Elderly people over 80 years old who suffer from prostate cancer generally do not undergo surgical treatment. The clinical situation of high-risk, medium-risk and low-risk can be evaluated based on the patient's clinical TNM staging, Gleason score, PSA (prostate-specific antigen), and treatment can be carried out as appropriate.
1, low risk group: PSA (prostate-specific antigen) 10ng/me, Gleason score 7 points, TNM stage is: T1-T2A stage, T1A stage: tumor is less than 1% of the resection volume, and digital rectal examination is normal; T1B stage: tumor is greater than 5% of the resection tissue, and digital rectal diagnosis is normal; T1C stage: PSA elevation, puncture or biopsy found, and digital rectal diagnosis or transrectal color ultrasound is normal; T2A stage: tumor is localized and less than 1/2 of single lobe. The above situations may not be treated or observed, and external or internal radiotherapy may be used.
medium-risk group: PSA is 10~20ng/me, Gleason score is 7 points, and TNM stage is T2B stage, that is, the tumor is greater than 1/2 of the single lobe. External radiotherapy, internal radiotherapy, or endocrine therapy can be used. It can also be not treated for the time being under close observation.
3, high-risk group: PSA 20ng/me, Gleason score 7 points, TNM stage is T2C or above, T2C stage: tumor invades two lobes of the prostate but is still localized in the prostate; T3A: tumor invades the prostate capsule; T3B: tumor invades the seminal vesicle; T4: tumor invades the bladder neck, external urethral sphincter, rectal levator anal muscle , or pelvic wall; N1 has regional lymphatic metastasis; the above situations can be used, combined with internal radiotherapy and endocrine therapy, or can be waited for observation. If the pathology is M1 stage, local radiotherapy combined with chemotherapy, or radiotherapy combined with endocrine therapy, or targeted, immunotherapy , etc. can be used.
