攝護腺癌列位臺灣十大癌症 安南醫院籲男性健檢及早追蹤
2023-3-2 記者田靖／台南報導
董聖雍醫師呼籲，男性民眾應在健康檢查中，加入定期追蹤「攝護腺」項目，且平時若出現排尿等攝護腺相關情況，也應儘速至泌尿科就醫。
排尿情況不同以往，當心是攝護腺癌。安南醫院泌尿科醫師董聖雍提及，63歲陳先生過去一直受排尿問題困擾，包括排尿速度慢、尿不乾淨、頻尿常跑廁所等，晚上也需多次起床小便而不得安眠。由於工作忙碌，加上他認為只是攝護腺肥大而不以為意，直到退休替自己安排了全身健康檢查，發現攝護腺指數異常且肛門指診摸到攝護腺硬塊，經切片及影像檢查後，竟確診為攝護腺癌。董聖雍醫師表示，幸好陳先生檢查當下，攝護腺癌仍在第二期尚未發生轉移。經過討論後，陳先生決定接受攝護腺全切除手術，而這幾年追蹤術後攝護腺指數都維持在零附近，困擾已久的小便問題也改善許多。
董聖雍醫師說明，攝護腺癌則是男性最常見的癌症之一，和家族史、基因、年齡、荷爾蒙、飲食、環境等有關。近年隨著人口老化，攝護腺癌的發生率逐漸上升，目前已列位臺灣男性十大癌症死因第五名。他提醒，攝護腺癌早期症狀和良性攝護腺肥大差不多，包括尿流細小斷續、尿急、頻尿等，嚴重時可能發生血尿或血精。
所幸，早期局限性攝護腺癌不論使用手術或放射線治療，治癒率都相當高，例如透過攝護腺全切除手術，可以將攝護腺連同癌組織完整移除，是最根本的治療方式。董聖雍醫師補充，安南醫院近期將引進「達文西機器手臂」系統，提供病人除了傳統開腹及腹腔鏡手術以外更先進的選擇，以微創方式減少術中出血，並縮短術後恢復時間；若想接受放射線治療，安南醫院也有南臺灣唯一的最新儀器「好神刀」，提供更精準的治療。
對於攝護腺癌已轉移到骨骼或其他臟器的患者，董聖雍醫師認為無須過度憂心，近幾年相關治療有許多突破性的進展，以安南醫院提供的五大服務為例：一、荷爾蒙針劑注射或化學治療；二、可申請多種第二代口服荷爾蒙藥物；三、採用鐳-223（Radium-223）放射線治療骨轉移；四、考慮接受基因檢測，尋找相關基因突變以進行精準醫療，像是給予標靶藥物或免疫治療；五、細胞治療或是臨床實驗等具潛力的治療方式。他表示，以上選項都可以和醫師諮詢後採用。
董聖雍醫師呼籲，男性民眾應在健康檢查中，加入定期追蹤「攝護腺」項目，且平時若出現排尿等攝護腺相關情況，也應儘速至泌尿科就醫，以利早期發現相關問題。針對診斷出攝護腺癌，他分享過往案例，患者通常只要積極接受治療、好好配合醫師指示，往往都能獲得不錯的控制。
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