Gacci Mauro, Baldi Elisabetta, Tamburrino Lara, Detti Beatrice, Livi Lorenzo, De Nunzio Cosimo, Tubaro Andrea, Gravas Stavros, Carini Marco, Serni Sergio
Department of Urology, University of Florence, Careggi Hospital, Viale Gramsci 7, 50121 Florence, Italy.
Department of Experimental and Clinical Biomedical Sciences, Section of Clinical Pathophysiology, University of Florence, Italy.
Int J Endocrinol. 2014;2014:470592. doi: 10.1155/2014/470592. Epub 2014 Mar 17.
Prostate cancer (PCa) is the most common malignancy in elderly men. The progressive ageing of the world male population will further increase the need for tailored assessment and treatment of PCa patients. The determinant role of androgens and sexual hormones for PCa growth and progression has been established. However, several trials on androgens and PCa are recently focused on urinary continence, quality of life, and sexual function, suggesting a new point of view on the whole endocrinological aspect of PCa. During aging, metabolic syndrome, including diabetes, hypertension, dyslipidemia, and central obesity, can be associated with a chronic, low-grade inflammation of the prostate and with changes in the sex steroid pathways. These factors may affect both the carcinogenesis processes and treatment outcomes of PCa. Any treatment for PCa can have a long-lasting negative impact on quality of life and sexual health, which should be assessed by validated self-reported questionnaires. In particular, sexual health, urinary continence, and bowel function can be worsened after prostatectomy, radiotherapy, or hormone treatment, mostly in the elderly population. In the present review we summarized the current knowledge on the role of hormones, metabolic features, and primary treatments for PCa on the quality of life and sexual health of elderly Pca survivors.
前列腺癌（PCa）是老年男性中最常见的恶性肿瘤。全球男性人口的老龄化进程将进一步增加对前列腺癌患者进行个性化评估和治疗的需求。雄激素和性激素在前列腺癌生长和进展中的决定性作用已得到证实。然而，最近几项关于雄激素与前列腺癌的试验聚焦于尿失禁、生活质量和性功能，这为前列腺癌整个内分泌学方面提供了新的视角。在衰老过程中，包括糖尿病、高血压、血脂异常和中心性肥胖在内的代谢综合征可能与前列腺的慢性低度炎症以及性类固醇途径的变化有关。这些因素可能会影响前列腺癌的致癌过程和治疗结果。前列腺癌的任何治疗都可能对生活质量和性健康产生长期负面影响，这应该通过经过验证的自我报告问卷进行评估。特别是，前列腺切除术后、放疗或激素治疗后，性健康、尿失禁和肠道功能可能会恶化，这在老年人群中尤为常见。在本综述中，我们总结了目前关于激素、代谢特征以及前列腺癌的主要治疗方法对老年前列腺癌幸存者生活质量和性健康影响的相关知识。
