The doctor and the patient will decide the treatment regimen after considering many factors. For example, it is necessary to take into account the age of the patient, the stage of the disease, his general state of health and the presence of any coexisting diseases. In addition, before making any decision, the patient's personal preferences are also taken into account, as well as the risks and benefits of each treatment protocol.
Radical prostatectomy involves complete removal of the gland. The operation can be performed using a perineal approach, where an incision is made between the scrotum and the anus, or using a retropubic approach, where an incision is made in the lower abdomen. The perineal approach is also known as nerve-sparing prostatectomy, because it is believed that it reduces the effect on nerves and thus reduces the side effects of impotence and incontinence. However, the retropubic approach allows simultaneous removal of pelvic lymph nodes, which can provide important pathological information about the spread of the tumor. The disadvantage of surgical treatment of early cancer is a significant risk of side effects affecting the patient's quality of life. This side effect can sometimes be countered by prescribing sildenafil citrate (Viagra). Despite the side effects, most men were satisfied with their choice of treatment. In addition, there is some evidence that the skills and experience of the surgeon are central factors in the ultimate side effects. The second method of surgical treatment of cancer is cryosurgery or cryotherapy. Surgeons, guided by ultrasound, make up to eight cryoprobes through the skin and in the immediate vicinity of the tumor. Liquid nitrogen circulates through the probe, freezing the tumor tissue. In surgery, a heating tube is also used to keep the urethra from freezing. Patients currently spend a day or two in the hospital after surgery, but in the near future it may be an outpatient procedure. The recovery time is about one week. Side effects have been reduced in recent years, although impotence still affects almost everyone who has had cryosurgery for cancer. Cryosurgery is considered a good alternative for those who are too old or sick to have traditional surgical or radiotherapy or when these more traditional treatments have failed. There is a limited amount of information about the long-term effectiveness of this cancer treatment.
Radiation therapy involves the use of high-energy X-rays to destroy cancer cells or shrink tumors. It can be used instead of surgery for stage I and II cancers. Radiation can either be injected from a machine outside the body (external beam radiation), or small radiographs can be implanted into the prostate gland in the area around the tumor, called brachytherapy or interstitial implantation. Side effects of radiation may include inflammation of the bladder, rectum and small intestine, as well as blood clotting disorders (coagulopathy). Impotence and urinary incontinence often delay the side effects of treatment. The study found that bowel control problems were more likely after radiation therapy compared to surgery, but impotence and incontinence were more likely after surgical treatment. Long-term results with radiation therapy depend on the stage. There does not seem to be much difference in survival between external rays or interstitial treatments.
Hormone therapy is usually used when the cancer is at an advanced stage and has spread to other parts of the body, such as stage III or IV. Hormone levels can be reduced in several ways. Orchiectomy is a surgical procedure that involves the complete removal of the testicles, which leads to a decrease in testosterone levels. Погребальные гробницы фиргийцев и скифов часто содержали семена марихуаны посевной (Sherr att 1995). Значительно способствовал их мобильности благодаря племенам бронзового века, особенно скифы, служили важными проводниками для распространения растения в Южную Азию, Ближний Восток и Восточную Европу.
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