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姚銘廣醫生回覆 - 病人如果發現有血尿，首先要作適當的檢查排除嚴重的泌尿系統疾病，如膀胱癌，泌尿系統結石等等。如果同時發現前列前列腺有結節和psa 指標升高，一般要確診前列腺癌都需要做穿刺活檢。如果病人身正常，手術風險；包括流血，細菌感染等等；都是相對低的。個別病人如果病徴明顯亦嚴重到而必須立刻治療，但身體不適合做穿刺的話，醫生亦可能會考慮先處方荷爾蒙治療,以舒緩病情 。
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范健醫生回覆
- PSA of 19ng/ml may or may not be due to cancer of prostate. Ancillary imaging like plain MRI may provide more information if biopsy is declined. Staging should follow after confirmation of prostate cancer. Either radical surgery or radical radiotherapy will do for localised cancer. While radical surgery is good for the physically fit, radical radiotherapy is the alternative for those who refuse or are unfit for surgery. Tumour aggressiveness, patient profile and preference, treatment morbidity will shape the ultimate management plan. If the cancer has spread to other parts of the body, hormonal therapy and other palliative measures become the main stay of treatment.
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葉維晉醫生回覆 - 確診前列腺癌是须耍抽取前列腺组織作化驗。前列腺活檢是不痛苦的，同為可以在麻醉医生監察用藥進行的。所提及的病人看來身体主要器官功能正常，是可以做前列腺活檢。前列腺活檢的危險是細菌感，血尿等等。磁力共振有8成機會看到腫瘤。
前列腺癌的治療是先要替病人定期。早期腫瘤是可以切除或电療。晚期才用荷爾蒙治療。
葉維晉医生
醫務信箱
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