Prostate Cancer

Prostate cancer is becoming more common and its incidence in Hong Kong is on the rise. In 2018, prostate cancer ranked third out of ten commonest male cancers in Hong Kong.

The diagnosis of prostate cancer has been revolutionized in recent years. Instead of directly proceeding to prostate biopsy for some highly suspected cases, we advocate a contemporary approach of prostate cancer diagnosis by providing the following tests and expert advices:

Prostate specific antigen (PSA) and prostate health index (PHI) tests: while PSA is organ-specific but not cancer-specific, PHI test can stratify the risk levels of having prostate cancer individually
Urinalysis and culture: to look for any urinary tract infection that can cause falsely elevated PSA level
Digital rectal examination: there are some occasions prostate cancer is present without an elevated PSA level, palpation of nodule(s) on the prostate by experienced urologists is crucial in detecting these cancers
MRI of the prostate: the new technique of multiparametric MRI of prostate with experienced radiologists allows detection of area(s) in the prostate method.
MRI-ultrasound fusion prostate biopsy: this new technique allows targeted biopsy of the suspicious area in the prostate detected by MRI, enhancing cancer detection accuracy compared with conventional biopsy method.
PSMA PET: this dedicated PET scan allows accurate staging of the prostate cancer and detection of early metastasis.

Source: https://emedicine.medscape.com/article/1967731-overview

前列腺癌局部治療

局部治療的優點是在治療前列腺癌的同時能最大程度保留其功能。這種治療適用於局部性、低至中危前列腺癌患者。局部定位治療可利用不同的方式，其中一種嶄新方式為電穿孔局部消融術（irreversible electroporation（IRE） focal ablation of prostate)，透過經皮膚置入數根電極針，並發出每對60-90次的短電脈沖，以非熱能、非冷凍的方式來破壞前列腺腫瘤細胞。此方式可精確鎖定腫瘤加以摧毀，而不損傷周圍支配勃起功能和排尿功能的組織。完成局部治療後，需要定期進行抽血、磁力共振掃描及前列腺活檢，以確定控制癌症的情況。