Wymenga L F, Mensink H J
Academisch Ziekenhuis, afd. Chirurgie, onderafd. Urologie, Groningen.
Ned Tijdschr Geneeskd. 2001 Mar 24;145(12):553-7.
In three men, aged 44, 47, and 48 years, prostatic carcinoma was diagnosed after a long delay, more than eight months after the onset of symptoms (obstructive and irritative micturition problems, erectile dysfunction, and haemospermia). The cancer was suspected on eventually performed rectal palpation and confirmed in biopsies. The serum prostate-specific antigen (PSA) levels were moderately increased. All were treated with goserelin and flutamide and radiotherapy on the emerging metastases (two patients). Two patients died, the third one, who had received antibiotic treatment for three months because at first prostatitis was suspected, was still in remission at the last follow up. Prostate cancer in young men is rare and may demonstrate aggressive biological behaviour. The age group less than 50 years of age accounts for 0.8% to 1.1% of all patients with prostate cancer. This form of the disease responds poorly to radiation or hormonal therapy and is often already too advanced for surgery. The symptoms at presentation of prostate cancer in young men are quite similar to those in prostate cancer patients beyond the fifth decade. When carcinoma grows beyond the margins of the prostate the prognosis is poor. In all men with micturition problems, rectal palpation of the prostate should be carried out as a routine.
在三名年龄分别为44岁、47岁和48岁的男性中，前列腺癌在出现症状（梗阻性和刺激性排尿问题、勃起功能障碍和血精）八个多月后才被诊断出来，诊断延迟时间较长。最终通过直肠指检怀疑患有癌症，并在活检中得到证实。血清前列腺特异性抗原（PSA）水平中度升高。所有患者均接受戈舍瑞林和氟他胺治疗，并对出现转移的两名患者进行了放射治疗。两名患者死亡，第三名患者最初因怀疑患有前列腺炎接受了三个月的抗生素治疗，在最后一次随访时仍处于缓解期。年轻男性前列腺癌罕见，可能表现出侵袭性生物学行为。年龄小于50岁的患者占所有前列腺癌患者的0.8%至1.1%。这种疾病对放疗或激素治疗反应不佳，通常对于手术来说已经太晚。年轻男性前列腺癌的症状与五十多岁以上前列腺癌患者的症状非常相似。当癌肿生长超出前列腺边缘时，预后较差。对于所有有排尿问题的男性，应常规进行前列腺直肠指检。
