MEDIX, God. 16 Br. 91  •  Pregledni članak  •  Urologija HR ENG

Karcinom prostate – dijagnostika i liječenjeProstate cancer

Ivan Krhen, Mario Šunjara, Marjan Marić

Karcinom prostate najčešći je solidan tumor u Europi, a 1/6 muškaraca kojima je dijagnosticiran od njega će i umrijeti. Danas se dijagnosticira značajan broj indolentnih karcinoma prostate. Međutim, kako ne postoje sigurni kriteriji za ocjenu agresivnosti tumora, velik broj bolesnika podvrgnut je nepotrebnom liječenju, tj. pretretiranju. Sigurno utvrđeni rizični čimbenici raka prostate su dob, genetski faktori i rasa. Karcinom prostate u ranoj fazi ne daje simptome. Razlog leži u činjenici što se karcinom prostate pojavljuje, u većini slučajeva (oko 85%), u perifernoj zoni prostate koja ne okružuje prostatičnu uretru, te ne dovodi do urinarnih simptoma. Za rano otkrivanje karcinoma prakticira se određivanje prostatičnog specifičnog antigena (PSA) i digitorektalni pregled. Liječenje karcinoma prostate zahtijeva individualan pristup svakom bolesniku. Takav pristup treba uzeti u obzir dob bolesnika, očekivano trajanje života, stadij bolesti i želje i očekivanja bolesnika od liječenja. Mogućnosti liječenja uključuju radikalnu prostatektomiju, radikalnu radioterapiju, hormonsku terapiju te palijativno liječenje. 

Ključne riječi:
antigen specifičan za prostatu; liječenje; novotvorine prostate; rana dijagnoza; rano otkrivanje karcinoma

Članak u cijelosti pročitajte u tiskanom izdanju MEDIX, God. 16 Br. 91

Prostate cancer is the most common solid tumour in Europe – one-sixth of all men diagnosed with prostate cancer will die from it. Today, a significant number of indolent prostate cancers are being diagnosed. There are no precise criteria for the assessment of tumor aggressiveness. Consequently, a large number of patients are subjected to unnecessary treatment. Definitive risk factors for prostate cancer are age, genetic factors and race. Prostate cancer at an early stage does not cause any symptoms. The reason for this lies in the fact that prostate cancer occurs in most cases (85%) in the peripheral zone of the prostate, which does not surround the prostatic urethra and, thus, does not lead to lower urinary symptoms. Serum prostate-specific antigen (PSA) value and transrectal palpation of the prostate are used for early detection of prostate cancer. There is no “normal” and “abnormal” PSA value, although 4 ng/ml is often used as the upper normal level. With the increase in serum PSA level, the likelihood of prostate cancer also increases. In addition prostate cancer, main reasons of increased PSA value are benign prostatic hyperplasia (BPH) and prostatitis. PSA can also be increased as the result of catheterisation or some other form of manipulation in the lower urinary system. Ejaculation can also elevate serum PSA values. Treatment of prostate cancer requires individual approach to each patient. Choice of treatment depends on patient’s age, life expectancy, comorbidities, stage of the disease and patient’s wishes. Treatment .possibilities include radical prostatectomy, radical radiotherapy, hormone therapy and paliative treatments. 

Key words:
prostatic neoplasms; early detection of cancer; early diagnosis; prostate-specific antigen; treatment