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前列腺癌药物及手术干预的综合综述

A Comprehensive Review of Pharmaceutical and Surgical Interventions of Prostate Cancer.

作者信息

Kaler Jasndeep, Hussain Azhar, Haque Ayema, Naveed Hassan, Patel Sundip

机构信息

Medicine, Xavier University School of Medicine, Oranjestad, ABW.

Healthcare Administration, Franklin University, Columbus, USA.

出版信息

Cureus. 2020 Nov 22;12(11):e11617. doi: 10.7759/cureus.11617.

Abstract

As the second most common cause of death amongst men in the United States, prostate cancer is a type of cancer that is known to develop and originate in the prostate gland. The main function of the prostate gland is to produce seminal fluid in which the sperm bathes. The seminal fluids are necessary for allowing the sperm to move easily through the urethra and also allows successful fertilization by providing an alkaline environment for the sperm in the acidic nature of the vagina. The seminal vesicles are two smaller glands that are attached to either side of the prostate gland and in radical prostatectomies, can get removed. In the event that the seminal vesicles are removed during a radical prostatectomy, the individual is unable to produce any seminal fluids and thus, becoming infertile. Prostate cancer is most commonly seen in patients over the age of 66 years, however, in the presence of predisposing risk factors, may occur as early as in the late 40s. Certain risk factors may speed the presentation of prostate cancer in individuals and thus, mandatory screening is recommended around the age of 45. If no risk factors are present, screening is recommended to begin after the age of 50 years. Screening for prostate cancer is focused on looking for prostate-specific antigen (PSA) in a blood test, though this may not be the most reliable method. The method of diagnosis stems from further testing done following an abnormal PSA test. A digital rectal examination and ultrasonography may also be used to assist with the diagnosis of prostate cancer. Though there are several different types of pharmaceutical interventions currently present in the eradication of prostate cancer, with androgen deprivation therapy being the most commonly used, surgical interventions may be utilized to completely resect cancer from an individual. Different radical prostatectomies are used; the appropriate approach utilized is dependent on the extensiveness of cancer and the type of cancer that is present.

摘要

前列腺癌是美国男性中第二大常见死因,是一种已知在前列腺中发生和起源的癌症。前列腺的主要功能是产生精液,精子在其中游动。精液对于使精子能够轻松通过尿道是必要的,并且通过在阴道酸性环境中为精子提供碱性环境,也有助于成功受精。精囊是两个较小的腺体,附着在前列腺的两侧,在根治性前列腺切除术中可能会被切除。如果在根治性前列腺切除术中切除了精囊,个体将无法产生任何精液,从而导致不育。前列腺癌最常见于66岁以上的患者,然而,在存在易感风险因素的情况下,可能早在40多岁时就会发生。某些风险因素可能会加速个体前列腺癌的出现,因此建议在45岁左右进行强制性筛查。如果不存在风险因素,建议在50岁以后开始筛查。前列腺癌筛查主要是在血液检测中寻找前列腺特异性抗原(PSA),尽管这可能不是最可靠的方法。诊断方法源于PSA检测异常后进行的进一步检测。直肠指检和超声检查也可用于辅助前列腺癌的诊断。尽管目前在根除前列腺癌方面有几种不同类型的药物干预措施,其中雄激素剥夺疗法是最常用的,但手术干预措施可用于从个体身上完全切除癌症。使用了不同的根治性前列腺切除术;所采用的适当方法取决于癌症的范围和所存在的癌症类型。

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