RT Book, Section
A1 Scher, Howard I.
A1 Eastham, James A.
A2 Jameson, J. Larry
A2 Fauci, Anthony S.
A2 Kasper, Dennis L.
A2 Hauser, Stephen L.
A2 Longo, Dan L.
A2 Loscalzo, Joseph
SR Print(0)
ID 1160011975
T1 Benign and Malignant Diseases of the Prostate
T2 Harrison's Principles of Internal Medicine, 20e
YR 2018
FD 2018
PB McGraw-Hill Education
PP New York, NY
SN 9781259644016
LK accessmedicine.mhmedical.com/content.aspx?aid=1160011975
RD 2024/04/18
AB Benign  and  malignant  changes  in  the  prostate  increase  with  age.  Autopsies  of  men  in  the  eighth  decade  of  life  show  hyperplastic  changes  in  >90%  and  malignant  changes  in  >70%  of  individuals.  The  high  prevalence  of  these  diseases  among  the  elderly,  who  often  have  competing  causes  of  morbidity  and  mortality,  mandates  a  risk-adapted  approach  to  diagnosis  and  treatment.  This  can  be  achieved  by  considering  these  diseases  as  a  series  of  states.  Each  state  represents  a  distinct  clinical  milestone  for  which  therapy(ies)  may  be  recommended  based  on  disease  extent,  current  symptoms,  the  risk  of  developing  symptoms,  or  the  risk  of  death  from  disease  in  relation  to  death  from  other  causes  within  a  given  time  frame.  For  benign  proliferative  disorders,  symptoms  of  urinary  frequency,  infection,  and  potential  for  obstruction  are  weighed  against  the  side  effects  and  complications  of  medical  or  surgical  intervention.  For  prostate  malignancies,  the  likelihood  that  a  clinically  significant  cancer  is  present  in  the  gland  and  the  concomitant  risk  of  symptoms  or  death  from  cancer  are  balanced  against  the  morbidities  of  the  recommended  treatments  and  preexisting  comorbidities.