horrors of plastic surgery

The awful plastic surgery and a lot of writing for a long time. Someone disfigured unqualified doctors. Someone too busy operations and moved the allowed nature face. However, for some patients, a dangerous transformation was the chance to become famous. About them in the newspapers, their photos appear on the Internet. But particularly lucky to manage this money and capital.
I want to be Nefertiti!awful plastic surgery
Namita Nilen artist of the city of Brighton (England) has to be content with photos in the network and commentaries. She made more than fifty plastic surgery to look like ... Nefertiti. Why exactly was the ancient Egyptian queen to Nilen benchmark? Yes, because she feels her reincarnation. Insight visited Nilen thirty years ago. In his youth, she always dreamed of legendary beauty. And in these dreams are clearly visible and all the everyday details: she saw the clothes of the queen, her maids, the interiors of the palace eunuchs ... Dreaming is repeated so often that she decided to go to a shrink. The doctor reassured her: the patient is healthy, well, and dreams as if showing her ancestral memory. That is, once in a former life was Nilen Nefertiti! The girl is so impressed that she decided to change her looks. And during all the years she maniac with tenacity to do plastic surgery to fit your face for a reference image of the queen. According to the artist, all these procedures - a way to release part of her personality. This summer Nilen banging fifty years. But to stop there is not going to.awful plastic surgery
But a young Chinese girl from Shanghai is still in the beginning. She decided to change her looks, not for love of the idol, and for the love of a man. Her boyfriend is crazy about actress Jessica Alba. But here's the problem - his girlfriend is not like the on-screen beauty. What to do? He asked her to apply makeup as Alba, his hairstyle, apply lashes. The girl sang every whim of her lover. But even after she was wearing a wig "on album" please others could not. He dumped her. And she knew that the only chance to get a loved one - to have plastic surgery. Doctors Hospital of Shanghai promised the patient to perform the surgery for free. Good publicity for the clinic. If the operation is successful, "Alba" would become her trademark, and she the patient - the idol of millions of Chinese ...

Nilen Namita dreams of becoming a copy of Nefertiti

Living embodiment of Barbie
But the story of Cindy Jackson, who wanted to be a copy of a Barbie doll. Imagine, she did it! True, it took a myriad of operations and many years of life. She began her arduous hospital life after 30 years. Cindy's father, the owner of a ranch in Ohio, and would not hear about any plastic surgery, and her daughter had to accept. At the time, she was fond of punk rock and moved to London, performing in one of the groups. Improving the appearance of conflict with her punk beliefs. But in 1988 a strict old man died. And his obedient daughter got a decent inheritance. It was then that she thought that beauty does not shine, and wishing to be transformed, put to use the first 10 thousand dollars. The desire to become a Barbie was so great that Cindy for fifteen years courageously withstood 28 operations. Several times she alter his eyelids, chin and cheekbones tinker, pumped up lips, cleaning fat from the hips and waist. For forty-six years, spending nearly $ 100 thousand, Cindy has achieved its goal. She even got into the Guinness Book of Records for the number of migrated plastic surgery.
And so began a new life - the life of Barbie! At first she sewed herself a complete wardrobe famous doll, and then began to pose for the press. And her idea brought good dividends. Transformed into a living doll, Cindy began advertising herself and opened in London help line on cosmetic surgery, which drew young ladies who dream to be like your favorite characters of children's dreams.
To draw attention to its service men, Cindy decided to find a mate - the living embodiment of Ken. Her partner was Miles Kendall, a former computer programmer. Prosizhivaya days on a computer monitor, it was like a death cup, but Cindy could see in him the future hero.
Yielding to her entreaties, Miles made three transactions, not sparing them 50 thousand dollars, and turned into a chic gentleman. According to him, the new look completely changed his life, and now he can win the girl of any vending him.
Glory requires sacrifice
Well, Cindy got her. It is quite clear that it is afraid of losing the title record holder. How to save it? Only one way - to continue the operation. And Cindy announced that it will now be converted from Barbie to Brigitte Bardot. That's just the risk is great. After all, if you do too many operations, we can achieve an undesirable effect.
It is this problem occurred with the Joslin Vindelshtayn, wife of a New York art dealer. Pretty by nature, Jocelyn wanted to please her husband and began a series of operations to turn in a copy ... his beloved cat. Surgeons have long conjured over her face, stretching from the wife of a millionaire more than four million dollars. But she was so absorbed in the Joslin his transfiguration, he did not notice as her face began to resemble more and more rubber mask of horror. After each operation, she willingly appear at social events and photo shoots. In the fear of watching the transformation of his wife, the unfortunate man fell asleep in the arms of 21-year-old Russian beauty Elena Marikovoy. The case ended with a scandalous divorce.
However, the transformation into a monster you can use to your advantage. This is what happened in the life of another "celebrity plastic" - Dennis Avner. He has shown remarkable ingenuity to transform into a terrible predator. A quiet young man with thinning hair sleek with thick glasses always went perfectly well - and at school, and at the University of California, but at different complexes. In 46 years, he decided to change his destiny and become a tiger - if not by nature, at least outwardly. By the time he was in demand by the programmer, in his account at the bank lay a tidy sum, and Dennis went under the surgeon's knife. He changed the shape of the eyes, nose and chin, pulled his upper lip, to get the fangs. Experienced dentists turned his teeth into fangs, skilled tattoo artists painted face and body, reproducing tiger color. His upper lip was implanted long whiskers made of latex, and inserted into the eyes yellow lenses. And Dennis has become famous! Now he has been invited to different talk shows, and there he says that he came from a powerful tribe of Indians Huron who grimiruetsya a totem animal. And Avner chose their totem tiger. Why not?

"Plastic celebrity" Dennis Avner

It would seem that you can celebrate - because no one remains indifferent: passers-by on the street shy apart at the sight of such a monster. En, no! Dennis planned to bring his transformation to the end - and to implant itself into the skin of a tiger fur. However, while still in front of cameras he has to just throw in the back of tiger skins. But as soon as he will get additional 100 thousa

liposuction plastic surgery

Liposuction plastic surgery provides the ability to remove excess subcutaneous fat from different parts of the body. This includes external and internal surfaces of the thighs, the inner surface of the knees, back, waist, abdomen, shoulders, neck also, chin and cheek area.

The operation takes a half hour to several hours depending on the amount of the operation. Sometimes liposuction is carried out in several stages. It is mated with the fact that a single session of liposuction, a person weighing 60-70 kg are not recommended to remove more than five liters of fat. Removing more fat increases the risk of surgery and lead to serious complications. However, the record fat removal, as described in the literature was 22 liters.

Patients who are planning such an operation, it should be made clear that it is intended merely to correct the shape of the body and remove excess localized fat deposits. This intervention is not the way to rapid weight loss for people with general obesity, since on the one hand, it is impossible to perform liposuction throughout the subcutaneous tissue, the other - Liposuction does not remove the cause of the excess weight.

Of great importance is the turgor and elasticity of the skin, allowing the skin to properly cut and smoothed after surgery. Of course, people with significant excess and the weakening of the skin tone, liposuction should be done with caution or be carried out in conjunction with the operations aimed at excision of excess skin. Typically, this anterior abdominal wall (abdominoplasty), the inner surface of the femur (thigh lift), and shoulder (arm lift).

Varieties

Today, there are several ways and methods of operation. The essence of their one - destroy the fat and then removing it.

Before performing liposuction subcutaneously injected a special buffer solution which painkillers, constricts blood vessels, thereby allowing minimal blood loss and minimizes damage to stromal elements (blood vessels, nerves).

Currently, the most popular, effective and efficient are the three methods of liposuction: vacuum, ultrasound and laser.




Vacuum Liposuction is the most common. In the subcutaneous tissue through small incisions in the skin (0.5 - 1 cm) introduced a kind of tube (cannula).
 At one end, there are several side holes, the other end of the tube is connected via a flexible hose to the vacuum unit. The diameter and shape of the cannula are varied and depend on the areas of intervention and remove fat. Mechanical failure with simultaneous removal of adipose tissue provides a negative pressure in the cannula and technique of propulsion cannula under the skin (forward / back).

Ultrasonic liposuction is based on the destruction of the subcutaneous adipose tissue with ultrasound waves. Under their influence the oil emulsifies and output mentioned above, the vacuum method. In this case, the punctures on the skin have several smaller. However, this type of liposuction is used less often, as the use of ultrasound requires additional expensive equipment, and may have an indirect effect on the internal organs and the skin in the area of ​​liposuction.

The third method - Laser Liposuction (destruction). This method of operation makes it possible to influence the subcutaneous adipose tissue, using the heat of the laser beam. Unlike the vacuum, adipose tissue is not removed, and coagulated (ie burnt). The decay products of adipose tissue derived naturally. Thermal effect in reducing the area of ​​the skin in the area of ​​liposuction. Method is good for minimal intervention.

There are other methods of liposuction, and more precisely lipodestruktsii such as E, enzyme, etc., but in practice they are rarely used.



Areas of liposuction

1 - forearm

2 - area of ​​the back of the shoulder


3 - cheek area

4 - neck and chin area

5 - brisket area

6 - epigastric

7 - subscapular region

8 - flanks

9 - gipogastralnoy area

10 - sacral region

11 - the pubis

12 - the outer area of ​​the thighs

13 - inner thigh area

14 - area of ​​the front of the thighs

15 - area of ​​the back of the thighs

16 - the inner surface of the knees

17 - shin area

The postoperative period

Depending on the amount and type of intervention, the patient is in good health, can go home the same day or on the second or third day.

Of course, that the rehabilitation period depends on the individual patient. Depending on the type of liposuction sutures are removed by 5 - 9 days after surgery. On average 2-3 weeks the patient resumes his former vitality. In the first postoperative day, the patient may be some increase in body temperature, the unpleasant sensation of pain. To speed up the recovery process may additionally prescribe a course of physical therapy, massage, lymphatic drainage, LPG. In this case, be sure to wear a compression garment as excess skin should reduce. It is possible that in Liposuction can form seals and bruises that will gradually diminish and disappear within 1-2 months. After this period, it is already possible to start playing sports, ranging from small exercise. The final result is evaluated after 2-3 months after surgery.

Contraindications

 Of course, as with any surgery, liposuction, there are contraindications. Not admissible, liposuction for people suffering from diabetes, as well as those who have impaired function of blood clotting. In addition, this operation is absolutely contraindicated in any serious somatic (diseases of internal organs) diseases, pregnancy and lactation.

Despite the fact that liposuction is an acceptable volume is a safe operation, as with any other operation that may have general surgical complications. However, through proper planning and postoperative care and prevention of complications can be avoided.



Liposuction is the most effective and fastest way to correction, allowing to achieve the desired results, which remain for a long time. Positive impact on the physical and psychological condition. However, people who have had this operation, but prone to obesity, should make some effort and a closer look at the sustainable and balanced nutrition.

Innovations in reconstructive mammoplasty

   The problem of breast cancer and the recovery period after the treatment - a serious topic of discussion around the world. After removal of the breast before doctors question is how to compensate for this woman, returning to her normal life.

Latest method of breast reconstruction using skin animal allows physicians to achieve maximum natural result without additional joints and skin grafts from other parts of the body. In carrying out such operations previously required "attract" a flap of skin from the back and abdomen, which significantly increased the trauma surgery and reduced the aesthetic result. By using a new material doctors can avoid these side effects and establish an implant without the risk of migration matrix is ​​used to strengthen the skin in those areas where there is shortage of it.

The so-called "animal skin" - is acellular dermal matrix, which is biologically neutral substitute for human skin. About the unique features of the new methodology says oncologist mammologist Ptukha Eugene: "The operation is to perform subcutaneous mastectomy: removal of the breast while preserving the skin. When we put the implant in a woman's body and cover the matrix, it behaves as its own tissue. Matrix provides a soft feel and does not allow the implant to fall out. This also reduces the size of the cuts and provides a good aesthetic result. For each operating case ordered a separate matrix. "

The method is still under development, but already more than ten women in Russia were operated on in this way. Report on its work and on the prospects of the method was presented by experts at the Medical Congress "Complex cases aesthetic mammoplasty", held in November 2012 in Moscow.

In the U.S., the development of the method are also involved in many doctors, among them - the plastic surgeon Dennis Hammond. According to him, the use of matrices - the future of reconstructive plastic surgery. As soon as you have accumulated enough material on the procedure, doctors all over the world will be able to evaluate the development of the Russian and American surgeons and learn from their experience

portable saunas

For those who want to use the sauna, in the comfort of home, there are now portable infrared saunas. This is a very convenient device for the guy that is designed for one person. And it is portable - if necessary, a sauna can be easily folded into a bag.



According hotbanya.ru such saunas have filamentary infrared heaters that are built into the walls of the bath. They emit long-wave infrared, evenly warms the entire body. In addition, the kit includes a heat sensor and said regulating thermostat, providing ease and safety of use.

To protect the body from excessive heat without losing useful effect during the sauna human head remains outside of the cabin, which allows access to fresh air.

In order to manipulate a control panel sauna, or perform other actions in the cockpit there are holes for your arms. In addition, the kit includes the usual chair to sit on. Eats a sauna from ordinary household power. She quickly warmed up and ready usually within 5 minutes to the visitor, as opposed to the usual steam in the sauna. As in the infrared sauna, the principle of "dry" heat, the excess steam and condensate on the walls you can not be perfect.



Controlled portable sauna control panel, with it you can set all the settings, and manage the sauna during the procedure.

Cabin portable infrared saunas come in two sizes - standard and large. As for the standard cab, its advantage is that it is:
- Takes up little space - with 0, 5 square meters. Unfolded meters;
- Economical - power consumption up to 1000 watts / hour (for example, an ordinary iron to be 2,000 W / h);
- Practical - her weight up to 10 kg, it can be installed anywhere.

Saunas larger more spacious, they are suitable for people with complexion and tall. It weighs a little more - 12-13 kg. To reheat it quickly, additional heating and emitting equipment, it can be a heater, or a panel with tourmaline infrared pad feet.

If we talk about the health benefits of infrared saunas, it stimulates blood flow and accelerate the healing process of injuries, you can relax. A sauna and helps to combat cellulite and excess weight.

skin health and saunas

Beautiful skin - a consequence of a healthy lifestyle. This includes exercise and a proper diet, but many believe that the sauna also promotes health and beautiful appearance of the skin. The Stone Age sauna treating various diseases, from arthritis to diseases of the respiratory system. Sauna improves blood circulation in the skin and reduces muscle tension. And because of the strong perspiration through the pores of the skin through sweat output harmful elements, including toxins, after which the skin is clean and soft. The result? Glowing pink skin.
   Saunas Preobrazhenka in Moscow offers a full range of services and treatments, and health than you can get a good rest. What is so useful sauna?

Improved circulation

   If you spend 15-20 minutes in the sauna, heartbeat accelerated by 50-75%, as well as after a quick walk. High temperatures in the sauna dilates blood vessels. When the blood flow increases, it quickly carries oxygen and nutrients to the skin, which contributes to its health.

Detoxication

   The constant use of the sauna will eliminate toxins through the skin. This also involved the lungs, kidneys, intestines, liver and lymphatic and immune systems, putting out the toxins from the body. When the body temperature increases, the skin produces sweat and can turn oily toxins in their water-soluble forms that are easier to deduce.

Improves skin elasticity

   Collagen fibers provide the inner layer of the skin - the dermis ability to maintain the necessary qualities such as elasticity, strength and texture. Aging, sun damage, free radicals, and smoking - they destroy collagen and the skin's ability to regenerate collagen decreases with time. Regular exfoliation can stimulate the production of collagen. Heavy sweating caused by being in a sauna, also exfoliates the skin, cleanses it of dead cells and encourages new cell growth. This process can provide an impetus for the development of collagen, which in turn, increases the elasticity of the skin.

Precautionary measures
 
   Doctors say that people with unstable angina, the ones that have recently experienced a heart attack, and those who have been diagnosed with aortic stenosis should not use the sauna. In no case do not drink alcohol in the sauna, it increases the risk of hypotension, arrhythmia and sudden death. Pregnant women should consult a doctor before deciding on spending time in the sauna.

Русская баня история

  История бани началась ещё в далёкой древности, и она была не только местом для купания, но и почти священным местом. Считалось, что она объединяет четыре основные природные стихии: огонь, воду, воздух и землю. Поэтому человек, сходивший туда, как бы набирался силой этих стихий и становился крепче, сильнее и здоровее. Наши предки всегда верили в лечебную и очистительную мощь парной. Она всегда являлась наилучшим методом лечения от различных заболеваний. С годами предложение сходить в туда стало признаком гостеприимства. Так, гостя первоначально вели в парную попариться и лишь, потом кормили и укладывали спать. Такие места были очень значимы для наших предков, так, даже в договоре с Византией в 907 году было специально отмечено, что русские послы в Константинополе могут посещать парные в любое время, когда они пожелают. Рассказы о парилках встречаются ещё в «Повести временных лет» и иностранных летописях. Русские бани поражали большинство иностранцев. Особенно их удивляло то, как русские парились, выливали на себя квас или ледяную воду и били друг друга веником. Иностранные странники даже предполагали, что парение - это добровольное мучение и пытка. Они очень сторонились парения, однако после посещения русской бани чужеземцы чувствовали себя гораздо лучше. Впечатления от посещения русской парной были достаточно сильными и слух о лечебном воздействии русских бань, распространился по всему свету. Между тем, лечебный эффект парилки был известен ещё в Древней Греции. Наши монахи, исследовав немало трудов древнегреческих греков, решили проверить, какое в действительности влияние оказывает парная на больных. Эти исследования подтвердили, что парная является хорошим лекарством от многих болезней. Повсеместно при парных стали строиться некие больницы.

Сауна и сердце

Для людей, которые пережили инфаркт, на первые шесть месяцев после инфаркта действует абсолютный запрет на посещение сауны. По истечении этого срока можно обсудить с врачом, можно ли уже начинать регулярные посещения. В своем решении врач обязательно должен принять во внимание, посещал ли пациент до болезни подобные места регулярно или он в этом деле новичок. Основной эффект сауны это улучшение кровообращения. Хороший приток крови является решающей предпосылкой хорошего здоровья и настоятельно рекомендуется в первую очередь людям с пониженным кровяным давлением. Для этой группы людей вообще не существует ограничений; единственный совет может заключаться лишь в том, чтобы не стоять слишком долго ни в фазе разогрева, ни в фазе охлаждения, а после значительного охлаждения подвигаться без значительного напряжения, например, на свежем воздухе, а после этого побыть некоторое время без движения. У людей с повышенным кровяным давлением значения кровяного давления снижаются, если после парилки не следует резкого охлаждения тела. Здесь рекомендуется постепенное выравнивание температуры тела. Это может происходит просто под воздействием воздуха, а можно и встать под душ с водой комнатной темпрературы. Как бы там ни было, но если вы страдаете повышенным кровяным давлением, обязательно посоветуйтесь с врачом, какой бы вид бани он вам посоветовал. А вообще для пациентов, причина высокого кровяного давления у которых неизвестна, и у которых лечения пока не вызвало видимого эффекта, рекомендуется воздержаться от походов в сауну, пока врач определенно даст на это свое согласие. У многих новичков часто возникает вопрос, а можно ли посещать баню при варикозном расширении вен. Очень часто можно услышать мнение, что при таком диагнозе баня оказывается под запретом. Однако это не так. Варикозное расширение вен? Если варикозное расширение вен не сопровождается раздражением, то нет никаких причин отказываться от сауны. Можно дать только один важный совет: В парилке ноги желательно разместить повыше. Например, если вы ляжете на полку, ноги следует поднять и упереть в стену. Это чрезвычайно благотворно сказывается на венах, снимая с них нагрузку. Ни в коем случае не следует свешивать ноги или при охлаждении слишком долго стоять на одном месте без движения. Очень эффективным методом при варикозном расширении вен является обливание ног холодной водой из шланга.

Источник:http://www.tiensmed.ru/news/post_new1012.html

Benefit of the Russian bath and Finnish sauna

Benefit of the Russian bath and Finnish sauna
In our country the most popular Russian bath and Finnish sauna with dry steam. Perhaps this is caused by the cold weather conditions. Lack of humidity makes it easier to carry a higher temperature in a Finnish sauna.

The main bath is good for the prevention of many diseases, as the steam room enhances immunity. Bath treats and pre-existing disease, because heating enhances local immunity. Stay in the steam room - a kind of exercise for the cardiovascular system, when vessels are first expanded under high temperatures, and then narrowed. Vessel walls are strengthened, and therefore reduces the risk of their disease.

By the way, the high temperature steam ensure sterility, as disease-causing microbes in it just did not survive.

Large bath and good for the skin because the pores at high temperature reveals, purification of the upper stratum corneum, and the destruction of the sebaceous plugs. In their effectiveness in this procedure is unmatched by any cleansing mask. Bath and sauna - a great remedy for blackheads (comedones). You just need to steam, and then steam clean the face using gentle scrubs and lotions.

With regular visits to steam the skin condition improves, it becomes more taut and youthful. For oily skin, these procedures are very useful. Owners of dry skin it is recommended to visit the Russian, not a Finnish sauna. Due to the aggressive effect of humidity on the skin is not so great.

Normalize metabolism also helps to get rid of extra pounds. Benefits bath slimming huge, but the real results will be when visiting bath and sauna will go down in a set of measures to get rid of excess weight (healthy eating, physical activity, treatment of existing disease).



Rules for steam baths and saunas
How to behave in the bath and sauna
In pursuit of beauty to remember about health. With all the benefits of baths there are contraindications to its visit. This worsening of chronic diseases, blood pressure problems, heart and fever. So, before you decide on a regular visit bath and sauna is best to consult with your doctor.

During menstruation visit baths is not recommended. Pregnant women should refrain from visiting the pair in the first and second semesters. In any case you should ask your doctor about the possibility of visiting the steam room, while in the "family way." Bath can be not only good, but also harmful.

Headdress when visiting steam required. It not only protects against heat stroke, but also protects the hair from drying and increased fragility.

Since the room temperature high enough, it is better to remove jewelry, or by heating a chain or pendant can cause burns.

The skin should be prepared for the steam room, took off her make-up, or under the influence of temperature, he just "float", and chemical components of cosmetics will be absorbed into the expanded pores. Especially harmful foundation and powder, clog pores. The lips can cause a bit of hygienic lipstick to help prevent overdrying skin.

On the first visit to the steam room are a few minutes, allowing the body to gradually get used to his new surroundings. The basic rule for steam baths is that the pair should be fun. If there is discomfort, it is best to leave the sauna.

Second run - longer, the third - even longer. Just one time you can go to the steam room 3-6 times, holding it in one go no more than 15 minutes.

After the pair need to cool off. People who have problems with blood vessels, to prefer natural cooling air "waiting room". Healthy people should dip in the pool with warm or slightly cool water (no swimming pool, you can just take a cool shower). Seasoned experienced amateur bath can take a cold shower, or, as was the custom in Russia, take a dip in the snow. Cold cooling after the pair is very useful for weight loss (is a kind of training is not only vessels, but also the muscles). Contrast procedure in the bath helps to get rid of cellulite. The body is hardened and the person gets sick less often. Well-chosen method of cooling increases the benefit baths and saunas.



Cosmetic procedures in the bath
The effect of the bath can be increased if the secondary entering the steam room, even after all the pores open and clean, smear your skin with liquid honey. This nourishing mask will make it soft and silky.

In a similar way we can proceed with the hair. If after shampooing apply to them nourishing mask, and top hat to wear, the result of it because the quality is the best warm-up.

To combat cellulite better place than the bath or sauna, you will not find. Excess fluid is derived from the intercellular space independently. It is desirable to massage problem areas hard sponge.

When they emerged from the bath is well applied to the skin nourishing agents as a supple state it will absorb them particularly active.

Homeopathy against prostate cancer

 In order to suspend the development of prostate cancer, traditional medicine uses the plant kotorye have properties inhibit the growth of cancer cells, purify the body from decay products and strengthen its protective function. The proposed national recipes vegetable alcohol tinctures and infusions in the water to cleanse the body and increase its immunity.

№ 1 folk remedy for the treatment of prostate cancer: hops common

Take fresh hop cones and 40% alcohol in a ratio of 1:4, to insist in the warm and cool place for 3-4 weeks. Take 3 times a day before meals for 40 drops. Infusion of hops recipe: Take 2 tablespoons ingredients: pour 0.5 liters of boiling water, leave for 2 hours, strain. Take 4 times a day before meals to 0.5 cups.

Folk remedy number 2 for the treatment of prostate cancer: a willow

Collect fresh willow catkins, tightly packed into a glass jar, cover with fully 96% alcohol. Infuse for 3-4 weeks in a cool dark place. Then strain. Drink 3 times a day for half an hour before meals for 1 tsp 0.5 cups of water. Infusion recipe: Take 1 tbsp crushed earrings, pour 0.6 liters of boiling water. Infuse for 30-60 minutes, then strain. Drink 3 times a day for 10-15 minutes before meals for 1 cup.

Folk remedy for number 3 for the treatment of prostate cancer: licorice

Take 1 tbsp powdered licorice root, pour 0.5 liters of boiling water, boil for 10 minutes on low heat. Insist to cool, then strain. Drink 3 times a day before meals. The prepared infusion stored in the refrigerator (in one day).

Folk remedy for number 4 for the treatment of prostate cancer: meadowsweet meadowsweet

1 tbsp meadowsweet flowers pour 1.5 cups of boiling water. Infuse for 3-4 hours, drain. The resulting amount present divided into 3-4 portions. Drink during the day before the meal.

№ 5 folk remedy for the treatment of prostate cancer: Thuja

20 g of dry powdered (young) leafy shoots Tui pour 1 liter of boiling water. Heat in a water bath for 15 minutes. Insist to cool, then strain. Take 3 times a day for 1 cup. Since arborvitae is a poisonous plant, you should strictly follow the dosage of traditional recipes. Recipe alcoholate Tui: Take 30 grams of fresh young leafy shoots, pour 100 ml of 60% alcohol, insist 10 days in a cool dark place, then strain. Take 2 times a day before meals for 10 kapel.

№ 6 folk remedy for the treatment of prostate cancer: Fireweed

1 tbsp powdered willow-buds, cover them with 1.5 cups of boiling water. Insist to cool, strain. Drink 3 times a day 30 minutes before meals of 100 ml.

№ 7 folk remedy for the treatment of prostate cancer: Chaga (birch fungus)

Collect fungus growths on the trunk of a birch, which are black on the outside, inside - a brown or reddish-brown. Dry them indoors, or in an oven at a temperature of 60 C. The recipe brew: Chaga wash, soak in cold boiled water for 4-5 hours. Then grind the soaked pieces on a grater or a meat grinder, pour slurry heated to 50 ° C water, which soaked chaga in a ratio of 1:5. Infuse 48 hours, drain. Squeeze to extract sediment through 3-4 layers of cheesecloth. Take b times a day before meals to 0.5 cups. Infusion to keep no more than 3-4 days.

If the patient can not take plenty of fluids, it is necessary to prepare infusion double strength (2:5) and drink as a tea. Studies confirm that chaga really is an effective folk remedy, hindering the development of cancerous tumors.

№ 8 folk remedy for the treatment of prostate cancer: celandine

1 tbsp celandine herbs, pour 3 liters of boiling water and infuse for 8 hours. Drink the tea in a heated state 1 cup 40 minutes before eating in the morning and evening for a month. Then take a break for six months, after which the treatment can be repeated.

Infusion recipe: take celandine herbs, nettle and calendula in equal parts, crushed, 1 tablespoon mixture, pour a glass of boiling water, a thermos. Drink 0.5 cups in the morning on an empty stomach in the evening - before dinner.

№ 9 folk remedy for the treatment of prostate cancer: viburnum

Decoction of twigs and fruit cranberry used in the treatment of cancer of any sites.

№ 10 folk remedy for the treatment of prostate cancer: peony

1 tbsp crushed dried roots peony pour 3 cups boiling water, boil for 5 minutes, 1 hour, drain. Take 1 tbsp 3-4 times a day 10 minutes before meals.

№ 11 folk remedy for the treatment of prostate cancer: bedstraw

2 tsp dry grass with tsvetkami insist 2 hours in a glass of boiling water in a tightly closed pocyde, drain. 0.25 cups to drink 3-4 times a day for 10 minutes.

№ 12 folk remedy for the treatment of prostate cancer: a potato

1 tbsp dried flowers potatoes pour 1 cup of boiling water, leave for 1 hour. Drink 0.3 glasses three times a day.

№ 13 folk remedy for the treatment of prostate cancer: calendula

1 tbsp crushed root calendula pour 0.5 liters of boiling water, leave for three days. Drink at 0.25 cup 4 times a day.

№ 14 folk remedy for the treatment of prostate cancer: mugwort

Infusion or tincture of the herb mugwort drink with genital cancer.

№ 15 folk remedy for the treatment of prostate cancer: the national collection of herbs for the treatment of tumors and hardenings

For the treatment of tumors in the hardening and folk medicine used the following composition: dill seed - 100 g, yarrow - 100 g, St. John's - 100 g, nettle root - 100 g series (before flowering) - 100 g, sage - 100 g, wormwood - 100 g sweet clover (grass, flowers and stems) - 100 g, prickly thistles (grass) - 100 g All herbs grind and mix. 1 tsp brewed cup of boiling water (to make 4 cups at once for two days) and soar 4:00, not boiling. Take 0.5 cups 2 hours after meals 2-3 times a day. Treatment long before the year. Folk remedy used for any hardening.

Paka popular treatment of prostate adenoma and aspen

Medicinal properties of aspen

Buds, leaves, bark of aspen is used to treat inflammation of the prostate gland in the complicated and painful mocheispyskanii for pain relief.

Infusion of aspen bark - good prophylactic for prostate cancer, especially in the early stages, when surgery is contraindicated.

Decoctions and infusions of the bark of young aspen shoots of spring used in prostate cancer, as well as its hypertrophy. Spring buds of aspen (with the kidneys black poplar) - an effective tool for the treatment of BPH.

YOUNG bark tincture aspen branches with leaves (in the form of drops of water) - is used for acute and chronic inflammation of the bladder, painful urination.

Recipes folk remedies of aspen in prostate cancer and BPH

When prostate cancer aspen leaves and buds are often used in combination with other plants. Therapeutic effects have alcohol and water form preparations.

Recipe present aspen buds. 2 tsp minced raw pour 2 cups boiling water, leave for 15 minutes, drain. Drink infusion during the day in 3-4 divided doses.

Broth recipe kidney and aspen bark (1:1). 45 g of minced raw pour 0.5 liters of boiling water, boil for as long as the broth has evaporated by half, strain, add honey to taste. Take 0.25 cup three times a day. The infusion of aspen buds by 40% alcohol (1:10) take 20-30 drops 3 times a day.

Aspen bark tincture recipe for vodka. Pour 0.5 liters of vodka 5 tablespoons minced raw, leave for 2 weeks, strain. Take 1 dessert spoon 3 times a day before meals.

Recipe present aspen bark. 3 tbsp minced raw pour 1 cup boiling water, simmer on low heat for 15 minutes, push to cool, strain. 0.25 cups to drink 3 times a day before meals.

Recipe infusion bark of young branches of aspen. 20 g of crushed raw sugar and 1 cup of boiling water, boil for 15-20 minutes, leave to cool, strain. Take 0.25 cup 3 times a day before meals.

erectile dysfunction prostate cancer impotence

Erectile Dysfunction
(Impotence)


Impotence (Latin impotentia - weakness), or erectile dysfunction - is a condition in which a man can not achieve an erection or an erection that is not enough for sexual intercourse. Erectile dysfunction affects men of all ages, from adolescence. There is hardly a grown man, buyout ever in my life have suffered sexual failure. In most cases, young men aged 25-30 years, psychogenic erectile dysfunction is the underlying cause, which in most cases successfully solved sexologist, psychologist. Preferable if the course are both partners.
Unfortunately, erectile dysfunction is a common phenomenon is that he devote today scientific conferences and symposia. Its individual species devoted dozens of scholarly monographs.
According to the most approximate estimates, in the U.S. alone suffer from erectile dysfunction about 10 million men. It is estimated that number of German scientists in the united Germany is approaching 5 million. It is obvious that in Russia, men who have erectile dysfunction, not fewer. Chronic stress, typical of a society in a difficult economic period, poor nutrition and thus atherosclerosis, smoking, play a negative role on the state of human genitalia. In both men and women.


Physiology of erection

It is now established that the key in the process of erection and detumescence (Latin DETUMESCO - stop swell) - reducing the size of the genitals with a decrease in sexual arousal due to the outflow of
blood), has the function of smooth muscles of the corpora cavernosa and bearing walls of the arteries and arterioles. In the absence of an erection of the penis is the latest in a reduced state under the influence of the sympathetic nerves. In the presence of sexual stimulation, the pulses transmitted by the parasympathetic nerves presumably, cause the release of neyroendotelialnyh structures in the corpus cavernosum and the so-called noncholinergic neadrenergi-cal neurotransmitter erection. Research in the last five years showed the highest activity of nitric oxide as a neurotransmitter erection. It is shown that under the influence of nitric oxide nitrik-oxide synthase, activates guanylate cyclase and calcium-sensitive potassium channels and Na / K ATPase, causes accumulation of cGMP and relaxation of smooth muscles of the corpora cavernosa and bringing arterioles, which in turn causes a significant increase in arterial blood flow to the cavernous bodies. Increases in diameter, the erectile tissues compress venules and there is a simultaneous significant reduction in venous outflow. Work of the so-called venookklyuzivnogo mechanism facilitates location venules directly under tunica to which they are pressed and expanding cavernous bodies. It is high prevalence of blood flow over the outflow leads to increased intracavernosal pressure to 100 mm Hg or higher and & Development rigid erection. Detumescence occurring as a result of ejaculation or cessation of sexual stimulation begins after activation of the synaptic structures, followed by separation in the cavernous body of neurotransmitters such as norepinephrine, neuropeptide Y, and endothelium, causing constriction of the smooth muscle of the newly cavernous bodies and arterioles, which is the basis of the inverse of an erection . Important integrative role in erectile function is average preoptic area of ​​the cerebral cortex. In this case, the most important neurotransmitters that determine sexual behavior are dopaminopodobnye (stimulation) and serotoninopodobnye (suppression) of substance.




Classification of erectile dysfunction:

In accordance with generally accepted at present classification of erectile dysfunction, impotence, 7 species isolated on etiopathogenic principle.

Psychogenic impotence.
Leading pathogenetic link psychogenic impotence is reduced sensitivity to the effects of the cavernous tissue neurotransmitter erection through direct inhibitory effect of the cerebral cortex or indirect effects of the cortex through the spinal centers and increased levels of peripheral catecholamines. The basis of these phenomena are fatigue, depression, phobias, sexual deviance, religious prejudices, associative stressful factors, etc. In recent years, with the development of an objective diagnosis of erectile dysfunction, psychogenic impotence in its pure form is diagnosed less often.
Neurogenic impotence.
Comes as a result of injury or disease of the brain or spinal cord, and peripheral nerves, which prevent the passage of nerve impulses to the corpora cavernosa. The most common cause of impotence is nerogennoy spinal cord injury (75%). Its other causes may be tumors, cerebrovascular pathology, syringomyelia, multiple sclerosis, herniated disc, etc.
Arteriogenic impotence.
Developmental and pathological dynamics of atherosclerotic coronary and penile vascular roughly correspond to each other, which makes the disease impotence age. Other causes of impotence are arteriogenic trauma, congenital abnormalities, smoking, diabetes, hypertension. With limited blood flow significantly affected the intracellular metabolism of the cavernous tissue and vascular endothelium bearing that forms a vicious circle, and often leads to irreversible dysfunction of cavernous tissue.
Venogennaya impotence
Causes of ill venokklyuzivnoy function is not clear, but it is already known the following: ectopic drainage of the corpora cavernosa through large dorsal subcutaneous veins or enlarged or nozhkovye cavernous veins, cavernous-cancellous shunt failure albuginea due to traumatic rupture, Peyronie's disease, primary or secondary thinning , functional impairment of cavernous erectile tissue as a result of a lack of neurotransmitters, psychogenic inhibition, smoking, and ultrastructural changes.
Hormone impotence
The leading cause of hormonal impotence is diabetes, which leads to serious structural changes in the penile blood vessels and the cavernous tissue.
Known fact that the normal level of testosterone in the blood serum is absolutely necessary for normal erections, questioned because visually-induced erection is not affected in patients with hypogonadism. Therefore, at present it is considered that more important is the degree of uptake of testosterone, rather than its level in the blood serum. However, hormone replacement therapy for the treatment of erectile dysfunction is shown in patients with hypogonadism and in male menopause.
Dysfunction of the cavernous tissue (cavernous failure).
The reasons for failure of the cavernous different. They lead to intra-and extracellular changes in the cavernous bodies, their blood vessels and nerve endings, which prevent normalnomk erektornogo functioning mechanism.
Impotence caused by age-related changes, system
disease and other causes.

The main causes of erectile dysfunction:

All the causes of erectile dysfunction according vysheprivdenoy klassifiktsii are divided into two groups - organic when there is a disturbance in the body, and the psychological, which are due to the peculiarities of the patient's mind only.

For psychological impotence is characterized by:

Outbreak
Nocturnal spontaneous erections are preserved
The problem of relations
Problems in certain circumstances
For organic impotence is characterized by:

Gradual onset
Nocturnal spontaneous erections are absent
Normal libido and ejaculation
Problems in all circumstances
In practice, the most common combination of these reasons, when a disease or disorder, which leads to erectile dysfunction, psychological factors are imposed that prevent further man always reach full erection. All organic causes of erectile dysfunction are divided into endocrine, medication, local, neurological and vascular.

Endocrine causes. If the male body produces insufficient amounts of the male sex hormone (testosterone), it can lead to erectile dysfunction. Simultaneously may appear symptoms such as an increase in the voice, stopping the growth of facial hair, the deposition of fat in the breasts, hips, buttocks. Usually, this is heavy human body's hormonal areas in which assistance is required endocrinologist.
In another situation, the pituitary gland (a gland in the brain) may occur tumor secretes the hormone prolactin. However, no other violations in the body, except for erectile dysfunction, can not be observed. For the diagnosis of the disease, except for the survey endocrinologist must perform a CT scan of the brain. Treatment in this case is reduced to a long reception of the drug bromocriptine.

Medicinal causes of erectile dysfunction. Some medicines and other drugs with a long reception cause erectile dysfunction. Typically, this is due to the blocking of nerve endings that provide the appearance of an erection. Erection quickly recovered after discontinuation of the drug. Substances, addictive (in particular this applies to drugs) lead to erectile dysfunction indirectly, as a result of the overall impact on the body and the violation of fundamental vital systems. In this case, to restore erections necessary not only to stop using the drug, but also the course of treatment that will restore all disability.

Substances that act on the central nervous system

Alcohol
Chlorpromazine
Amitriptyline
Arrametidin
Barbiturates
Haloperidol
Heroin
Hydroxyzine

Glyutetimid
Guanethidine
Debrizokvin
Doxepin
Isocarboxazid
Imipramine
Cannabis
Cocaine

Mebanazin
Methadone
Morphine
Pargyline
Protriptyline
Lithium salts
Thioridazine
Tranylcypromine

Benzedrine
Phenelzine
Phenoxybenzamine
Ftorfenazin
Hlomipramin

Antihypertensives

Clonidine

Clofibrate

Methyldopa

Reserpine

Alimentary synapses

Inderal

Anticholinergics

Phentolamine

Hormonally active drugs

Antiandrogens

Estrogens

Antihistamines

Diphenhydramine

Suprastin

Miscellanea

Antiparkinsonian funds
Digoxin
Indomethacin

Spironolactone
Thiazide diuretics
Cimetidine

Local factors that lead to erectile dysfunction, are different, but they all lead to the development of sclerosis of the cavernous tissue of the penis. Normally, this tissue resembles a sponge with fine mesh. During erection, each cell (cavern) tightly filled with blood, the penis increases in size and becomes hard. When sclerosis cavernous tissue walls of the cells stick together, and they can no longer fill with blood.
Sclerosis cavernous tissue occurs normally in older men, and therefore they lose the ability to commit a sexual act. Accelerate the development of multiple sclerosis cavernous tissue can such factors as:

injuries of the penis;
frequent practice of overextended sex acts in which a man, wanting to deliver maximum satisfaction to his partner, long delayed ejaculation;
multiple injections (injections) in the penis;
transferred priapism (prolonged spontaneous erection).
Neurological causes of erectile dysfunction. Erectile dysfunction can develop after an injury of the brain or spinal cord, Parkinson's disease, epilepsy, multiple sclerosis, after undergoing surgery on the pelvis, pelvic injury or perineum. In almost all cases, the prognosis for cure causes of the disease is poor.
Vascular causes of erectile dysfunction. The most common group of reasons. During an erection is a significant change of blood flow to the penis - dramatically increases blood flow through the arteries and blocks blood flow to almost the veins. From here there are two groups and vascular causes of erectile disorder - lack of blood flow through the arteries to the penis (arterial insufficiency) and excessive discharge of blood during erection the veins (venous insufficiency).
Arterial insufficiency of the penis can occur with endarteritis, atherosclerosis, aortic aneurysm, trauma, pelvic, perineum, pelvic fractures, and other diseases of the arteries. Venous insufficiency of the penis may occur in diseases of the veins, such as their varicose. It should be said that the causes of vascular disorders of the penis to date are not well understood and install them is not always possible.

Special mention should be diseases such as diabetes and hypertension. In these diseases often develop erectile dysfunction, which is caused by several factors - vascular, neurological, local, medication.

Psychological causes of erectile disfukntsii occupy a special place in the development of this disease. They can independently lead to erectile dysfunction, but more psychological factors superimposed on the organic cause narushniya erection, which greatly complicates the diagnosis and treatment of this condition. Psychological causes of erectile dysfunction may be to anxiety and depression, indifference to the partner, fear of inability to perform sexual intercourse, conflicts between partners, sexual habits discrepancy partners, strong excitement before sexual intercourse, fatigue, and general poor health and the health of men. In favor of the psychological causes of erectile dysfunction say symptoms such as selective erection, preservation of spontaneous erections, erection during masturbation, nocturnal erections (erections when a man says, waking up in the morning). Such patients require assistance of an experienced sex therapist or psychotherapist.

Testosterone is not associated with prostate cancer risk

 Natural level of testosterone in the blood does not affect the risk of prostate cancer (prostate), although this was once thought. This information should encourage scientists to ensure that take a fresh look at the problem of prostate cancer.

More than two dozen clinical studies have been devoted to the relationship between testosterone and prostate cancer risk. However, research is not conclusive.

Epidemiologist Andrew Roddam (University of Oxford, UK) and colleagues analyzed data collected from around the world. Scientists interested in the level of testosterone in men, sick or diseased prostate cancer (3886 men and 6438 respectively). Prostate cancer usually affects older men. This disease is the second leading cause of cancer death in men (at first - lung cancer).

"We compared the level of testosterone in men who develop prostate cancer later, and those who are not ill. Was found that between hormone levels and the risk of the disease there is no connection," - says Andrew Roddam. Testosterone - is the main male hormone responsible for the development of muscle mass, fat distribution, bone mass, sex drive and potency. In females testosterone is also present, but its level is much lower.

The role of testosterone in maintaining men's health is controversial. Testosterone promotes the growth of prostate cancer, so the scientists thought that hormone levels affect the risk of the disease. Some types of prostate cancer by blocking the action of testosterone.
Last year, it was proved that men with higher testosterone levels less likely to die from heart attacks, strokes, and other factors. A study conducted by British epidemiologists, should lead scientists to search for new risk factors.

"These findings require the scientific community to reject an attractive and convenient hypothesis seriously and to study these modifiable risk factors," - said the new study Paul Godley (University of North Carolina, USA).

prostate cancer diet

Not to develop prostate cancer, you must be a vegetarian diet, stop smoking and alcohol, lead a physically active lifestyle.
This therapeutic diet for prostate cancer can be a prevention of prostate cancer, relieve the patient during treatment, and reduce the level of cholesterol in the blood.

Diet is applied in prostate cancer painted on each day of the week.

Monday
1-and breakfast:
apple, orange juice.
2nd breakfast:
millet porridge with dried apricots, oatmeal cookies, tea.
Lunch:
lentil soup, white bread, baked fish, vegetable stew, tea.
Dinner:
beans in tomato sauce, tea.
Late dinner:
yogurt.

Tuesday
1-and breakfast:
olives, apple juice.
2nd breakfast:
buckwheat, radish salad, seasoned with vegetable oil, nuts;
tea.
Lunch:
pea soup, bread, green salad with avocado, dressed with lemon juice, shrimp, baked with cheese, rice, tea.
Dinner:
eggplant cooked with tomatoes and garlic, oatmeal cookies, green tea.
Late dinner:
broth hips.

Wednesday
1-and breakfast:
a bunch of grapes, mineral water
2nd breakfast:
oatmeal, biscuits, tea.
Lunch:
tomato soup with basil, green salad, boiled fish, pasta with vegetables, tea.
Dinner:
salad with tuna and anchovies, olive oil, tea.
Late dinner:
carrot juice.

Thursday
1-and breakfast:
orange, apple juice.
2nd breakfast:
eggs stuffed with shrimp and avocado, oatmeal cookies, tea.
Lunch:
squash soup, green beans, steamed, boiled seafood cocktail, salad of tomatoes and cucumbers, tea.
Dinner:
Boiled potatoes with parsley and dill, bread, apricot jam, tea.
Late dinner:
nuts, cranberry juice.

Friday
1-and breakfast:
steamed dried apricots, berry juice.
2nd breakfast:
cutlets of marine fish, rice, tea.
Lunch:
cabbage soup, black bread, green salad, baked fish with carrots and beets, tea.
Dinner:
sautéed broccoli and cauliflower, oatmeal cookies, tea.
Late dinner:
yogurt, apple.

Saturday
1-and breakfast:
nuts, pear juice.
2nd breakfast:
semolina, orange marmalade, tea.
Lunch:
onion soup, bran bread, pepper stuffed with rice and minced meat, green salad with avocado, dressed with lemon juice, tea.
Dinner:
pasta, cheese, tea.
Late dinner:
steamed dried fruit, orange juice.

Sunday
1-and breakfast:
pear, grapefruit juice.
2nd breakfast:
salad with seafood, olive oil, bread and butter, tea.
Lunch:
milk soup, green salad, chicken stewed with apples, boiled potatoes with parsley, tea.
Dinner:
barley porridge, fruit, tea.
Late dinner:
vanilla biscuit, cranberry juice.

Compliance with this diet for prostate cancer would be a good preventive measure in individuals predisposed to prostate cancer, as well as facilitate the state during medical treatment.

prostate cancer vaccine

In the Cuban province of Camagüey, located in the east of the country, the first stage of clinical trials on the road to certification of a therapeutic vaccine against prostate cancer, created by Cuban scientists. As reported in its pages portal medlinks.ru, the results of these tests, according to the Cuban government, can be called "successful."

The drug, which is in question here is a vaccine developed by Cuban specialists through programs of Havana Center for Bioengineering and genetics. According to the published information on the Sabbath, the development of Cuban scientists, known as the "Eberprovak," has been successfully tested on patients suffering from "cancer of the prostate in an advanced stage."

At the moment, scientists Liberty Island are busy preparing new vaccine trials, which at this time should be conducted with a large scale. As expected, the experiments will be conducted on the basis of medical institutions eastern provinces Holguin and Santiago de Cuba, with the participation of a large number of patients.

In view of the foregoing, it must be said that at present, prostate cancer is the Cuban doctors are among the most common diseases. According to the latest official data published by the end of 1998, the total number of Cubans affected by the disease at that time was close to two thousand people, while the total population of Cuba is 11.2 million.

prostate cancer causes

Prostate cancer is a threat to all men. This is due not only to its epidemiological prevalence - a hundred men with prostate cancer sick 4 - 5 people, but also to the fact that almost every man has the makings for its development.

Scientists have found that the prostate contains active ingredients that suppress tumor growth. However, the impact of adverse factors, these components are deactivated, which leads to cell proliferation (growth) immunological and histological changes of cells.

Causes


Have multiple causes of prostate cancer. Since this disease "likes" older men and older, the main factor - age. Back in the early 2000s was the subject of a study that showed that men who had surgery for malignant tumors of the prostate, smokers was three times higher than non-smokers. Is the role of heredity.

Ironically, but prostate cancer is almost unknown to the men from Asia and South America. What determines this fact, scientists do not yet know, but it is believed that a healthy diet and active lifestyle - a means of prevention of this tumor. However, the indigenous inhabitants of the African continent, the disease is detected much more often, and death rates among them - above.

Symptoms


Unfortunately, prostate cancer by accident is virtually impossible. He malosimptomatichen, any subjective symptoms men experience. The more so because the tumor grows slowly and a person manages to get used to new sensations in connection with the changes.

Only in the later stages of prostate cancer is similar to the symptoms of prostatitis. Most often, men pay attention to changes in urine: urine stream is weak, intermittent, at the end of urination there is pain.

Diagnosis and treatment


In the early diagnosis of prostate cancer clinical examination plays an important role. Doctors strongly recommend that all men over forty to have regular check-ups with a urologist, who will detect cancer at its earliest stages. If a urologist finger study gives reason to suspect any wrongdoing in the prostate, blood will be assigned to specific antigens, which clearly indicate the nature of the tumor process.

Additional instrumental examination (prostate ultrasound, computed tomography) and biopsy confirmed the diagnosis. Treatment is started immediately after diagnosis, because this type of cancer is very active and easily metastasizes. If metastases are not, the prostate is removed completely with the testes, and then assigned to chemotherapy or radioisotope prevention of metastases. If the cancer is detected at an advanced stage, chemotherapy and radiation therapy as palliative treatment.

Forecast


With modern cancer detection, followed by resection prostate full recovery - are not uncommon. And, accordingly, the later found to have cancer of the prostate, the worse the prognosis, especially in older men.

treatment for prostate cancer

In this article, we review the various treatments and their side effects. We will consider treatment options, taking into account:

Tumor grade and stage (severity) of cancer
Age
Life style factors
What are the treatment options for prostate cancer early?

Prostate cancer at an early stage - is a cancer that is located entirely within the prostate. It does not spread (non-metastasized) or to nearby tissue or the bone. This type of cancer that doctors are often called low-risk disease, it is best to treat.

There are three main options for treating prostate cancer early. Two active form of treatment, surgery and radiation therapy, can often lead to a cure, when administered alone. To achieve a high probability of cure or control the disease, men with the disease of medium and high risk usually requires a combination of several treatments.

Three treatment options for prostate cancer early / low risk:

Surgery.
Radiation therapy - external beam or implantation of radioactive seeds (brachytherapy).
Hormone.
Which includes surgery?

If the tumor is located entirely within the prostate, an experienced surgeon can remove the gland completely. This procedure is known as a radical prostatectomy.

To make sure the cancer has not spread, surgeons perform pelvic lymphadenectomy. In this procedure, they remove the pelvic lymph nodes. Pathologist then examines the nodes, which checks for the presence of cancer cells. After radical prostatectomy, the prostate and seminal vesicles are removed. Seminal vesicles - are small glands that produce a significant part of the seminal fluid. Surgeons can reach the prostate gland in several ways:

First - zalobkovaya prostatectomy. To get to the prostate, the surgeon makes an incision in the abdominal wall. During surgery, the surgeon also removes nearby lymph nodes. This is a precaution that can help prevent the spread of disease.

The second option - perineal prostatectomy. The surgeon makes an incision in the perineum. This is the area between the scrotum and the anus. With this, you need another incision in the abdomen to remove the lymph nodes.

In some hospitals, surgeons can make laparoscopic prostatectomy. The surgeon uses instruments that are inserted through several small incisions. This option is usually associated with fewer complications and a faster recovery. But technically it is difficult and may not be suitable for the removal of all types of tumors.

Some men may be transurethral resection of the prostate. This type of operation is also used in the treatment of benign prostate enlargement. The surgeon inserts a small surgical instrument into the urethra. This is a tube through which urine flows from the bladder to the penis. Next, the surgeon removes the prostate tissue, which causes disorder, such as difficulty or painful urination. However, during this operation, the prostate is not removed completely. Sometimes it is used to relieve the symptoms associated with the prostate gland in older men. The fact that such men to radical prostatectomy may not be appropriate.

In some centers also perform cryosurgery. This is an experimental method, in which prostate tissue is destroyed by alternately freezing and thawing. Experience with this type of surgery for prostate cancer is limited. Therefore, it is unclear whether it provides any benefits over traditional surgery or radiation therapy.

What are the effects and side effects of surgery?

One possible complication is erectile dysfunction. Some surgeons use the technique of nerve sparing. Erectile dysfunction after surgery for prostate cancer has a tendency to take some time. About half of all men, whose nerves were not affected during the operation, restore normal erectile function after one year. And three-quarters of restoring normal function after two years. Studies have shown that drugs such as Viagra, Cialis and Levitra can help men with erectile dysfunction after surgery with preservation of the nerve. But these drugs are less effective if the nerves of the penis significantly damaged.

Other common complications of radical prostatectomy include urinary incontinence - the involuntary leakage of urine from the bladder and incontinence - the involuntary excretion of feces from the rectum. These complications may become less pronounced over time. They may even disappear entirely. But some men have complications remain for an indefinite period of time. About 25% of men experience urine leakage after surgery and have the hygroscopic hygroscopic pads or disposable underwear for up to six months after surgery. In severe cases, some men may need an operation to maintain sfinkerov muscles that control the flow of urine

metastatic prostate cancer

Locally advanced prostate cancer involves spread beyond the capsule without the presence of distant metastases, and metastases to regional lymph nodes. Metastatic prostate cancer indicates metastases in the lymph nodes, bone metastasis or metastatic soft tissue
Primary treatment for patients with locally advanced or metastatic prostate cancer - hormonal treatment.
Hormone therapy for prostate cancer

For the first time the effectiveness of hormonal treatment (operative castration and estrogen appointment) in patients with metastatic prostate cancer is shown in 1941.
Since then hormone therapy is one of the main methods of treatment for patients with advanced forms of prostate cancer. Currently the use of hormone replacement therapy is not limited to a group of patients with metastatic disease, its use as a single agent or discuss multimodalyyugo treatment for non-metastatic prostate cancer
Molecular basis of the hormonal control of the prostate

Growth, functional activity and cell proliferation in the prostate may be adequate stimulation androgens. The main androgen, circulating in the blood, testosterone. Not having oncogenic properties, it is necessary for the growth of tumor cells.
The main source of androgens in the male testes, about 5-10% of adrenal androgens are synthesized. More than half of testosterone in the blood is associated with sex hormone, 40% albumin. Functionally active. unbound form of testosterone is only 3%.
After passive diffusion across the cell membrane testosterone be converted into dihydrotestosterone by the enzyme 5-a reductase. Although the physiological effects of testosterone and dihydrotestosterone are similar, the latter has 13 times more active. The biological effect of the two substances is realized by binding to androgen receptors located in the cell cytoplasm. Later complex "ligand-receptor" moves to the nucleus, where attached to specific areas promouternym genes.
Testosterone secretion is under the regulatory influence of the hypothalamic-pituitary-gonadal axis. Secreted by the hypothalamus stimulates LHRH secretion of LH and FSH in the anterior pituitary. The action is aimed at the stimulation of LH release of testosterone by interstitial Leydig cells in the testes.
Negative feedback to the hypothalamus provide circulating in the blood androgens and estrogens derived from androgens by biotransformation.
Regulation of androgen synthesis in the adrenal axis is' hypothalamus (corticotropin-releasing factor), pituitary (adrenocorticotropic hormone) - adrenal glands (androgens) "feedback mechanism. Virtually all of androgens secreted by adrenal glands, are in a state bound to albumin, their functional activity in comparison with testosterone and DHT is extremely low. Androgen levels. allocated by the adrenal glands, at the maintenance level after bilateral orchiectomy.
ADT prostate cells completing their apoptosis (programmed cell death).
Create androgen blockade

Now to create androgen deprivation use two basic principles:
suppression of androgen secretion by the testes due to medical or operative castration;
inhibition of the action of circulating androgens at receptor interaction in prostate cells (anti-androgens).
The combination of these two principles is reflected in the concept of "maximum (or total) androgen blockade"
Reducing the concentration of testosterone (castration)

Bilateral orchiectomy

Bilateral orchiectomy in a short time leads to a decrease in testosterone levels less than 50 ng / dL (based on the results of operations that level considered castration). 24 hours after the operative castration testosterone is reduced by 90%. Given this, bilateral orchiectomy considered the "gold" standard for building androgen deprivation therapy, the effectiveness of all the other methods evaluated in comparison with the operation.
Possible to perform this operation on an outpatient basis under local anesthesia by one of two methods: complete subcapsular orchiectomy or orchiectomy with preservation of the epididymis and visceral leaf tunica vaginalis. Subcapsular orchiectomy allows patients to avoid the negative psychological impact of the "empty" scrotum, but must account for the complete removal urologist intratesticular tissue containing Leydig cells. When technically true of the operation results of propene and subcapsular orchiectomy identical.
Recently mentioned the decreasing prevalence operative castration associated with diatonic disease at an early steel, as well as the use of pharmacological treatments are equivalent in effectiveness of castration.
Estrogens

Estrogens have a multicomponent mechanism of action:
decreased secretion of LHRH by a feedback mechanism:
Inactivation of androgens;
direct suppression of Leydig cell function:
direct cytotoxic effect on prostatic epithelium (shown only in vitro).
The most common estrogen diethylstilbestrol. The use of estrogens is limited due to high risk of cardiac and vascular complications (thrombogenic properties of estrogen metabolites), even at a low dose (1 mg), although comparable to the operational effectiveness of castration.
At present, interest in the estrogen therapy is based on the three positions.
Compared with LHRH agonists estrogens have lower costs and lead to dangerous side effects (osteoporosis, cognitive disorders).
Estrogens are highly effective in patients with advanced prostate cancer androgenrefrakternym.
Currently, the discovery of new classes of estrogen receptor beta. allegedly involved in oncogenesis in the prostate.
To prevent cardiovascular toxicity of estrogens proposed the use of parenteral routes of administration (to prevent the formation of toxic metabolites, due to the effect of the first passage through the liver), as well as cardioprotective drugs. However studies have shown that the use of anticoagulants and antiplatelet agents for their calculation angioprotektivnoe action actually reduces the risk of embolic complications tromoo.
Inhibitor-releasing hormone

Agonists-releasing hormone (LHRH) (buserelin, goserelin, leuprorelin, triptorelmn) - synthetic analogs of LHRH. The mechanism of action lies in the initial stimulation of the pituitary LHRH receptors and the allocation of LH and FSH, which increases testosterone production of Leydig cells. 2-4 weeks for the feedback mechanism is suppression of the synthesis of pituitary LH and FSH, which reduces the blood level of testosterone to castration. However the use of LHRH agonists can not achieve this in about 10% of cases.
Meta-analysis of 24 major studies involving about 6,600 patients, showed that the life expectancy of patients with prostate cancer in LHRH agonists alone did not differ from that of patients who underwent bilateral orchiectomy.
An initial "flash" LH, and therefore of testosterone begins 2 3 days after injection of these drugs and lasts for up to 10-20 days. This "flash" can lead to a life-threatening exacerbation of symptoms, particularly in patients with advanced forms of it. Among these symptoms should list bone pain, acute urinary retention, renal failure due to ureteral obstruction, spinal cord compression, severe complications of the vascular system seodechno the tendency to hypercoagulability. There are differences between the phenomena of "clinical flare" and "biochemical flare" (increase in PSA). Most susceptible to the phenomenon of "clinical flare" patients with large lesions of bone occurring symptomatically (about 4-10% of patients with advanced disease Ml).
When using LHRH-receptor agonist, simultaneously assign antnandrogennye drugs, which prevents unwanted effects described elevated levels of testosterone. Antiandrogens used for 21-28 days.
For patients at high risk of spinal cord compression should be a means, leading to a rapid decrease in testosterone levels in the blood (operational castration, LHRH antagonists).
Receptor antagonists releasing hormone

Appointment of LHRH-receptor antagonist (cetrorelix) leads to a rapid decrease in testosterone levels by blocking LHRH receptors in the pituitary gland: within 24 hours after the appointment of a decrease in LH concentrations to 84%. Given this, there is no need to appoint anti-androgen drugs in the absence of the phenomenon of "flash."
LHRH antagonist monotherapy is comparable to that in the appointment of LHRH agonists in combination with anti-androgens.
The possibility of widespread use of drugs of this group complicates a number of facts. Most of the LHRH-receptor antagonists can cause severe allergic reactions mediated by histamine, including after a previous successful applications. Taking this into account. these drugs are used in patients who have waived their operative castration for which other medications hormonal treatment options are not possible.
Medical staff monitor patients for 30 minutes after administration of the drug due to the high risk of allergic reactions.
Inhibitors of androgen synthesis

Ketoconazole is an oral antifungal drug that inhibits the synthesis of adrenal androgens and testosterone Leydig cells. Effect after the drug comes very quickly, sometimes within 4 hours after administration: effect of ketoconazole and quickly reversible, therefore, a constant (400 mg every 8 hours) dosing regimen to maintain a low level of testosterone.
Ketoconazole - quite well-tolerated and effective drug, it is administered to patients who have first-line hormonal treatment was not effective.
Despite the fast-paced, duration of treatment with ketoconazole in patients without concomitant hormonal modulation (operational, medical castration) leads to a gradual increase of testosterone in the blood to normal within 5 months.
At present, the use of ketoconazole limited group of patients with prostate cancer androgenrefrakternym.
Side effects of ketoconazole: gynecomastia, lethargy, weakness, liver dysfunction, blurred vision, nausea.
Given the suppression of adrenal function, Ketoconazole is usually prescribed in combination with hydrocortisone (20 mg 2 times a day).
Antiandrogen treatment

Antiandrogens block the intracellular receptors, having a greater affinity than testosterone, causing apoptosis of prostate cells.
Orally administered androgens attributed to two main groups:
antiandrogens with steroid structure (cyproterone, medroxyprogesterone);
nonsteroidal antiandrogens (flutamide, bicalutamide, nilutamide).
Steroidal anti-androgens also have suppressive effect on the pituitary gland, through which there is a decrease in testosterone levels, whereas during treatment with non-steroidal drugs testosterone levels remained normal or slightly elevated.
Steroidal antiandrogens

Cyproterone one of the first and most well-known drug in the group antiandrogens direct blocking action on androgen receptors also reduces testosterone levels in the blood by the central suppression (progestogen properties). Cyproterone is taken orally, the recommended dose -100 mg 2-3 times a day.
In monotherapy efficacy cyproterone compared with flutamide.
The side effects caused by cyproterone gipogonadnzmom (decreased libido, impotence, fatigue), to 10% of patients may experience severe complications of the cardiovascular system, which limits the use of this drug. Gynecomastia - a side effect, less than 20% of men taking cyproterone. The literature rarely mentioned observations of fulminant hepatic toxicity.
Non-steroidal anti-androgens ("pure" antiandrogens)

Blocking androgen receptor antiandrogen leads to increased concentrations of LH and testosterone levels about 1.5 times due to the mechanism of positive feedback to the hypothalamus. The lack of decline in testosterone levels to avoid a number of side effects due gipogonadnzmom: loss of libido, poor health, osteoporosis.
Although a direct comparison of the three drugs used (bicalutamide, flutamide, nilutamide) monotherapy did not spend, they do not differ in the severity of the pharmacological side effects of gynecomastia, mastodynia, hot flashes. However bnkalutamil somewhat safe versus nilutamide and flutamide.
Gynecomastia, mastodynia, hot flashes due to peripheral aromatization is in excess of testosterone to zstradiola.
Toxicity to the gastrointestinal tract (mainly diarrhea) is more common in patients taking flutamil. Hepatotoxicity (from mild to fulminant forms) in varying degrees, all antiandrogens, in this regard, requires periodic monitoring of liver function.
Although the mechanism of action of the "pure" antiandrogens is not intended to reduce testosterone levels, long-term preservation of erectile function is possible only in every fifth patient.
Nilutamide. At the moment, there are no studies on the use of the drug as monotherapy for prostate cancer in comparison with other antiandrogens or castration.
Recent studies using nilutamide as a second-line treatment for patients with prostate cancer androgenrefrakternym showed a good response to therapy.
Nonpharmacologic nilutamide side effects include blurred vision (long-term adaptation to darkness after the bright light - about 25% of patients), and 1% of patients can be interstitial pneumonia (up to lung fibrosis), hepatotoxicity, nausea, sensitization to alcohol.
The half-life is 56 hours nilutamide elimination occurs with the participation of cytochrome P450 liver. Recommended dosage - 300 mg once a day for 1 month, then a maintenance dose of 150 mg once a day.
Flutamide - the first drug in the family of "pure" anti-androgens. Flutamide - prodrug. The half-life of the active metabolite, 2-gidroksiflutamida is 5-6 hours, it makes it necessary to 3x daily dosing (250 mg 3 times daily). Derivation 2 gidroksiflutamida perform kidney. Unlike steroidal anti-androgen, side effects due to fluid retention or thromboembolic complications are absent
The use of flutamide as monotherapy versus orchiectomy and maximal androgen blockade does not affect the life expectancy of patients with advanced forms of prostate cancer.
Pharmacological side effects - diarrhea, hepatotoxicity (rare - fulminant form).
Bicalutamide - nonsteroidal antiandrogen with a long half-life (6 days). Bicalutamide take 1 time a day, it had a large compliance.
Bicalutamide has the most active and best safety profile of the "pure" anti-androgens. On the pharmacokinetics of the drug did not affect age, renal and hepatic disease of mild to moderate severity.
In most patients, the level of testosterone in the blood remains constant. The use of bicalutamide 150 mg in patients with locally advanced or metastatic disease is comparable to the performance of operational or medical castration. However, he has a much better side from the position of sexual and physical activity. However, the incidence of gynecomastia (66.2%) and mastodynia (72.8%) in this group of patients is high.
The use of bicalutamide is not recommended for patients with limited forms of the disease, as it is associated with a decrease in life expectancy. Response to hormonal treatment
Following the appointment of drugs that cause androgen deprivation. effect to some extent evident in most patients. Given that the target for the hormonal treatment - androgenchuvstvitelnye prostate cells, incomplete or blurred effect indicates the presence of a population of androgen-refractory cells.

Side effects of hormone treatment of patients with cancer poostaty known for a long time (see Table 33-19). Some of them Kozin adversely affect the quality of life of patients, especially the young while others can significantly increase the risk of health problems associated with aging.

Side effects of hormone treatment

Castration

Side Effects

Treatment / Prevention

Decreased libido

No

Impotence

Phosphodiesterase-5, intracavernous injection therapy using local negative pressure

Hot flashes (55-80% of patients)

Cyproterone, clonidine. venlafaxine

Gynecomastia, mastodynia (50% of maximum androgen blockade, 10-20% of castration)

Prophylactic radiotherapy mammektomiya tamoxifen, aromatase angibitory

Weight gain

Exercise

Muscular weakness

Exercise

Anemia (severe in 13% of patients with maximal androgen blockade)

Erythropoietic drugs

Osteopenia

Exercise, calcium and vitamin D, bisphosphonate

No cognitive impairment

The pathology of the cardiovascular system (heart attack, heart failure, stroke, deep vein thrombosis, pulmonary embolism), Parenteral, anticoagulants

Antiandrogens

Steroid

Pharmacological side effects: loss of libido, impotence, gynecomastia rarely

Nonpharmacological

Nonsteroidal

Pharmacological side effects: mastodynia (40-72%), hot flushes (9-13%), gynecomastia (49-66%) Prophylactic radiotherapy mammektomiya tamoxifen, aromatase angibitory

Nonpharmacological

Osteoporosis

Likelihood of bone fractures in patients receiving hormonal treatment for prostate cancer, significantly higher than that in the population. Hormone therapy for 5 years increases the risk of fracture by 1.5 times over 15 years - more than 2 times.

Oeteoporoza diagnosis is to perform rentgenabsorbtsiometrii to determine bone mineral density of the femur, performed all the men who are planning to hormonal treatment.

Improve mineral density allow regular exercise, not smoking, the use of calcium and vitamin D. For the prevention of osteoporosis, use drugs from the group of bisphosphonates Bisphosphonates (preferably zoledronic acid) should be administered to all men with confirmed osteoporosis.

Hot flashes

Hot flashes subjective sensation of heat in the upper body and head. objectively followed by excessive sweating.

Presumably the reason for this complication toning adrenergic centers in the hypothalamus, abnormalities in the concentration of beta-endorphin, the effect of peptides, calcitonin gene-related, the thermoregulatory centers of the hypothalamus.

Treatment of hot flashes should be done only in patients who are not tolerant to this side effect of hormonal treatment.

Cyproterone (initial dose of 50 mg / day. Subsequently titrated to 300 mg / day) due to his actions progestagen greatly reduces the frequency of hot flashes.

The use of estrogen (diethylstilbestrol in the minimum dose or estradiol transdermal form) is most effective (90% efficiency). However pronounced mastodynia and thromboembolic complications due to use of estrogen generally limit their use.

Antidepressants (especially selective serotonin reuptake inhibitors, venlafaxine) reduce the frequency of hot flashes by 50%.

Sexual function

About 20% of patients receiving hormonal treatment, in some way preserve sexual function. Libido is being negatively influenced to a greater extent. Only about 5% of patients maintain a high level of sexual interest.

In appropriate patients, the effectiveness of oral phosphodiesterase type 5, intracavernous injections of alprostadil.

Gynecomastia

Gynecomastia is caused by an excess of estrogen in the body (estrogen therapy, peripheral transformation of androgens to estrogens in the treatment of antiandrogen medication) to 66% of patients receiving bicalutamide 150 mg. detect gynecomastia, including up to 72% reported pain in the breast.

For the prevention or elimination of painful gynecomastia explored the possibility of radiotherapy (10 Gy), which is ineffective if gynecomastia is emerging. For the treatment of this complication also use liposuction and mastectomy. To reduce the severity of mastodynia using tamoxifen.

Anemia

Normochromic, normocytic anemia is diagnosed in 90% of patients receiving hormone therapy for prostate cancer. Usually note a decline in hemoglobin of 10%. The hemoglobin concentration decreased after 1 month. the majority of men (87%) returned to baseline values ​​after 24 months because of compensatory mechanisms.

For the treatment of anemia, regardless of etiology, use of recombinant erythropoietin products. Anemia is reversible after discontinuation of hormone replacement therapy for a year.

Combined hormonal treatment

Minimal androgen blockade (peripheral androgen blockade)

Involves the simultaneous use of an inhibitor of 5-a-reductase inhibitors and non-steroidal anti-androgenic drug. The advantages of this treatment regimen - maintaining the quality of life and sexual function at an acceptable level

Before final results of clinical studies, the use of this regimen is not recommended.

Maximum androgen blockade

Given that after operational or medical castration in the blood to maintain certain low androgen levels allocated to the adrenal glands, the concept of maximal androgen blockade (the combination of castration and anti-androgens) is interesting.

However the clinical benefit of this treatment regimen is questionable in daily clinical practice.

Systematic reviews and meta-analyzes recently completed large-scale studies have shown that 5-year survival rate of patients on background maximal androgen blockade higher than that in patients treated with monotherapy (castration) of less than 5%.

The use of maximal androgen blockade in patients with advanced forms of prostate cancer associated with a high frequency and severity of side effects, and the significant increase in the cost of treatment.

Continuous or intermittent hormonal therapy

Some time after the start of treatment to androgen deprivation, the cancer cells in the prostate are androgenrefrakterny Status: no longer serves androgens trigger apoptosis of certain cell lines.

The concept of intermittent hormonal therapy is based on the assumption. the abolition of the hormone therapy further tumor growth is due to differentiation androgenchuvstvitelnoy cell line. thereby allowing the re-use of androgen withdrawal phenomenon. That's why to be delayed in time the transition of prostate cancer androgenrefrakterny.

In addition, intermittent hormone treatment allows for improved quality of life in the intervals between treatment cycles, and reduce treatment costs.

Equivalence of intermittent and continuous approaches to the treatment of patients with metastatic prostate cancer and recurrence after radical treatment confirmed by a number of clinical studies.

In one study, PSA nadir, reached after 9 months of hormonal induction treatment, served as an independent prognostic factor in the length of life. Decline in PSA levels after induction treatment cycle of less than 0.2 ng / ml, less than 4 ng / ml, more than 4 ng / ml corresponded to the average life expectancy of patients with advanced forms of prostate cancer 75 months, 44 months and 13 months, respectively.

Immediate or delayed hormonal therapy

At present there is no clear opinion concerning the start of hormonal treatment. Previously proposed modes include the possibility of therapy, directly after the failure of radical treatment, and after the appearance of clinical signs of metastasis.

This situation is the lack of possibility to extrapolate the results of clinical trials because of their limitations in practice.

During prostate cancer and the use of hormonal treatment characterizes a number of facts.

First, even in men, intact in the hormonal level, the progression of prostate cancer takes a long time. Studies show that after a recurrence of prostate cancer to metastatic disease is 8 years old. 5 years from the date of metastasis to the patient's death.

Secondly, 20% of men in the background of the hormonal treatment for prostate cancer cause of death will not be linked with the disease, while the remaining cause of death - cancer in the transition of hormone form. One prospective randomized study shows. that 10 years after the start of hormone therapy in a group of patients were still alive, only 7%. The average life expectancy after the start of hormone therapy is 4.4 years, after 8 years of living are about 4.5% of patients.

Third, hormonal therapy is not harmless. Without taking into account the side effects of treatment, men receiving hormone therapy for prostate cancer, age faster, which leads to an early death from causes related to age.

In this regard, needs-based approach to the choice of the start of hormonal therapy in patients with prostate cancer.

Currently, there is a definite position regarding the hormonal treatment for patients with localized prostate cancer. Life expectancy in this group of patients in terms of hormone replacement therapy significantly lower than that in the delayed treatment strategy. This is so. that the appointment of the hormonal treatment leads to rapid aging of the patients in whom the risk of death from prostate cancer, and so low.

In this situation, the appointment of hormonal treatment should be thoroughly discussed with the patient himself.

Prostate cancer with metastases to regional lymph nodes

Results of immediate and delayed treatment with hormonal therapy in patients with advanced disease pNl-Z (histological examination after RP) evaluated a group of researchers Grour Eastern Cooperative Oncology (ECOG) and the European Organization for Research and Treatment of bladder cancer.

The first study showed that after 7.1 years of follow deaths in patients with delayed treatment exceeded that in the group of patients with immediate hormonal therapy. Subsequent updates of this study showed that the average duration of life with immediate treatment is 13.9 years versus 11.3 years in patients with delayed treatment of the disease. Despite the high mortality rate from unrelated causes of prostate cancer (55 vs. 11% in the delayed treatment), immediate use of hormonal treatment has been unequivocal clinical benefit.

However a clear interpretation and the objectivity of the results of this study are limited due to the small group of patients studied (100 men), lack of correlation calculation of life expectancy and the degree of differentiation of tumor cells, the lack of patients treated with hormonal therapy.

Study performed by a group of the European Organization for Research and Treatment of bladder cancer (302 patients with advanced disease pN1-W. M0 without first treating the underlying source) showed that the average life expectancy of patients receiving hormonal treatment immediately after diagnosis was 7.8 years compared to 6.2 years in patients with delayed treatment.

Locally advanced and asymptomatic metastatic prostate cancer

In one study, Medical Research Council Prostate Cancer Working Party Investigators Group (934 patients), launched in 1997 (the results are evaluated in 2004) it was shown that, for this group of patients immediate appointment of hormonal treatment has a positive effect on both cancer- specific survival, and on the severity of symptoms associated with prostate cancer. However, on the background of long-term observation of patients, overall survival, depending on the time of the beginning of hormonal treatment was not significantly changed.

Findings

Hormone therapy should not be used in men with localized prostate cancer, as it does not lead to an increase in overall survival, only worsening the mortality due to other causes.

For patients with locally advanced, metastatic asymptomatic and symptomatic, but not prostate cancer using stalirovannym immediate hormonal treatment leads to a significant increase in cancer-specific life expectancy, without affecting overall survival.

In patients with prostate cancer with stage N + after RP, life expectancy is much higher with immediate hormonal treatment for patients without primary treatment increased life expectancy is not significant.

Up of patients with prostate cancer receiving hormone treatment

Patients were examined at 3 and 6 months after treatment. The minimum volume of the survey: PSA, digital rectal examination and careful assessment of symptoms, aimed at obtaining evidence of the effectiveness of treatment and its side effects.

Observation of the patient is carried out on an individual basis, taking into account symptoms, prognostic factors and treatment assignment.

Patients with stage M0 disease with a good response to treatment, examine (assessment of symptoms, digital rectal examination, PSA determination) every 6 months.

Patients with stage M1 disease with a good response to treatment, are examined (assessment of symptoms, digital rectal examination, determination of PSA, clinical blood count, creatinine, alkaline phosphatase) every 3-6 months.

In cases where there is evidence of disease progression or poor response to treatment, an individual approach to monitoring.

Routine use of instrumental methods of examination (ultrasound, MRI, CT scan, bone scan) with stable patients is not recommended.