内容紹介
Summary
Because of both the indolent and aggressive nature of prostate cancers, it is not easy to select the best treatment for patients receiving home medical care who already have many diseases. Since the growth of prostate cancer is generally slow and all treatments adversely affect the quality of life to some degree, conservative treatment may well be the best option for these patients with prostate cancer. However, it is also true that we often encounter home medical care patients with a locally advanced cancer who had symptoms such as difficulty to urine, macrohematuria and/or lumbago. Such patients need to be diagnosed soon and treated with mainly hormonal therapy after consultation with the specialist. Thus, after a careful evaluation of the nature of the cancer and comorbidity, we need to provide the best option of diagnosis and treatment for home medical care patients to maintain their quality of life.
要旨
治療を必要としない癌,進行癌のいずれも存在する前立腺癌であるがゆえに,在宅医療患者の前立腺癌の診断や治療の選択は容易ではない。一般に腫瘍の成長は緩徐であり,一方ですべての治療方法には生活の質を低下させる合併症が存在することから,保存的療法が最もふさわしい。しかし一方で,排尿障害,肉眼的血尿,腰痛などを伴う進行癌で発見される在宅医療患者もまれではなく,専門医との相談の下,迅速な診断と治療が必須である。したがって,腫瘍の性格や患者がすでにもつ合併症を十分検討した後に,生活の質を保つことを念頭に置いて最善の選択肢を提供する必要がある。
目次
Because of both the indolent and aggressive nature of prostate cancers, it is not easy to select the best treatment for patients receiving home medical care who already have many diseases. Since the growth of prostate cancer is generally slow and all treatments adversely affect the quality of life to some degree, conservative treatment may well be the best option for these patients with prostate cancer. However, it is also true that we often encounter home medical care patients with a locally advanced cancer who had symptoms such as difficulty to urine, macrohematuria and/or lumbago. Such patients need to be diagnosed soon and treated with mainly hormonal therapy after consultation with the specialist. Thus, after a careful evaluation of the nature of the cancer and comorbidity, we need to provide the best option of diagnosis and treatment for home medical care patients to maintain their quality of life.
要旨
治療を必要としない癌,進行癌のいずれも存在する前立腺癌であるがゆえに,在宅医療患者の前立腺癌の診断や治療の選択は容易ではない。一般に腫瘍の成長は緩徐であり,一方ですべての治療方法には生活の質を低下させる合併症が存在することから,保存的療法が最もふさわしい。しかし一方で,排尿障害,肉眼的血尿,腰痛などを伴う進行癌で発見される在宅医療患者もまれではなく,専門医との相談の下,迅速な診断と治療が必須である。したがって,腫瘍の性格や患者がすでにもつ合併症を十分検討した後に,生活の質を保つことを念頭に置いて最善の選択肢を提供する必要がある。