk. Engaged in rubber industry workers are also more likely than the general population suffering from prostate cancer. However, more research is required to confirm these allegations. 

 Scientists are also looking to identify benign prostatic hyperplasia or through sexually transmitted virus will increase the risk of prostate cancer risk. At present there is no evidence to prove that it will increase the risk of both. 

 The United States in some of the men over the age of 55 are using the treatment of benign prostatic hyperplasia drugs (Proscor). Would like to know whether the drug can prevent prostate cancer from happening. 

  Early detection 

 Researchers are studying new approaches to screening for prostate cancer patients (used to check the prostate cancer in asymptomatic patients). Still do not know whether the current screening can save lives. The United States related to the ongoing clinical trials are aimed at 55-74 year-old male for digital rectal examination and blood prostate-specific antigen screening studies concentration. The results of this experiment is likely to change men seized a manner acceptable to prostate cancer. 

 Men and their physicians should discuss prostate cancer, should be prepared to observe the symptoms and follow-up inspection program. Physician will depend on the diagnosis and treatment of patients with the advantages and disadvantages, age, medical history and other factors make recommendations.

Prostate cancer treatment

To seek a second opinion 

 Treatment decisions are complex. Before the start of treatment, patients may want to seek advice on diagnosis and treatment plan of a second opinion. And short-term treatment of delayed and will not reduce the chance of success. The following are a few seek "second opinion" approach: 

 Your physician may refer you to the expertise of experts in the treatment of prostate cancer, such as a urologist, radiation oncology and medical oncology doctors physicians. 

Cancer Center Cancer Advisory Services. 

 Patients from other nearby hospitals, medical centers or medical will be given the names of these experts. Also available at public libraries or the Internet has made out the names of physicians, expertise and background of the list. 

  Treatment preparation 

 The treatment of prostate cancer according to many factors, including disease stage, tumor grade (cell growth and possible spread to other parts of the speed), the patient's age, general health status and treatment of patients views and the possible side effects. Physicians will be in accordance with these factors set out a treatment plan for patients. 

 Many cancer patients will want to know all about their disease, the selective treatment and possible treatment side-effects which have, so that they can actively participate in medical care decisions. There are many ways for the treatment of male prostate cancer (surgery, radiation therapy, hormone therapy). Not all patients are required to accept such treatment. Patient and his physician may consider the benefits of each treatment and potential side effects, especially the impact of sexuality and the role of voiding, as well as the other will affect the quality of life issues. Patients and physicians may want to discuss the new treatment to participate in relevant research, such studies called "clinical trials" are designed to improve cancer treatment. 

 When the patient was diagnosed with cancer, shock and stress are natural reactions. These feelings may result in patients not think they want to ask doctors questions. Patients can use the notes or recordings to help them bring a note of physicians said, some patients hope that they will discuss with the doctor can have relatives or friends, together with participation in decision-making, or just want to accompany them to the side to listen to. 

 Patients do not need to first ask or write down all the questions. Questions may arise throughout the course of treatment. Patients may also be asked about the doctors, nurses or other health care team and the future-related questions or provide more information. 

 Patients before receiving treatment doctor may want to asked the following questions: 

 Stage of disease? 

 Level of disease? 

 I need to accept the treatment? What are the treatment options? Do you have any suggestions? Why? 

 Each treatment which has the desired effect? 

 Each treatment and the possible risk of side effects which have? 

 Treatment would affect my sexual life? 

 I may be voiding the problem? 

 Treatment of the number of chances of success? 

 What are the new treatments in clinical trials under way? I have clinical trials for it? 

  Treatment method 

 Many prostate cancer disease progression in patients with a view to early detection are slow and may not need treatment. For older or have other serious medical disease or may not have been recommended for treatment. Of these patients, the possible side-effects and treatment of the risk of treatment may far exceed the benefits; Instead, doctors may recommend "close observation" and close tracking of patients, when symptoms occur again when the treatment. Researchers conducting the study to find out which patients with early prostate cancer treatment to be effective and the time and manner. 

 Prostate cancer treatment may include surgery, radiation therapy or hormonal therapy. Sometimes, patients will receive combined treatment. In addition, doctors are studying other treatment methods to discover whether they can effectively combat the disease.

Surgery 

 Surgical treatment of early prostate cancer are the most common forms of treatment. Surgical resection of the entire prostate, known as radical prostate surgery. Surgery usually have two types of the method is feasible. One is "retropubic prostate surgery," make an incision in the abdomen, from where to remove the prostate and nearby lymph nodes. The other is "the will prostate surgery," are in the scrotum and make an incision between the anus and from there to remove the prostate gland, and nearby lymph nodes are sometimes necessary to do another one in the abdominal incision to remove. If the physician found pathological lymph nodes have cancer cells, may mean that cancer cells have been transferred to other parts of the body of the. 

 The following are the patients before surgery would like to ask the doctor some questions: 

 I will accept what kind of surgery? 

 After surgery I will feel? 

 If there is pain in the case, you can help me? 

 There will be any delayed side effects happen? 

 Radiation Therapy 

 Radiotherapy in patients with prostate cancer are another treatment. Radiation therapy (commonly known as electrotherapy), is the use of high-energy radiation damage to cancer cells and inhibit their growth and splitting. The same as surgery, radiation therapy is local treatment, the treatment of the region can only kill cancer cells. Early prostate cancer, radiation therapy can be used to substitute for surgery, or it may be used in patients after surgery to kill remaining cancer cells in the region. For patients with extensive prostate cancer, radiotherapy may be used to alleviate pain or other problems. 

 Radiation may come from the machine (in vitro radiation) or from the implant (a small container containing radioactive material) placed directly in or near the tumor (in vivo radiation). Some patients use a combination of both radiotherapy. 

 In vitro in patients with radiation therapy, takes a day to the hospital for treatment. Usually five days a week, about six weeks. This timing is to the total dose of radiation given separately in order to protect normal tissue. Radiation exposure in the major pelvic region. Throughout the treatment before the end, usually have small pelvic region is the site of primary tumor additional strengthening of the so-called radiation. 

 Acceptable radiation therapy in vivo, when the implants after implantation in vivo, the patient must be hospitalized for several days. Implants may be temporary or permanent. When the temporary implant is removed, the body, there is no radiation. Permanent implant radiation volume has too much to others is not a danger, but patients should pay attention to or during the implantation to be careful to avoid too long intimate contact with others. 

 The following patients are at the beginning of radiation therapy before doctors will be asked some questions: 

 What is the purpose of treatment? 

 Radiation therapy are how to implement? 

 When to start treatment? When The End? 

 During treatment, I will feel? 

 During treatment How do I take care of themselves? 

 How do I know if radiation therapy effective for me? 

 During treatment can continue normal activities? 

 Hormone therapy 

 The principle of hormonal treatment of prostate cancer cells are not required to get it the growth of male hormones. When patients receiving hormone therapy, the amount of male hormones will be reduced. So reduce the amount of hormones can affect all prostate cancer cells, even if they have been transferred to other parts of the body. Therefore, hormone therapy is a systemic treatment. 

 Hormone therapy has a variety of ways. Include: 

 Orchiectomy: the testicles are removed in order to get rid of the major manufacturing source of male hormones. 

 Lutein to promote hormone (LHRH): are used to prevent testicular testosterone manufacture. 

 Estrogen: A female hormone, used to inhibit testicular testosterone manufacture. 

 Anti-androgen preparations: in the orchiectomy or luteinizing hormone or the promotion of estrogen treatment, the body can no longer be testosterone from the testicles. However, the adrenal glands still produce small amounts of male hormones. Sometimes, patients also eat anti-androgen agents, which should be blocking any residual effect of male hormones. By this combined treatment to achieve complete androgen blockade. 

 Transferred to other parts of the body of prostate cancer can usually be controlled with hormone therapy for some time, usually several years. However, the majority of prostate cancer cells can ultimately necessary evolution to only a small amount of or no male hormones will be able to grow. At this time, hormone therapy is no longer effective, and doctors will recommend a number of studies in other treatment methods. 

 Clinical trials 

 There are many prostate cancer patients participate in clinical trials. Physicians to conduct clinical trials by the discovery of new treatment methods are safe and effective. In some clinical trials, all patients received the new treatment methods. In other trials may in some patients receiving the new therapy, some people accept the standard therapy, physicians can use this method to compare the efficacy of therapy. 

 Patients involved in clinical trials are the medical has a great contribution, but also the first to receive improved treatment, which benefits the person received. 

 Many of the new treatment of prostate cancer clinical trials are still ongoing. For example: physicians are relatively early stage prostate cancer patient to receive treatment with the only difference between careful observation. The results of this study will help physicians understand the patients with early prostate cancer should be treated immediately or wait until the onset of symptoms until the beginning of treatment. 

 Physicians with ongoing radiation therapy and hormonal therapy to use a new study. Some physicians are also under study cryosurgery, and is based on a very low temperature to kill the cancerous cells, which are in addition to surgery and radiation therapy in addition to a method of treatment. Cryosurgery are using a low temperature probe placed in the apparatus Cancer frozen up it, to avoid the healthy tissue nearby. 

 Researchers are also looking at does not respond to hormone therapy or has ceased to react to chemotherapy in patients with prostate cancer and the therapeutic effect of biological agents. In addition, scientists are also looking for the combined therapy of a variety of new treatment modalities. Relating to clinical trials of prostate cancer-related information may contact Cancer Center.

Treatment side effects 

 Although physicians are well prepared and careful treatment plan, but usually it is difficult to the role of treatment is confined to remove or destroy cancer cells. Treatment because it will also upset the healthy cells and tissues, it often cause uncomfortable side effects. 

 The main side effects of cancer treatment, as treatment methods and scope of, and response of each patient are also different. Medical and nursing staff will explain the treatment of side effects that may occur at the same time help reduce the treatment period or after treatment of the symptoms may occur. Any side effects happen when doctors know is very important. 

 Surgical Treatment: Although the patients in a few days after surgery are usually very uncomfortable, but their pain can be controlled with drugs. Patients should be very comfortable and the physician or nursing staff to discuss how to reduce the pain. After the operation for some time feel tired or weak is also very common. Recovery time for each patient in accordance with accepted surgical methods vary. 

 Surgery to remove the prostate may lead to permanent impotence and sometimes cause urinary incontinence. These side effects happen less now. Some surgeons will use a new surgical approach, especially to remove small tumors. This technology is called nerve dissection, may be able to control and prevention of permanent nerve injury erectile and injury to the bladder to the opening. When the surgery is very successful, impotence and incontinence is temporary. However, the acceptance of prostate surgery patients will no longer manufacture of semen, so they do have a climax. 

 Radiation therapy: patients receiving radiation therapy may become very tired, especially in the weeks after treatment. Rest is important, but doctors also advise patients usually try to keep the load can take part in physical activities. May occur in patients with diarrhea or urinary frequency and voiding discomfort. In addition, when patients receiving radiation therapy in vitro, the region in the treatment of skin red, dry, tenderness and itching. Radiation therapy can also lead to pelvic region hair. This may be temporary or permanent, depending on the dose of radiation may be. 

 Radiation therapy can cause a number of male impotence. In vitro impotence caused by radiation therapy than the probability of radiation therapy in vivo high, due to radiation therapy than the body will not hurt to the control of erectile nerves. 

 Hormone therapy: orchiectomy, luteinizing hormone to promote (LHRH) and estrogen will cause some side effects, such as reduced libido, impotence and hot flashes and so on. The beginning of the use of luteinizing hormone early promotion will promote tumor growth, exacerbate the symptoms of patients. This temporary problem is called "Tumor Flare". However, the drug will be gradually let the blood concentration of testosterone decline. Do not have enough testosterone, tumor growth will be slowed and the patient's situation will improve. Prostate cancer patients receiving estrogen or anti-androgen treatment may cause nausea, vomiting or breast swelling and tenderness. (Estrogen is now being used less because it will increase the patient's heart problem. This therapy for patients with a history of heart disease are not suitable). 

 Chemical treatment: Chemical treatment of patients with major side effects is acceptable according to the type and dose of drugs to another. Cancer Center issued "going chemotherapy haze" provides a cancer chemotherapy and in response to side effects related to the message. 

 Biological agents therapy: side effects of therapy of biological agents, as the different types of treatment vary. These treatments may cause flu-type symptoms such as chills, fever, myalgia, weakness, nausea, vomiting and diarrhea. Patients sometimes rash, easy bruising or bleeding. These questions may be very serious, but they will gradually disappear after cessation of treatment, sometimes in the treatment of patients must remain in hospital. 

 Nutrition for cancer patients 

 Some cancer patients feel during treatment difficult to eat well, they may lose their appetite. In addition, treatment of common side effects such as nausea, vomiting or oral inflammation will make things more difficult to import. For some patients to eat when the food tastes also change. In addition, when feel uncomfortable or tired, they do not eat anything. Eating well can be express enough calories and protein to help prevent weight loss and restoration of physical strength. During treatment in cancer patients are usually eating well will feel better and have more stamina. In addition they may have more ability to control the side effects during treatment. 

 Physicians, nurses and dietitians can offer cancer treatment during the recommended healthy diet. Information patients and families can contact the hospital dietitian.

The importance of tracking 

 Any prostate cancer after treatment of patients with regular follow-up examinations are very important. Physicians will recommend appropriate follow-up plan. Physicians will be the arrangements for patients to do regular checks to determine whether the disease has relapsed or deteriorating condition, and decide whether or not to make other checks need to be explored further. Follow-up examinations may include X-ray, bone scan and laboratory tests such as PSA blood test. 

 Supporting Cancer Patients 

 And the coexistence of serious diseases are not easy. Cancer patients and their caregivers will also be faced with many difficulties and challenges, when people have the benefit of information and support services, often in response to these difficulties would be more easier. 

 Friends and relatives can be a lot of support, the same way, and other people who have cancer to discuss their matters of concern, but also can help many patients. Cancer patients can often take in supporting the team together, to share experience and adaptation of cancer treatment, however, very important to remember that every patient is different, even in the same two cancer patients suffering from inter - , cancer treatment and the way these individuals deal with effectively, it may not be suitable for another person. In addition to the recommendations made by friends and relatives used to discuss with the doctor is good. 

 Cancer patients might be worried about how to keep their jobs, take care of the family, to maintain the pace of daily life or create new interpersonal relationships. Concerned about the cancer will go the examination, treatment, hospitalization and medical costs. Physicians, nurses and other health care team members can answer some regarding treatment, job or other activities. In addition, patients can also be about their feelings, concerns, or the future of the questions related to personal relationships, and social workers, counselors, or religious discussions are useful. 

 Patients and other partners concerned about prostate cancer treatment on sexual life, as well as the impact is very natural. And physicians who may wish to discuss possible side effects and these side effects may be temporary or permanent. During treatment or after treatment, the patient and his partner if we can share each other's concerns, and to help another with the expression of his love, it will be helpful to them. 

 Typically, in a hospital or clinic can provide a number of social workers can help rehabilitation, emotional support, economic assistance, transportation or home care groups. Related information, please contact the Department of our hospital social workers. 

 Future Prospects 

 Researchers are looking for better ways to treat prostate cancer and to improve opportunities. However, patients and their families concerned about their future is very natural. Sometimes patients will use some statistical values go outlines recovery chances. However, the need to bear in mind is that these statistics can not predict the future patients, because patients are different, treatment and results may also have significant differences. Most physicians understand patients, so the discussion is the prognosis of patients with the most suitable candidates, patients and physicians should be comfortable to discuss their prognosis, but they must be remembered that even the doctors can not predict all patients will have what kind of future . 

 Doctors often talk about the survival rate of cancer when patients often will tell the outcome of remission are not cured, because even though there are many patients suffering from prostate cancer has been completely cured, the disease still may be in a few years after the relapse. 

 Prospects for prostate cancer research 

 In 1997, prostate happened the total number of cases of cancer occurred in the 2.56 percent the number of cases, prostate cancer deaths among all deaths of 1.66%; the incidence of the ranking of sixth place in the male , the mortality rate ranked ninth in the men. In the initial diagnosis of prostate cancer total of 1096 people, representing the number of cases of genital male 90.21%, died of prostate cancer a total of 463 person. Therefore, researchers in many ongoing research, would like to know more causes of prostate cancer and early detection methods.