Nihon rinsho. Japanese journal of clinical medicine
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Since the discovery by Huggins and Hodges that androgen deprivation therapy is effective for prostatic cancer, surgical castration or the administration of exogenous estrogen has been the mainstay of treatment for advanced prostatic cancer. However, surgical castration is refused by some patients because of psychological impact and estrogen therapy is reported to be associated with significant morbidity and mortality. ⋯ Medical castration with LHRH analogue has been demonstrated to be safe and effective in patients with advanced prostatic cancer. But the traditional surgical castration still remains as another powerful option, because it is more excellent in the points of compliance and cost-benefit than a monthly injection of expensive LH-RH analogue.
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Clinical staging can be defined as the attempt to determine the pathologic extent of cancer by clinical tests. Accurate preoperative assessment is essential for the appropriate selection of therapy and design of treatment for the individual patients with prostate cancer. Transrectal ultrasonography (TRUS) was initially applied clinically in 1971. ⋯ More importantly, ultrasound guidance allows accurate sampling of prostatic tissue. However, the role of sonographic imaging itself in diagnosing of tumor extent remains uncertain. In this chapter we will assess critically the present role of ultrasound in staging prostate cancer based on currently available criteria.