de Klerk D P
Department of Urology, University of Stellenbosch, Parowvallei, CP.
S Afr Med J. 1988 Feb 6;73(3):157-8.
Since the aetiology of prostatic cancer is unknown, and therapy for metastatic disease non-curative, a decrease in the mortality rate from this condition can only be achieved by early diagnosis and effective treatment of the primary tumour. For diagnosis of localised cancer no practical alternative exists to rectal palpation. Of 629 cases of prostatic cancer seen at Tygerberg Hospital, the disease had metastasised in 29% of white and 58% of coloured patients at initial diagnosis. Prostatism or urinary retention was the presenting complaint in 74.7% of patients. The letters of referral of 97 patients were examined to determine whether prostatic cancer had been diagnosed by the primary care physician before referral. Rectal examination by the referring physician was recorded or implied in 64.9% of patients, and in those patients who underwent rectal examination before referral prostatic cancer was diagnosed in 54%. These findings imply that the opportunity for early diagnosis of prostatic cancer may be missed in many patients in whom rectal examination by the primary physician is indicated.
由于前列腺癌的病因不明，且转移性疾病的治疗无法治愈，因此只有通过早期诊断和有效治疗原发性肿瘤才能降低这种疾病的死亡率。对于局限性癌症的诊断，直肠指检是唯一可行的方法。在泰格堡医院就诊的629例前列腺癌患者中，初诊时29%的白人患者和58%的有色人种患者已有转移。前列腺增生或尿潴留是74.7%患者的主要症状。检查了97例患者的转诊信，以确定初级保健医生在转诊前是否已诊断出前列腺癌。转诊医生进行直肠检查的记录或暗示见于64.9%的患者，在转诊前接受直肠检查的患者中，54%被诊断出前列腺癌。这些发现表明，在许多应由初级医生进行直肠检查的患者中，可能会错过早期诊断前列腺癌的机会。
