Prostate cancer is a malignant tumor that seriously threatens the life and health of men. According to the latest statistics from the World Health Organization, prostate cancer has become the second most common cancer and the fifth leading cause of cancer death in men. Although it is unfortunate to have prostate cancer, it progresses slowly, and most of the early stages (confined to the prostate) can be surged**, so prostate cancer is also called "lazy cancer". But "lazy cancer" doesn't mean you can let your guard down. The five-year survival rate of prostate cancer patients in China is only 664%, and its harm cannot be ignored. Because the early symptoms of prostate cancer are relatively insidious, many patients are often difficult to detect, and once the symptoms appear, they are usually at an advanced stage.
"Lazy cancer" cannot relax its vigilance, and the coverage rate of early screening is still insufficient.
Professor Chen Ming, director of the Department of Urology at Zhongda Hospital Affiliated to Southeast University, said that the incidence of prostate cancer in Europe and the United States is extremely high. However, with the improvement of life expectancy and changes in living and dietary habits, the incidence of prostate cancer in China has also increased in recent years. In 2016, there were 78,300 new cases of prostate cancer and 33,600 deaths in China, and prostate cancer has become the sixth malignant tumor in the incidence of men in China.
Professor Chen Ming, Director of the Department of Urology, Zhongda Hospital, Southeast University.
The increase in the number of new cases is related to the increased popularity of disease screening. Professor Chen Ming said that due to people's emphasis on physical examination, more and more asymptomatic people have received early screening for prostate cancer. In addition, with the improvement of people's living standards, the lifestyle of Chinese people has changed, such as sedentary lifestyle, high-fat diet, especially the increase in red meat intake, which has further increased the incidence of diseases.
Prostate cancer grows very slowly, and if it can be detected at an early stage, the rate is very high. But "lazy cancer" doesn't mean you can let your guard down. In fact, it is precisely because the early symptoms of prostate cancer are not obvious, the coverage rate of early screening is insufficient, and the incidence involves intimate parts, which leads many men to have the idea of "avoiding medical treatment", and most patients are already in the middle and advanced stages of their disease when they are first diagnosed.
The main factors affecting the survival prognosis of prostate cancer patients in China are late in the time of consultation, high baseline level of PSA and poor control throughout the whole process. Professor Xu Bin of the Department of Urology, Zhongda Hospital Affiliated to Southeast University, said that early prostate cancer usually has no specific symptoms, and when the tumor enlarges or invades the periurethral glands, there will be symptoms similar to benign prostatic hyperplasia, such as frequent urination, urgency, interruption of urine flow, incomplete urination, difficulty urinating, etc., "Many elderly people think that this is prostatic hyperplasia, or think that it is normal to get up two or three times at night when they are old, and ignore screening." Professor Xu Bin said that many patients have already had very serious symptoms, and even after going to the orthopedic department for lumbosacral pain or fracture, they were found to be caused by bone metastasis of prostate cancer, which is basically at an advanced stage.
Professor Xu Bin, Department of Urology, Zhongda Hospital, Southeast University.
Why is the survival time so different for prostate cancer?
Professor Chen Ming said that according to the development stage of prostate cancer, it is mainly divided into localized prostate cancer, metastatic hormone-sensitive prostate cancer (MHSPC), non-metastatic castration-resistant prostate cancer (NMCRPC) and metastatic castration-resistant prostate cancer (MCRPC).
There are many methods for prostate cancer, including surgery, radiotherapy, endocrine, etc., and the appropriate regimen can be selected according to the specific situation of the patient. In recent decades, there have been two important evolutions in the surgical approach to prostate cancer**. It was first a traditional open surgery, and then evolved into laparoscopic prostate cancer surgery, which greatly reduced the degree of surgical trauma; At present, the mainstream is robot-assisted prostate cancer surgery, which can not only reduce the surgical trauma, but also achieve clear vision and flexible movements. The da Vinci robotic surgery team led by Professor Chen Ming from the Department of Urology of Zhongda Hospital Affiliated to Southeast University ranks among the top in the country in terms of the number of surgical cases, types and degrees of difficulty.
As a progressive disease, some patients may still develop metastatic castration-resistant prostate cancer and enter the terminal stage of the disease after first-line endocrine **. In the non-metastatic stage, patients with prostate cancer have an annual risk of progression of 34% and a 16% risk of all-cause mortality; Once patients progress to metastatic prostate cancer, the annual risk of progression increases dramatically to 74% and the risk of all-cause mortality increases to 56%. Therefore, delaying the progression and metastasis of patients in the non-metastatic stage is the key to clinical progression, and a very important starting point is the continuous achievement of PSA.
On December 13, 2023, the National Healthcare Security Administration and the Ministry of Human Resources and Social Security issued the National Drug Catalogue for Basic Medical Insurance, Work-related Injury Insurance and Maternity Insurance (2023), in which the oral androgen receptor inhibitor darolutamide is another indication for metastatic hormone-sensitive prostate cancer is included in the medical insurance, which means that more patients in China will benefit from this innovative product. Previously, darolutamide has been approved for the use of ** non-metastatic castration-resistant prostate cancer with high-risk metastatic risk, and the expansion of the indication covers the entire course of prostate cancer.
Experts pointed out that for patients who have already suffered from prostate cancer, it is necessary to maintain good confidence and actively cooperate. With the continuous emergence of new drugs, it can provide better curative effect for prostate cancer**. Moreover, the coverage of national medical insurance is also increasing, and the financial burden of patients** is gradually decreasing. Professor Chen Ming said that the whole process of medical insurance and full protection have a positive role in promoting the whole process of prostate cancer management.
Men over the age of 50 should be screened regularly for prostate cancer.
The reporter was informed that in order to implement the purpose of "paying attention to urological health, caring for urinary patients, and walking hand in hand for love", the Urology Branch of the Chinese Medical Association launched a series of large-scale national public welfare activities of "U Medical Public Welfare Tour", and organized national urology experts to go to the border, grassroots and rural areas to carry out free consultation, disease screening, expert surgery, academic lectures, health education and other activities. Professor Chen Ming introduced that since the launch of the "U Medical Public Welfare Tour" activity, it has been strongly supported by urology experts across the country, and the experts have carried out activities in various forms such as free consultation, free surgery by experts, health education, etc., to serve the grassroots people, so that more high-risk men of appropriate age can improve their health awareness, and achieve "early detection, early diagnosis, and early diagnosis" have been well received by the majority of patients.
The incidence of prostate cancer has increased rapidly since the age of 50, and it is called "retirement cancer". Experts remind that men over the age of 50 should undergo routine PSA screening. Routine screening for TPSA greater than 4 ng mL requires regular follow-up or even further testing. If you have a family history of prostate cancer, you can start annual prostate cancer screenings over the age of 45. "In the physical examination, there is also a digital examination that cannot be ignored. Professor Xu Bin of the Department of Urology, Zhongda Hospital Affiliated to Southeast University, reminded that through digital examination, you can feel the size, position, hardness, smoothness of the surface, whether there are nodules, whether the groove has become shallow, etc., to help doctors judge the basic condition of the patient's prostate.
Yangtze Evening News Purple Cow News reporter Yu Dandan.
Proofreading Tao Shangong.