Treatment plan for prostate cancer in the elderly

Treatment plan for prostate cancer in the elderly? Prostate cancer (PCa) is the most common malignant tumor in the male reproductive system. According to reports, the mortality rate of prostate cancer ranks second only to lung cancer in the ranking of male cancer mortality. Experts point out that due to the different locations and ranges of lesions, the symptoms of prostate cancer vary greatly. Many reasons can induce the occurrence of prostate cancer, such as common reasons such as heredity, diet and bad living habits. Heredity is the main reason, so when there is a patient with prostate cancer in the family, you should pay attention to prevention.

Experts also mentioned that there are several treatments for prostate cancer, but they vary from person to person.

1. Early stage of prostate cancer: watchful waiting

Watchful waiting means that after prostate cancer is diagnosed, no treatment intervention is used, but the patient is closely followed up and observed. Once the patient shows signs of disease progression, such as elevated PSA, other treatment methods are used. Currently, there is controversy among patients and doctors about the treatment option of watchful waiting. Generally, patients who adopt this method should be older than 70 years old, have a low tumor stage, a well-differentiated tumor, and a life expectancy of less than 10 years.

It is important to emphasize that patients who undergo observational waiting must have regular and careful PSA follow-up. If PSA continues to rise, other treatments such as radical prostatectomy or hormone therapy should be started immediately.

2. Radiation therapy

It includes external radiation therapy and internal radiation therapy. External radiation therapy now mainly refers to three-dimensional conformal radiotherapy, which is a painless treatment performed in an outpatient clinic and has a therapeutic effect comparable to radical prostatectomy. Its advantage is that the therapeutic radiation is more concentrated on the prostate being treated, reducing the impact on surrounding tissues. External radiation therapy can cause acute cystitis, prostatitis and enteritis.

Internal radiotherapy is divided into high-energy rate internal radiotherapy and low-energy rate internal radiotherapy. High-energy rate internal radiotherapy generally refers to the use of isotopes to release a large amount of energy in the prostate in a short period of time, usually combined with external radiotherapy, but its complication rate is higher than that of low-energy rate internal radiotherapy; low-energy rate internal radiotherapy is a more convenient, single-time treatment method, also known as radioactive particle implantation. During the operation, multiple tiny radioactive particles are placed in the prostate under the guidance of B-ultrasound. The rays emitted by the particles kill tumor cells at close range. Its complications include acute urinary retention, urinary incontinence, enteritis and erectile dysfunction.

3. Hormone therapy

All treatments that reduce androgen levels in the blood are called hormone therapy. Because the occurrence and development of prostate cancer is closely related to androgens, treatments that block or reduce androgens can significantly reduce tumor size, reduce tumor growth rate and the occurrence of metastasis, but it cannot cure prostate cancer. For early prostate cancer, hormone therapy is rarely needed. However, in some special cases, such as advanced age, patients who are not willing to accept radical surgery or have other serious diseases, conservative treatment is required and hormone therapy can be considered.

Currently, the hormone treatment options include surgical castration and drug therapy: surgical surgery mainly refers to bilateral orchiectomy. Drug therapy includes LHRH analogs, which play a role in drug castration; androgen receptor blockers, which block the action of androgens and thus terminate the biological effects of androgens; and the use of estrogen, which can reduce the level of androgens. Compared with other drug treatments, estrogen is much cheaper, but it may cause serious adverse cardiovascular reactions.

4. Radical surgery

Refers to surgical treatment in which the entire prostate and bilateral seminal vesicles are removed. Radical prostatectomy is the first choice for radical treatment of early prostate cancer. Generally, patients who are estimated to be curable before surgery, with an expected life expectancy of more than 10 years, and with good tumor staging and grading are selected for radical prostatectomy. The advantage of radical prostatectomy is that it is a method that can remove prostate tumors, thereby having a positive psychological effect on patients. Complications of radical prostatectomy include urinary incontinence, urethral stenosis, erectile dysfunction, etc. With the development of technology, minimally invasive surgery can now be performed with the help of laparoscopes and robots.

Finally, experts remind all patients: In order to effectively treat prostate cancer, you should first actively avoid re-stimulation of the inducement and actively carry out treatment.