前列腺癌

诊断

Prostate cancer diagnosis often starts with an exam and a blood test. A healthcare professional might do these tests as part of prostate cancer screening. Or you might have these tests if you have prostate cancer symptoms. If these first tests detect something concerning, imaging tests can make pictures of the prostate to look for signs of cancer. To be sure whether you have prostate cancer or not, a sample of prostate cells might be removed for testing.

前列腺癌筛查

是否对无前列腺癌症状的健康男性进行检查尚存争议。医疗组织之间对检查的益处是否大于潜在风险存在一些分歧。

大多数医疗组织鼓励 50 岁以上男性与医生讨论前列腺癌筛查的利弊。讨论内容应包括审查风险因素和对筛查的偏好。

黑人、有前列腺癌家族史或其他风险因素的患者可能应考虑及早开始讨论。

前列腺筛查可能包括：

• 直肠指检（DRE）。DRE 期间，医生会向直肠插入戴手套、润滑过的手指以检查前列腺，后者与直肠相邻。如果医生发现腺体质地、形状或大小有任何异常，则您可能需要进一步检查。
• 前列腺特异性抗原（PSA）检查。从手臂静脉抽取血样进行 PSA 分析，PSA 是前列腺天然产生的一种物质。血流中有少量 PSA 是正常的。然而，如果发现其高于正常水平，可能表明前列腺发生感染、炎症、增大或癌症。

Digital rectal exam

A digital rectal exam lets a healthcare professional examine the prostate. It's sometimes done as part of prostate cancer screening. It might be recommended if your symptoms lead your health professional to think you might have a prostate condition.

During a digital rectal exam, a healthcare professional inserts a gloved, lubricated finger into the rectum. The prostate is right by the rectum. The health professional feels the prostate for anything concerning in the texture, shape or size of the gland.

Prostate-specific antigen test

A prostate-specific antigen test is a blood test that measures the amount of prostate-specific antigen in the blood. Prostate-specific antigen, also called PSA, is a substance that prostate cells make. Some PSA circulates in the blood. A PSA test detects the PSA in a blood sample.

Having a high level of PSA in your blood can be a sign of prostate cancer. But many other things also can cause a high PSA level, including prostate infection and prostate enlargement. If a PSA test detects an increased level of PSA in your blood, the test is usually repeated. Your healthcare professional might recommend doing the test again in a few weeks to see if the level goes down. If the level stays high, you might need an imaging test or a biopsy procedure to look for signs of cancer.

A PSA test is often used for prostate cancer screening. It also might be used if you have prostate cancer symptoms. The results can give your healthcare professional clues about your diagnosis.

Prostate ultrasound

Ultrasound is an imaging test that uses sound waves to make pictures of the body. A prostate ultrasound makes pictures of the prostate. A healthcare professional might recommend this test if a digital rectal exam detects something concerning.

To get ultrasound pictures of the prostate, a healthcare professional puts a thin probe into the rectum. The probe uses sound waves to create a picture of the prostate gland. When an ultrasound is done this way, it's called a transrectal ultrasound.

Prostate MRI

Magnetic resonance imaging, also called MRI, uses a magnetic field and radio waves to create pictures of the inside of the body. A prostate MRI makes pictures of the prostate. It's often used to look for concerning areas in the prostate that could be cancer.

Prostate MRI images may help your healthcare team decide whether you should have a biopsy procedure to remove prostate tissue for testing. The prostate MRI images also might help with planning the biopsy. If the MRI detects concerning areas in the prostate, the biopsy can target those areas.

During a prostate MRI, you lie on a table that goes into an MRI machine. Most MRI machines are large, tube-shaped magnets. The magnetic field inside the machine works with radio waves and hydrogen atoms in your body to create cross-sectional images.

Healthcare professionals use different kinds of MRI tests for prostate cancer, including:

• Contrast-enhanced MRI. A contrast-enhanced MRI scan uses a dye to make the pictures clearer. A healthcare professional puts the dye into a vein in your arm before the MRI.
• MRI with endorectal coil. MRI with endorectal coil uses a device inserted in the rectum to get better pictures of the prostate. Before this kind of MRI, a healthcare professional inserts a thin wire into your rectum. This thin wire, called an endorectal coil, sends signals to the MRI machine.
• Multiparametric MRI. A multiparametric MRI, also called mpMRI, tells the healthcare team more about the prostate tissue. This kind of MRI can help show the difference between healthy prostate tissue and prostate cancer.

诊断前列腺癌

如果前列腺癌筛查检测出异常，医生可能建议进一步检查来确定您是否患有前列腺癌，例如：

• 超声检查。经直肠超声检查时，会在直肠中插入大小和形状酷似香烟的小型探针。这根探针利用声波形成前列腺图像。
• 磁共振成像（MRI）。在某些情况下，医生可能会建议对前列腺进行 MRI 扫描，以获得更详细的图像。MRI 图像可能有助于医生安排医疗程序，提取前列腺组织样本。
• 前列腺组织取样。为确定是否为前列腺癌，医生可能建议通过一种程序采集您的前列腺细胞样本（前列腺活检）。通常会用细针插入前列腺来采集组织，完成前列腺活检。在实验室分析组织样本，确定是否存在癌细胞。

确定是否是侵袭性前列腺癌

如果活检确诊患有癌症，那么下一步就是确定癌细胞的侵袭水平（级别）。实验室医生会检查癌细胞样本，以确定癌细胞与健康细胞的差异有多大。级别越高，癌症侵袭性越强，越有可能快速扩散。

用于确定癌症侵袭性的技术包括：

• 格里森评分。评估前列腺癌细胞级别最常见的等级体系是格里森评分。格里森评分包含两个数字，范围从 2（非侵袭性癌症）到 10（极具侵袭性癌症）不等，但是低范围部分不常使用。

  多数用于评估前列腺活检样本的格里森评分范围为 6 到 10。6 分表示低级别前列腺癌。7 分表示中等级别前列腺癌。8 至 10 分表示高级别癌症。

• 基因组检测。基因组检测会分析前列腺癌细胞，以确定存在哪些基因突变。这种类型的检测可以提供有关预后的更多信息。但目前尚不清楚谁可能从这些信息中受益最多，因此这些检测并未广泛使用。并非所有前列腺癌患者都需要进行基因组检测，但在某些情况下，基因组检测可以提供更多信息，帮助做出治疗决策。

Prostate cancer biomarker tests

Biomarkers are things that can be detected in the body. Results from biomarker tests tell healthcare professionals about what's going on inside the body. Biomarker testing for cancer looks for biomarkers in the cancer cells. The results help healthcare professionals learn more about what's going on inside the cancer cells.

Healthcare professionals use prostate cancer biomarker tests to:

• Decide whether to do a prostate biopsy. Some prostate cancer biomarker tests use blood and urine samples to detect signals made by prostate cancer cells. The tests can tell your healthcare team whether a prostate biopsy is likely or not likely to find prostate cancer.
• Decide on a treatment for early prostate cancer. Some prostate cancer biomarker tests involve testing the cancer cells to see if the cancer has a high risk or a low risk of spreading beyond the prostate. If the results of other tests haven't been clear, this kind of test might help your care team understand your risk. The results can help decide between starting treatment right away or watching the cancer closely to see if it grows.
• Decide on a treatment for advanced prostate cancer. Other prostate cancer biomarker tests help when the cancer is advanced. For prostate cancer that has spread to other parts of the body, the results of these tests can tell your healthcare team whether certain treatments are likely to work on your cancer cells. For this kind of test, your healthcare team may test some of the cells that have spread. The cells might be removed with a biopsy procedure or collected from a blood sample.

Not everyone needs a prostate cancer biomarker test. These tests are new, and healthcare professionals are still deciding how best to use them.

确定癌细胞是否已经扩散

前列腺癌得到确诊后，医生的工作是确定癌症的程度（分期）。如果医生怀疑您的癌症可能已经扩散到前列腺以外，建议您做以下一种或多种成像检查：

• 骨扫描。
• 超声检查。
• 计算机体层成像（CT）扫描。
• 磁共振成像（MRI)。
• 正电子发射体层成像（PET）扫描。

不是每个人都应该进行所有检查。医生会帮助您确定哪些检查最适合您的个人情况。

医生会根据这些检查中获取的信息来判断您癌症的分期。前列腺癌的分期用罗马数字 I 至 IV 表示。最低分期表示癌症局限于前列腺。到了 IV 期，癌细胞的生长范围已超出前列腺，可能已经扩散至身体其他部位。

Prostate cancer stages

Your healthcare team uses the results of your tests and procedures to give your cancer a stage. The cancer's stage tells your healthcare team about the size of the cancer and how quickly it's growing.

To decide your prostate cancer stage, your healthcare team uses these factors:

• How much of the prostate contains cancer.
• Whether the cancer has grown beyond the prostate, such as into the rectum, bladder or other nearby areas.
• Whether the cancer has spread to the lymph nodes.
• Whether the cancer has spread to other parts of the body, such as the bones.
• The level of PSA in the blood.
• The grade group.

Prostate cancer stages range from 1 to 4. A lower number means the cancer is small and only in the prostate. A lower number stage typically means the cancer is very likely to be cured. If the cancer grows larger or spreads, the stage goes up. A higher number stage may mean a cure is less likely. Your prognosis depends on many factors, so talk about this with your healthcare team.

The stages of prostate cancer are:

• Stage 1 prostate cancer. A stage 1 prostate cancer means the cancer is small and only in the prostate. The cancer only affects one side of the prostate gland. The PSA level is low and the grade group is 1.
• Stage 2A prostate cancer. A stage 2A prostate cancer may be a small cancer that only affects one side of the prostate, but the PSA level is intermediate. This stage also can mean that the cancer affects both sides of the prostate, but the PSA level is low. At this stage, the grade group is 1.
• Stage 2B prostate cancer. A stage 2B prostate cancer is only in the prostate. The cancer may have grown to involve both sides of the prostate gland. At this stage, the PSA level is intermediate. The grade group is 2.
• Stage 2C prostate cancer. A stage 2C prostate cancer is only in the prostate. The cancer may have grown to involve both sides of the prostate gland. The PSA level is intermediate. The grade group is 3 or 4.
• Stage 3A prostate cancer. A stage 3A prostate cancer is only in the prostate. The cancer may have grown to involve both sides of the prostate gland. The PSA level is high. This stage includes grade groups 1 to 4.
• Stage 3B prostate cancer. A stage 3B prostate cancer has grown beyond the prostate. The cancer might extend to the seminal vesicles, bladder, rectum or other nearby organs. The PSA level may be low, intermediate or high. This stage includes grade groups 1 to 4.
• Stage 3C prostate cancer. A stage 3C prostate cancer has a grade group of 5. It includes any size prostate cancer. The cancer may have grown beyond the prostate, but it hasn't spread yet.
• Stage 4A prostate cancer. A stage 4A prostate cancer has spread to the lymph nodes.
• Stage 4B prostate cancer. A stage 4B prostate cancer has spread to other parts of the body, such as the bones.

Prostate cancer prognosis

The cancer prognosis tells you how likely it is that the cancer can be cured. Your healthcare team can get a general sense of your outlook using your prostate cancer stage. But the stage can't tell your future. Your personal prognosis may depend on:

• Your age.
• Your overall health.
• The cancer's stage.
• PSA test results.
• Prostate biopsy results.
• Grade group.

Talk with your healthcare team about your prognosis if you want to know what to expect. Your healthcare team can explain what they consider when thinking about your prognosis.

Prostate cancer survival rates

The chance of surviving prostate cancer is quite good for most people. To understand prostate cancer survival rates, experts study many people with prostate cancer to see how many are living five years after their diagnosis.

When the cancer is only in the prostate, the chance of surviving at least five years is 100%. As the cancer spreads beyond the prostate, the chances get lower. When prostate cancer has spread to other parts of the body, called metastatic prostate cancer, the chances of surviving at least five years is about 37%.

Keep in mind that survival statistics take five years to collect. The most recent survival rates include people who had prostate cancer treatment more than five years ago. These people may not have had access to the latest treatments. Over the last few decades, prostate cancer death rates have been falling and survival rates have been increasing.

治疗

前列腺癌治疗方法取决于多种因素，例如癌症发展速度、扩散范围、患者整体健康状况，以及治疗方案的潜在益处或副作用。

可能不需要立即治疗

低级别前列腺癌可能不需要立即治疗。有些患者可能永远都不需要治疗。医生有时会建议用主动监测取代治疗。

在主动监测中，可以通过定期随访血液检测、直肠检查和前列腺活检来监测癌症进展。如果检查结果显示癌症正在进展，您可以选择手术或放疗来治疗前列腺癌。

对于那些不会引起症状、预期生长非常缓慢且局限于前列腺较小部位的癌症，可以选择进行主动监测。对于有其他严重病症的患者或因高龄导致癌症治疗起来更加困难的患者，也可以考虑进行主动监测。

前列腺切除手术

前列腺癌的手术包括切除前列腺（根治性前列腺切除术）、一些周围组织和少数淋巴结。

手术可用于治疗局限于前列腺的癌症。手术有时可与其他治疗方法联合用于治疗晚期前列腺癌。

为了进入前列腺，外科医生可能会使用一种技术，其需要：

• 在您的腹部做几个小切口。在机器人辅助腹腔镜前列腺切除术中，将手术器械连接到一个机械设备（机器人）上，通过几个小切口插入您的腹部。外科医生坐在控制台旁，使用手动控制器引导机器人移动器械。大多数前列腺癌手术都是使用这种技术完成的。
• 在您的腹部做一个长切口。在耻骨后手术中，外科医生会在您的下腹部做一个长切口，以进入并切除前列腺。这种方法不太常用，但在某些情况下可能是必要的。

与医生讨论哪种类型的手术最适合您的具体情况。

放射疗法

放射疗法使用大功率能量束杀伤癌细胞。前列腺癌放射疗法可能涉及：

• 体外照射（外照射）。外照射疗法期间，您躺在治疗台上，同时同时一台机器围绕您移动，指引大功率能量束（如 X 线或质子）至前列腺癌。一般一周五天接受外照射治疗，持续数周。有些医疗中心提供较短疗程的放射疗法，即在较少天数内递送较高剂量的辐射。

  外照射可用于治疗局限于前列腺的癌症。如果癌症有扩散或复发的风险，术后也可采用外照射来杀死任何可能残留的癌细胞。对于扩散至身体其他部位（如骨骼）的前列腺癌，放射疗法可能有助于减缓癌细胞的生长并缓解症状（如疼痛）。

• 置于体内照射（近距离治疗）。近距离治疗需要在前列腺组织中放置放射源。通常，辐射被包含在米粒大小的放射性籽粒中，这些籽粒会被插入前列腺组织。这些放射性籽粒长时间递送低剂量辐射。近距离治疗这一选项可用于治疗还未从前列腺扩散到其他器官的癌症。

在某些情况下，医生可能会同时推荐这两种类型的放射疗法。

Brachytherapy for prostate cancer

Brachytherapy involves placing radiation inside the body. Brachytherapy is one type of radiation therapy used to treat prostate cancer.

Most prostate cancer brachytherapy treatments are permanent. Permanent brachytherapy is sometimes called low dose rate brachytherapy. This treatment uses rice-sized seeds that contain radioactive material. A healthcare professional uses a device to insert the seeds into the prostate gland. The seeds slowly give off a low dose of radiation over time.

Sometimes prostate cancer brachytherapy treatments are temporary. Temporary brachytherapy is sometimes called high dose rate brachytherapy. This treatment involves placing radioactive material in the prostate for a short period. Then the radioactive material is removed. The treatment might repeat over multiple days.

Healthcare professionals use brachytherapy to treat prostate cancer that's only in the prostate. Brachytherapy doesn't treat cancer that has spread to other parts of the body.

Side effects of brachytherapy for prostate cancer include frequent urination, painful urination and blood in the urine. There may be diarrhea, constipation and a feeling that the bowel can't be emptied completely. There also can be difficulty getting an erection.

冷冻或加热前列腺组织

消融治疗通过冷冻或加热破坏前列腺组织。治疗方案可能包括：

• 冷冻前列腺组织。针对前列腺癌的冷冻消融或冷冻疗法需要使用极冷的气体来冷冻前列腺组织。然后使组织解冻，接着重复该程序。冷冻和解冻的循环会杀死癌细胞和周围的一些健康组织。
• 加热前列腺组织。高强度聚焦超声（HIFU）治疗使用集中的超声能量加热前列腺组织，致其死亡。

对于无法进行手术的非常小的前列腺癌，可考虑使用这些治疗方法。对于其他治疗（例如放射疗法）无效的晚期前列腺癌，也可以使用这些治疗方法。

研究人员正在研究用冷冻疗法或 HIFU 治疗前列腺的一部分是否可以作为局限于前列腺的癌症的一种治疗方案。这种疗法被称为“局部疗法”，能够识别前列腺中存在最具侵袭性癌细胞的区域，并只对该区域进行治疗。研究发现局部疗法可降低副作用的风险。但目前尚不明确其能否像治疗整个前列腺一样带来相同的生存益处。

激素治疗

激素治疗旨在阻止人体分泌睾酮这种雄性激素。前列腺癌细胞依靠睾酮才能生长。切断睾酮供应可导致癌细胞死亡或减缓其生长。

激素治疗方案包括：

• 能够阻止人体分泌睾酮的药物。某些药物（称为促黄体素释放激素 [LHRH] 或促性腺激素释放激素 [GnRH] 激动剂和拮抗剂）会阻止人体细胞接收关于生成睾酮的信息。因此，睾丸停止生成睾酮。
• 阻止睾酮进入癌细胞的药物。这些药物称为抗雄激素，通常与 LHRH 激动剂联合使用。这是因为 LHRH 激动剂在睾酮水平降低之前可能会导致睾酮暂时升高。
• 切除睾丸的手术（睾丸切除术）。切除睾丸会迅速而显著地降低体内睾酮水平。但是与药物治疗方案不同，睾丸切除手术是永久性且不可逆的。

激素治疗通常用于治疗晚期前列腺癌，以缩小肿瘤并减缓其生长。

对于未发生扩散的前列腺癌，有时会先进行激素治疗，然后再进行放射疗法。这有助于缩小肿瘤，提高放射疗法的效果。

化疗

化疗使用药物杀死快速生长的细胞，包括癌细胞。化疗可以通过手臂静脉注射或口服这两种方式进行，也可以同时进行。

如果前列腺癌已扩散到身体其他部位，化疗可能是一种治疗选项。对于那些激素治疗对其没有效果的癌症，也可选择化疗。

靶向药物治疗

靶向药物治疗专门针对癌细胞中存在的特定异常。靶向药物治疗可以通过阻断这些异常来杀死癌细胞。

如果激素治疗不起作用，可能会建议使用靶向治疗药物来治疗晚期或复发性前列腺癌。

有些靶向治疗仅对癌细胞发生特定基因突变的患者有效。医生会在实验室检验您的癌细胞，以便了解这些药物是否有效。

免疫疗法

免疫疗法是指利用免疫系统对抗癌症。您体内负责对抗疾病的免疫系统可能无法攻击癌症，原因是癌细胞会产生能够躲避免疫系统细胞的蛋白质。免疫疗法正是通过干扰这一过程来发挥作用。

前列腺癌免疫疗法可能涉及：

• 通过基因工程使细胞能够对抗癌症。Sipuleucel-T（Provenge）疗法采集一些您自身的免疫细胞，在实验室进行抗前列腺癌基因工程，然后将这些细胞经静脉重新注入体内。对于那些对激素治疗不再有反应的晚期前列腺癌，也是一种治疗选项。
• 帮助免疫系统细胞识别癌细胞。对于那些对激素治疗不再有反应的晚期前列腺癌，也可选择帮助免疫系统细胞识别和攻击癌细胞的免疫疗法药物。

Radiopharmaceutical treatments for prostate cancer

Radiopharmaceutical treatments are medicines that contain a radioactive substance. Radiopharmaceutical treatments used for cancer can deliver radiation to cancer cells.

For prostate cancer, radiopharmaceutical treatments are typically used when the cancer is advanced. People with stage 4 prostate cancer that has spread to other parts of the body, also called metastatic prostate cancer, might consider radiopharmaceutical treatments.

Radiopharmaceuticals used for prostate cancer include:

• Treatments that target PSMA. Radiopharmaceutical treatments can target a protein that's common on prostate cancer cells called prostate-specific membrane antigen. It's also called PSMA. One radiopharmaceutical medicine that works in this way is lutetium Lu-177 vipivotide tetraxetan (Pluvicto). This medicine contains a molecule that finds and sticks to the PSMA on prostate cancer cells. The medicine also contains a radioactive substance. A healthcare professional gives this medicine through a vein. The medicine finds the prostate cancer cells and releases the radiation directly into the cells. PSMA therapy can treat prostate cancer anywhere in the body. This treatment only works if the prostate cancer cells make the PSMA protein. Side effects include dry mouth, nausea and feeling very tired.
• Treatments that target the bones. Some radiopharmaceutical medicines contain a radioactive substance that is attracted to bones. When a healthcare professional puts this medicine into a vein, it travels to the bones and releases the radiation. One medicine that works in this way is radium Ra-223 (Xofigo). Healthcare professionals sometimes use it when prostate cancer spreads to the bones but not to other parts of the body. This treatment can help with bone pain and other symptoms. Side effects include diarrhea and feeling very tired.

替代医学

尚未发现可以治愈前列腺癌的辅助或替代治疗。然而，前列腺癌的辅助和替代治疗可能有助于您应对癌症及其治疗的副作用。

几乎所有确诊为癌症的患者都会在某些时刻感到痛苦。当您感到痛苦时，您可能会感到悲伤、愤怒或焦虑。您可能难以入睡，或者发现自己总在想自己的癌症。

下述几种辅助医学技术可能有助于您应对痛苦，包括：

• 艺术疗法。
• 舞蹈或运动疗法。
• 运动。
• 冥想。
• 音乐疗法。
• 放松技巧。
• 精神支持。

将您的感受和担忧告诉医生。在某些情况下，可能需要借助药物才能消除痛苦。

妥善处理与支持

当您被诊断为前列腺癌时，您可能经历一系列的情绪，包括多疑、恐惧、愤怒、焦虑和抑郁。逐渐地，每个人都会找到自己应对前列腺癌诊断的方法。

找到适合方法前，可尝试：

• 学习足够的前列腺癌知识，让自己能够做出治疗决定。尽可能多地了解您的癌症及其治疗，以便了解治疗预期和治疗后的生活。让您的医生、护士或其他医疗保健专业人士推荐一些可靠的信息资源，以便开始了解。
• 与朋友和家人保持密切的联系。您的朋友和家人可在您治疗期间和治疗后提供支持。在治疗过程中，他们可能很希望帮助您完成治疗期间没有精力做的小事。当您感到压力大或不堪重负时，与亲密的朋友或家人聊天会有所助益。
• 联系其他癌症幸存者。朋友和家人不可能总是理解面对癌症的感受。其他癌症幸存者可以提供独特的支持网络。询问您的医疗服务提供者有关互助组或社区组织的信息，以让您与其他癌症幸存者进行沟通。美国癌症协会等机构能提供在线聊天室和论坛。
• 照顾好自己。在治疗癌症的过程中照顾好自己，多吃水果和蔬菜。尝试每周多天进行锻炼。。每晚保证睡眠充足，以确保醒来时感觉精神饱满。
• 继续性的表达。如果您出现勃起功能障碍，您的本能反应可能是避免所有性接触。但可考虑将触摸、搂握、拥抱和抚摸，作为与伴侣继续分享性行为的方式。

准备您的预约

如果您对自己的体征或症状感到担心，请先向家庭医生就诊。

如果医生怀疑您的前列腺可能有问题，可能会将您转诊给尿路专家（泌尿科医生）。如果您被诊断出前列腺癌，可能将您转诊给癌症专家（肿瘤学家）或使用放疗治疗癌症的专家（放射肿瘤学家）。

由于就诊时间可能很短，而且往往要讨论很多信息，因此最好做足准备。以下信息可以帮助您做好准备，并了解医生可能会做些什么。

您能做些什么

• 了解就诊前的全部限制规定。约诊时，一定要询问是否需要提前做准备，例如限制饮食。
• 写下您目前的任何症状，包括与您本次约诊原因看似无关的症状。
• 写下重要个人信息，包括任何主要压力或近期生活变化。
• 列出您正在服用的所有药物、维生素或补充剂。
• 考虑让家人或朋友陪同就诊。有时很难记住约诊时告知您的全部信息。陪同人可能会记住您遗漏或遗忘的信息。
• 写下要问医生的问题。

您的就诊时间有限，因此，准备好问题清单以帮助您充分利用就诊时间。按问题的重要性对其排出先后顺序，以防时间不够。如果是前列腺癌，要问医生的基本问题包括：

• 我有前列腺癌吗？
• 我的前列腺癌有多大？
• 我的前列腺癌已经扩散到前列腺以外了吗？
• 我的格里森评分是多少？
• 我的前列腺特异抗原 (PSA) 水平如何？
• 我需要做更多检查吗？
• 我的治疗方案有哪些？
• 您认为有最适合我的治疗方案吗？
• 我需要立刻进行癌症治疗吗，还是观望癌症是否增长？
• 每种疗法可能有哪些潜在的副作用？
• 我的前列腺癌被治愈的几率有多大？
• 如果您的朋友或家人出现我这种情况，您有哪些建议？
• 我是否应该看专科医生？治疗费用是多少，我的保险能报销吗？
• 有我可以带走的手册或其他印刷材料吗？您推荐哪些网站？

除了您准备咨询医生的问题外，在约诊期间，您可以随时询问其他问题。

医生可能会做什么

医生可能会问一些问题。请做好回答这些问题的准备，这样有利于更好地安排时间，以详细了解您所关注的任何方面。医生可能会问：

• 何时开始出现症状？
• 您的症状是持续存在还是偶尔出现？
• 症状有多严重？
• 有没有什么因素似乎会改善您的症状？
• 哪些因素（如有）看似会加重您的症状？