Symptoms and diagnosis of prostate cancer

Prostate cancer is one of the main causes of cancer death in many men. If people get sick, they will lose confidence in life. I personally think that people's psychological effects are very strong, so it is important for patients to maintain a positive and optimistic attitude. So what are the symptoms of prostate cancer and how to diagnose it?

There are three key points in the diagnosis of prostate cancer: ① primary tumor; ② lymph node metastasis; ③ distant metastasis.

(I) Primary tumor Rectal digital examination reveals prostate nodules, which can be examined by tru-cut biopsy or transrectal Franzen fine needle aspiration cytology. Transrectal prostate ultrasound scan can help understand the size and range of the tumor. Normal prostate echoes are uniform, and the boundaries are unclear when the capsule is invaded. Echo changes can also be caused by inflammation and stones, which should be differentiated. CT and magnetic resonance imaging (MR) can also help understand the range of tumor lesions and lesions in the bladder, seminal vesicles, and lymph nodes.

(II) Lymphatic metastasis The first lymph nodes invaded by prostate cancer are the obturator-internal iliac chain. In fact, the lymph nodes at the obturator foramen are generally not invaded. In clinical practice, the internal iliac lymph nodes are often called obturator lymph nodes. They are located on the inner side of the external iliac vein and are the most important lymph nodes that should be removed along the course of the internal iliac vessels.

In recent years, the diagnosis of lymph node metastasis relies on CT and MR, but they cannot detect small lesions. Lymph node angiography can detect 70% to 90% of metastases. However, the false negative and false positive rates are high, and it is rarely used in recent years. The most valuable diagnostic modified lymph node dissection, that is, the removal of the lymph nodes between the internal and external iliac vessels and the obturator foramen, is more accurate for staging and can avoid complications such as lymph leakage, lymphadenopathy, and lower limb swelling caused by the previous removal of iliac vessels, obturator foramen, pelvic wall, and anterior iliac lymph nodes, because even extensive dissection cannot prevent existing spread.

(III) Distant metastasis: When ureteral obstruction is detected during intravenous urography, it indicates that the tumor has invaded the seminal vesicle, bladder neck and lymph nodes, and may have distant metastasis.

Bone metastasis is common, second only to lymph nodes. Whole body isotope scanning is enhanced but the plain film is normal, which should be considered as metastasis. Lung X-ray can detect lung metastasis, which is often lymphatic spread and nodules are rare.

The above is an introduction to the manifestations and diagnosis of prostate cancer. I sincerely hope that every patient can maintain an optimistic heart, actively cooperate with the doctor's treatment, get rid of the torture of the disease as soon as possible, and return to the arms of their family as soon as possible. I sincerely hope that every patient can recover soon.