以患者为中心的前列腺癌诊断治疗选择

Options of the diagnosis and treatment according to evidence-based patients with prostate carcinoma

前列腺癌是老年男性恶性肿瘤,多数肿瘤的生物学活性低,疾病进展缓慢,少数高危前列腺癌进展快、预后差。临床应根据患者发病年龄、全身状况以及肿瘤病理,制订合适的诊断治疗方法。PSA检测、直肠指检、前列腺MRI检查以及前列腺穿刺活检是前列腺癌诊断的主要方法,要认识各方法学上的不足,合理使用,避免滥用。直肠指检作为基本诊断方法可以提供很多信息。前列腺癌的治疗有多种选择,总体疗效相似,每种治疗方法均有其不足,要给患者充分知情权,选择合适的治疗措施。果断处理晚期前列腺癌的严重并发症,提高患者生活质量。

Prostate cancer(PC)is the most common malignancy in elderly men.While the majority of PC keeps an indolent biological behavior and progresses slowly,quite a few progresses very fast with poor prognosis.Urologists should take into account of patients′age,general health status and tumor pathology to make an appropriate strategy for PC clinical management.Prostate specific antigen(PSA),digital rectal examination(DRE),magnetic resonance imaging(MRI)of prostate and prostate biopsy are main tools for PC diagnosis.However,appropriate application of all kinds of diagnostic tests to prevent overdiagnosis and overtesting cannot be overemphasized,because methodological defects objectively exist.DRE is a basic examination which is able to provide valuable information for diagnosis.There are multiple therapeutic options for PC with generally similar efficacy and individual shortcoming,which stresses the importance of patients’consents and choices.Managements of severe complications of advanced PC is critical for improving patients’life quality.