How to treat prostate cancer in the elderly

Prostate cancer in the elderly is a malignant tumor originating from the prostate gland and is a common malignant tumor in the male urogenital system. Among all malignant tumors of all organs, the natural history of prostate cancer is the most unique. The treatment of prostate cancer in the elderly mainly includes endocrine therapy, chemotherapy, radiotherapy and surgical therapy.

(I) Endocrine therapy: Endocrine therapy is the main treatment for advanced prostate cancer. Commonly used methods include estrogen therapy, anti-androgen drug therapy, gonadotropin-releasing hormone analog promoters and adrenal enzyme synthesis inhibitor therapy.

(ii) Chemotherapy: after endocrine therapy fails, single-drug or combined chemotherapy can be used. Commonly used drugs include cyclophosphamide (CTX), doxorubicin (ADM), taxol, vincristine (VCR), estradiol mustard phosphate (EMP), cisplatin (DDP), 5-fluorouracil (5-Fu), etc.

(III) Radiotherapy: It is currently mainly used for patients whose local prostate cancer cannot be surgically treated or whose lesions cannot be removed without obvious metastasis. It can also play a palliative role in patients with metastasis.

(IV) Surgical treatment: including radical prostatectomy and endocrine gland resection. At present, due to the limited level and means of diagnosis, most cases are diagnosed in the late stage, and the surgical treatment effect is not good. For patients in stage C or D, endocrine gland resection (such as bilateral testicles) is a good palliative treatment.

Prognosis

The prognosis of prostate cancer is closely related to its grade and stage. For patients in stage A, especially stage A1 (Tla), treatment or not has no effect on the survival rate, and patients with lymph node metastasis have a poor prognosis. Patients with well-differentiated cells have a better prognosis. The 5-year survival rates of patients in stages A, B, C, and D are 70%, 50%, and 25%, respectively. Therefore, if active treatment is given to patients with advanced prostate cancer, the survival rate can be greatly improved.