2006年，66岁的经济学教授B先生从其普通内科医师处得知自己的前列腺特异性抗原（PSA）水平为4.5 ng/mL，与前一年的3.0 ng/mL相比有所升高。其泌尿科医师在检查中只发现轻度前列腺肥大，同时证实PSA水平升高并建议其接受活检。B先生同意接受活检。12个活检标本中有2个显示癌变，格利森评分为7分。向B先生介绍根治性前列腺切除术、放疗和主动监测三种方案后，其泌尿科医师强烈倾向于手术，同时承认手术可能导致阳痿和尿失禁。同意手术之前，B先生曾到一位肿瘤内科医师处就诊，并与其讨论了主动监测。
作者信息
Robert Aronowitz, M.D., and Jeremy A. Greene, M.D., Ph.D.
From the University of Pennsylvania, Philadelphia (R.A.); and Johns Hopkins University, Baltimore (J.A.G.).
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