Prostate Cancer : Indications of Optimal Treatment by Clinical Stage
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概要
- 論文の詳細を見る
While prostate cancer is common in older populations and tends to progress slowly, many patients are diagnosed only after the disease reached the metastatic stage. Thus, the cancer is becoming one of the most important male health issues in Japan as well as in western societies. Diagnosis of prostate cancer has been enhanced by introduction of prostate specific antigen (PSA) assessment and improvement in biopsy techniques. For instance, the cancer detection rate at our hospital is 34.3%. Accuracy of clinical staging is also increasing with new approaches including the Gleason score and the Partin nomogram. Treatment of prostate cancer is characterized by its wider choice of strategies compared to treatment of other many malignancies. Radical prostatectomy and radiation therapy are commonly performed for locally confined cancer, while radiotherapy and endocrine therapy are combined for locally invasive diseases. Prostate cancers in the metastatic stage are mainly treated with endocrine therapy. Nevertheless, treatment strategies for different patients in the same stage may vary depending on several factors including differentiation state of the tumor, age, and systemic condition of the patient. Even not giving treatment, i. e., watchful waiting, is another option in some cases. In our hospital, we treat locally confined prostate cancers with three-month neoadjuvant hormonal therapy followed by minilaparotomy radical retropubic prostatectomy. With this approach, prostate cancer-specific survival at 5 and 10 years at our hospital was 96.7%. For metastatic prostate cancer, maximum androgen blockade (MAB) is commonly selected as the initial endocrine treatment. For those not responsive to endocrine therapy, adrenocortical hormones, intravenous bolus of estrogen, and chemotherapy may be performed. Their efficacies are still limited, however, and further studies are needed to establish standard treatment for these cancers.
- 愛知医科大学の論文
- 2003-12-15
著者
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Honda Nobuaki
Department Of Urology Aichi Medical University School Of Medicine
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Yamada Yoshiaki
Department Of Urology Aichi Medical University School Of Medicine
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Yamada Yoshiaki
Department Of Cardiovascular And Thoracic Surgery
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Yamada Yoshiaki
Department Of Biology Faculty Of Science Okayama University
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HONDA NOBUAKI
Department of Urology, Aichi Medical University School of Medicine
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