The Treatment Of Advanced Prostate Cancer (67 Cases)

Prostate cancer (Pca)is the most common malignancy in old man.The morbility increasing year by year all over the world.In the USA,more than 230 thousands patiennts were diagnosed every year,about 30 thousands patients succumbed to this malignancy. In China,the incidence of prostate cancer growing up year by year due to the aging of people,the changing of dinning habit,the widespread use of PSA.Bcause lack of mass screening,patients went to see a doctor when clinical symptom emerged obviously,most of them became advanced prostate cancer,the treatment effect and prognosis were poor.To understand the treatment and therapeutic effect of advanced prostate cancer,67patients of advanced prostate cancer were analyzed.There are 67 cases advanced prostate cancer in data,the ratio between advanced prostate cancer and all the prostate cance patients is 73.6%,age from 53 to 92 years old,average age is 72.5 years old,50 to 59 6 cases,60 to 69 23 cases,70 to 79 38 cases,more than 80 10 cases.Urinary obstruction 38 cases, lumbosacral area pain 7 cases,blood urine 8 cases,two symptoms emerged 7 cases,health examination 4 cases,PSA recured after castration 4 cases. DRE 67cases, Positive 51cases(76.1%);TRUS 60 cases, Positive 49 cases(81.7%); PSA 67cases,less than 4ng/ml 6 cases,4-10ng/ml 4 cases,more than 10ng/ml 57 cases; PSAD calculation 67 cases,less than 0.15 4 cases(6%),more than 0.15 63 cases(94%),patho-checking 60 cases,all of them are aden- carcinoma,Gleason score:2-4 0 case,5-7 23 cases,8-10 38 cases; GX 6 cases; ECT 52 cases,Positive 28 cases(53.8%);CT/MRI 36 cases, Positive 20 cases ;TNM staging,T3 31 cases; T4 36 cases; T3 31 cases,bilateral orchiectomy 3 cases; Bilateral orchiec -tomy plus Casodex 23 cases;LH-RH analogue plus Casodex 4 cases;MAB plus chemotherapy 1case.T4 36 cases,bilateral orchiec -tomy 2 cases; Bilateral orchiectomy plus Casodex 27 cases; LH-RH analogue plus Casodex 5 cases;MAB plus chemotherapy 2cases.There are 67 cases advanced prostate cancer in data,the ratio between advanced prostate cancer and all the prostate cance patients is 73.6%. Metastasis 48 cases, the ratio in advanced prostate cancer is 71.6% .Androgen blockage is the chief therapy, including castration, castration plus antiandrogen,LHRH plus antiandrogen,MAB plus chemotherapy.55 cases advanced prostate cancer patients were followed 3 months to 3 years.Subjective symptom,PSA and ECT were included. 46 patients felt symptom relief.PSA was rechecked every three months after healing, PSA of all the patients were decrease. Less than 4ng/ml 32 cases,4 to 10ng/ml 14 cases,more than 10ng/ml 9 cases;12 patients PSA increased again after healing 13 months to 20 months.Death 9 cases,the mortality is 16.4 %.ECT rechecking 12 cases ,positive 5 cases. Bilateral orchiectomy 5 cases,75% of the patients we followed,felt symptomatic relief; Castration plus antiandrogen 50 cases,85% of the patients felt symptomatic relief;LHRH plus antiandrogen 9 cases, 87.5% of the patients felt symptomatic relief;MAB plus chemotherapy 3 cases, 66.7% of the patients felt symptomatic relief.Because lack of mass screening,patients went to see a doctor when clinical symptom emerged obviously, most of them became advanced prostate cancer.The proportion of metabasis is very high,prognosis is poor,mortality is high.MAB is the utility way for curing advanced prostate cancer.