Multidisciplinary Treatment of Prostate Cancer

Authors

  • Danaiphand Akarasakul ศัลยกรรมระบบทางเดินปัสสาวะ โรงพยาบาลราชวิถี

Abstract

มะเร็งต่อมลูกหมากเป็นมะเร็งที่พบได้บ่อยในยุโรปและอเมริกา¡–‡√ÁßμàÕ¡≈Ÿ°À¡“°‡ªìπ¡–‡√ÁßΣ’Ëæ∫‰¥â∫àÕ¬„π¬ÿ‚√ª
·≈–Õ‡¡√‘°“ „π¢≥–Σ’Ë‡√‘Ë¡‡ªìπ¡–‡√ÁßΣ’Ëæ∫∫àÕ¬¢÷Èπ„πª√–‡Σ»
À√◊Õ„π à«πÕ◊ËπÊ ¢Õß‚≈° °“√¥Ÿ·≈ºŸâªÉ«¬¥—ß°≈à“«‰¥â√—∫Õ‘ΣΠ‘æ≈
®“°≈—°…≥–°“√¥”‡π‘π‰ª¢Õß‚√§‡ªìπ°√≥’Ê ‰ª ‚¥¬¡–‡√Áß
μàÕ¡≈Ÿ°À¡“°¡’≈—°…≥–摇»…§◊Õ ‡ªìπ‚√§Σ’Ë¡’Õ—πμ√“¬∂÷ß·°à
™’«‘μ„πºŸâªÉ«¬∫“ß√“¬ ·≈–Õ“®‰¡à‡ªìπÕ—πμ√“¬„πºŸâªÉ«¬Õ’°
À≈“¬Ê √“¬ Õÿ∫—μ‘°“√≥åΣ“ßæ¬“Π‘ (histological apparent
cancer) “¡“√∂æ∫‰¥â„π™“¬Õ“¬ÿ >75 ªï∂÷ß√âÕ¬≈– 42
‚¥¬Õ—μ√“‡ ’ˬ߄π§πÕ‡¡√‘°“æ∫‰¥â√âÕ¬≈– 16 ·μàÕ—μ√“°“√
‡ ’¬™’«‘μ¥â«¬‚√§¡–‡√ÁßμàÕ¡≈Ÿ°À¡“°π’È æ∫‰¥â√âÕ¬≈– 3.6
‡Σà“π—Èπ[1,2] ¥—ßπ—Èπ°“√√—°…“Σ’Ë‡À¡“– ¡„πºŸâªÉ«¬ ®÷ߢ÷ÈπÕ¬Ÿà
°—∫°“√ª√–‡¡‘𧫓¡‡ ’Ë¬ß«à“ºŸâªÉ«¬√“¬„¥¡’§«“¡‡ ’Ë¬ß ŸßΣ’Ë‚√§
®–°√–®“¬Õ¬à“ß√«¥‡√Á« ¡“°°«à“™à«ß™’«‘μΣ’Ë‡À≈◊ÕÕ¬Ÿà §«“¡
‡ªìπ‰ª‰¥â¢Õߧ«“¡ ”‡√Á®„π°“√√—°…“ ·≈–ªí®®—¬‡ ’ˬßÀ√◊Õ
¿“«–·Σ√°´âÕπΣ’ËÕ“®‡°‘¥¢÷Èπ‡π◊ËÕß®“°°“√√—°…“·μà≈–™π‘¥
¡’°“√ª√–‡¡‘𧫓¡‡ ’ˬßμà“ßÊ Σ“ß°“√·æΣ¬å„π
ªí®®ÿ∫—π ‚¥¬¡’°“√π” normogram À√◊Õ algorithms „™â„π
°“√ª√–‡¡‘πº≈°“√√—°…“ ´÷Ëß√«¡‰ª∂÷ß √–¬–§«“¡√ÿπ·√ß
¢Õß‚√§ (stage) §«“¡√⓬·√ߢÕß¡–‡√Áß (grade) ·≈–§à“
PSA (prostate specific antigen) Σ—Èßπ’È √Ÿª·∫∫ (model)
¢Õß°“√μ—¥ ‘π„®®–Õ“»—¬°“√ª√–‡¡‘πº≈‰¥âÀ√◊Õ‡ ’¬ (gain
or loss) ¢Õߧÿ≥¿“æ™’«‘μª√—∫¥â«¬™à«ß™’«‘쇪ìπ§à“‡©≈’ˬ[3]
·π«Σ“ß°“√μ—¥ ‘π„®®– –ΣâÕπ∂÷ߺ≈‰¥âº≈‡ ’¬´÷Ëß
ºŸâªÉ«¬®–‡ªìπºŸâª√–‡¡‘π μ—«Õ¬à“߇™àπ ºŸâªÉ«¬¡’§«“¡°—ß«≈¡“°
πâÕ¬À√◊Õ°“√¬Õ¡√—∫‰¥â‡æ’¬ß„¥À“°‡°‘¥¿“«–™È”√—Ë« À√◊Õ‡°‘¥
¿“«–‡≈◊Õ¥ÕÕ°®“°≈”‰ â„À≠à (replication prostate) À√◊Õ
¡’™’«‘μÕ¬Ÿà√à«¡°—∫¡–‡√Áß´÷Ë߉¡à‰¥â√—∫°“√√—°…“‰¥âÀ√◊Õ‰¡à ‚¥¬
«μ— ∂ªÿ √– ߧÀå ≈°— μÕà ¡“§Õ◊ °“√‡≈Õ◊ °«Π‘ °’ “√√°— …“Σ‡Ë’ À¡“– ¡
„π‡«≈“Σ’ËºŸâªÉ«¬¬Õ¡√—∫‰¥â
°“√√—°…“ºŸâªÉ«¬¡–‡√ÁßμàÕ¡≈Ÿ°À¡“°®–·∫àßÕÕ°‡ªìπ 2
°≈ÿà¡„À≠àÊ §◊Õ °“√√—°…“ºŸâªÉ«¬¡–‡√Áß´÷Ë߬—߉¡à¡’°“√°√–®“¬
(localized prostate cancer) ·≈–°“√√—°…“„π°≈ÿࡺŸâªÉ«¬
´÷Ëß¡’°“√°√–®“¬‰ª¬—ß à«πÕ◊Ëπ (metastasis prostate cancer)
´÷Ëß®–‰¥â°≈à“«∂÷ß„π≈”¥—∫μàÕ‰ª

Downloads

Published

2012-12-01

How to Cite

Akarasakul, D. (2012). Multidisciplinary Treatment of Prostate Cancer. Insight Urology, 33(2), 73–83. Retrieved from https://he02.tci-thaijo.org/index.php/TJU/article/view/63153

Issue

Section

Original article