Walker A R
S Afr Med J. 1986 Jan 4;69(1):44-7.
In Western populations prostate cancer was probably rare in the past, yet in many populations the mortality rate has risen 3-5-fold since 1910. The disease now affects 1 man in 20. While the incidence in Third World populations living traditionally remains low, it increases with urbanization and prosperity, as in South African blacks. While the disease is age-related, more common in married than in single men and family-orientated, knowledge of specific aetiological factors is meagre. Abnormal hormonal status may well be involved, and possibly diet (Western v. Third World diet). There is a strong hormonal influence on tumour development. Treatment, according to the stage of the disease, includes prostatectomy, hormonal manipulation, external irradiation and chemotherapy; 70% of patients are surgically incurable at the time of presentation. Survival is greatly affected by the stage at diagnosis; the percentage surviving 5 years is 3 times higher for patients at stage A than for those at stage D. Little can be done to avoid prostate cancer because of inadequate understanding of risk factors. Annual rectal examination between 40 and 65 years is urged, since surgical cure is possible when metastases are absent.
在西方人群中，前列腺癌在过去可能较为罕见，但自1910年以来，许多人群的死亡率已上升了3至5倍。如今，每20名男性中就有1人受此疾病影响。虽然传统生活的第三世界人群中的发病率仍然较低，但随着城市化和生活水平的提高，发病率会上升，如南非黑人的情况。虽然该疾病与年龄有关，在已婚男性中比单身男性中更常见且具有家庭聚集性，但对具体病因的了解却很少。异常的激素状态很可能与之有关，饮食（西方饮食与第三世界饮食）也可能有影响。激素对肿瘤发展有很强的影响。根据疾病阶段，治疗方法包括前列腺切除术、激素治疗、外部放疗和化疗；70%的患者在确诊时已无法通过手术治愈。生存情况受诊断时疾病阶段的影响很大；A期患者5年生存率比D期患者高出3倍。由于对危险因素了解不足，几乎无法采取措施预防前列腺癌。建议40至65岁的男性每年进行直肠检查，因为在没有转移的情况下手术治愈是可能的。
