Cover News Reporter Qiu Tian
Prostate cancer is a malignant tumor that seriously threatens men’s life and health, mainly occurring in males over 50 years old. With the improvement of China’s economic level, the improvement of people’s living standards, and the extension of the average life expectancy, the incidence of prostate cancer in China is showing a significant upward trend, gradually becoming an important disease affecting the health of middle-aged and elderly Chinese men. Due to the subtle early symptoms of the disease, many patients often find it difficult to detect, and once significant symptoms appear, they are usually already in the advanced stage, making treatment much more difficult. Currently, over 2/3 of domestic patients are already in the advanced stage at the initial diagnosis, missing the optimal treatment window, resulting in a gap in the overall prognosis of prostate cancer patients in China compared to Western developed countries.
In order to enhance the public and patients’ awareness and understanding of prostate cancer, Cover News interviewed Professor Shen Pengfei from the Department of Urology at West China Hospital of Sichuan University and West China Tianfu Hospital of Sichuan University, allowing him to popularize knowledge about prostate cancer and introduce treatment advances to the public.
Professor Shen Pengfei in surgery
No significant clinical features, early examination and screening are key
Professor Shen Pengfei said that the overall incidence of prostate cancer in China is showing a clear upward trend. In terms of incidence rate, globally, prostate cancer has a high incidence rate in Europe and America, with the incidence rate among Caucasians being the highest. The incidence of prostate cancer is not only related to race but also closely related to the aging of the population, dietary structure, and health awareness.
Due to the lack of unique clinical symptoms in prostate cancer, there may be no distant metastasis in the early or even middle stage of the disease, and the body may show no symptoms at all. This is because men over the age of 50 will experience age-related changes in the prostate, known as benign prostatic hyperplasia, which often leads to symptoms of urinary obstruction and are commonly found in elderly men. Prostate cancer, because of the lack of specific early clinical manifestations, can often be masked by symptoms of benign prostatic hyperplasia. This requires screening with PSA (prostate-specific antigen) to increase the detection rate of prostate cancer. Many people are not familiar with PSA screening, when in fact it only requires a blood test, generally recommended to start screening from the age of 50, or from 45 if there are hereditary factors.
What are the current treatment methods for prostate cancer
There are various treatment methods for prostate cancer, such as watchful waiting, active surveillance, radical prostatectomy, radiation therapy, immunotherapy, ADT therapy, etc., and different treatment plans can be chosen for patients with different conditions.
ADT therapy for prostate cancer refers to androgen deprivation therapy and includes various methods, mainly lowering the level of testosterone in the body through medication or surgery to inhibit the development of prostate cancer. ADT therapy can be classified into the following four mechanisms:
1. Surgical castration, by surgically removing both testicles to block testosterone secretion.
2. Drug castration, by injecting drugs to suppress testosterone secretion by the testes.
3. Antiandrogen drugs, with the emergence of new hormonal therapies in recent years, innovative drugs can effectively control the progression of prostate cancer in patients resistant to castration.
4. Drugs that inhibit testosterone synthesis.
“In clinical practice, we have found that the incidence of prostate cancer is increasing in patients under 55 years old, and the youngest patients are 45 years old. Therefore, early screening, diagnosis, and treatment are key to improving the survival rate of patients, prolonging the overall survival time of prostate cancer patients, and improving their quality of life is our vision. Currently, the MDT team of the Department of Urological Tumors at West China Hospital has been committed to the early diagnosis and personalized treatment of prostate cancer. After our treatment and standardized management and follow-up, the median survival time of patients with advanced metastatic disease is now close to 8 years,” Shen Pengfei said.
Shen Pengfei reminds male friends to avoid prostate congestion in daily life, avoid prolonged sitting, long-term cycling, etc. They should engage in aerobic exercise, maintain a balanced diet, drink more water during the day, consume less spicy and high-fat foods, and avoid smoking and alcohol. For patients already diagnosed with prostate cancer, they must maintain good confidence in treatment.
