What should the elderly do if they have prostate cancer

Treatments for prostate cancer include follow-up observation, transurethral resection of the prostate (TURP), radical prostatectomy, radiotherapy, cryotherapy, endocrine therapy, comprehensive treatment, etc. The choice of a specific treatment plan should be based on the patient's age, general condition, and various examinations.

1. Castration + anti-androgen treatment. Castration is the use of external means to remove the patient's reproductive function, including medical castration and surgical castration. In terms of the choice of castration methods, we should make it clear that medical castration (including goserelin, leuprorelin and triptorelin) and surgical castration (that is, bilateral orchiectomy) have similar efficacy and survival rates. So far, no drug has been able to prove that its castration effect is better than bilateral orchiectomy. In terms of treatment costs, medical castration requires about 2,000 yuan per month (the lowest price is goserelin 3-month package, which is less than 1,800 yuan per month), while surgical castration only requires one operation to maintain castration for life, which is relatively cheaper, but it is not easy for patients to accept it in terms of concept. In terms of anti-androgenic drugs, the most mainstream ones are flutamide and bicalutamide. Both drugs can effectively counteract androgen receptors, and the prices are basically similar, about 1,000-1,400 yuan/month. However, since bicalutamide only needs to be taken orally once a day (flutamide needs to be taken orally 3 times), and its efficacy is considered to be better than flutamide, bicalutamide should be the first choice at present. Castration + anti-androgenic therapy can effectively control prostate cancer. Many prostate cancer patients can achieve a long survival period with only castration + anti-androgenic therapy. Moreover, even if anti-androgenic therapy fails, second-line anti-androgenic drugs can be used. For example, abiraterone.

2. Chemotherapy: Chemotherapy drugs represented by docetaxel also have a good effect on prostate cancer. However, chemotherapy is often the last line of defense in the hands of doctors, and is usually performed after prostate cancer has reached the point where second-line anti-androgenic treatments have failed.