Patient's question:
82-year-old, male, 1.72 meters tall. Before the Spring Festival, a health check at the workplace showed elevated levels of the prostate-specific antigen (PSA). After the holiday, when home renovation work was done on the residential building's elevator, outdoor activities were reduced. Exposure to noise, odors, and frequent visitors added to the psychological stress of the previously elevated PSA levels, raising suspicion of cancer. Upon a thorough examination of the prostate at the urology department, an MRI revealed a lump. The doctor recommended a biopsy for confirmation, but the patient refused. The doctor then prescribed a medication called "Chuanliu" (likely a brand name), after which the patient experienced incontinence, gradually progressing to being unable to urinate, requiring a urine collection bag. The doctor recommended minimally invasive surgery for the prostate, but it was not performed due to high blood pressure. How should the condition be treated? What medication is appropriate? How can the urine collection bag be removed?Doctor's answer:
Prostate-specific antigen (PSA) levels have decreased, and MRI has detected a nodule, which should still be considered as a prostate tumor. In this case, urinary difficulties should be considered as caused by tumor compression. The definitive treatment is surgery. It is recommended to perform a prostate needle biopsy for pathological confirmation. If there are contraindications to surgery, rigorous treatment can be administered. Radiotherapy combined with preoperative preparatory treatment can shorten survival. It is unlikely that the urinary catheter can be removed, but stents are now available. Prostatitis can be cured, but the treatment period is generally long, and it is prone to recurrence after treatment.