Questions and answers about prostate cancer

Prostate Cancer FAQ

1. What is prostate cancer?

98% of prostate cancers are adenocarcinomas, which originate from glandular epithelial cells. The structure of the prostate is divided into the peripheral zone, transition zone, and central zone. The cross section of the prostate is like an orange cut into round slices. The orange peel is equivalent to the peripheral zone, and the orange core is equivalent to the transition zone and central zone. The urethra runs through it. Prostate cancer most often occurs in the peripheral zone.

Due to the hidden location of the prostate, patients with early prostate cancer often have no symptoms or mild symptoms, and the disease progresses slowly, but patients with advanced disease progress quickly, mainly showing symptoms of lower urinary tract obstruction, and even seeking medical treatment for metastatic symptoms such as bone pain. The occurrence of prostate cancer may be related to race, genetics, environment, food, smoking, obesity and sex hormones.

2. Who is prone to prostate cancer?

Most people who develop prostate cancer are over 65 years old, with the peak age being 70 to 74 years old. A small number of patients have been screened out through the serum prostate-specific antigen (PSA) test in physical examinations for men under 50 years old, and there are quite a few men over 80 years old. Since prostate cancer is highly related to genetics, if a direct relative has prostate cancer, the risk of developing prostate cancer is twice as high as that of others; if there are two people with prostate cancer, the risk of developing prostate cancer is even greater, and it is more likely to develop early, and the age of diagnosis is 6 to 7 years earlier than that of ordinary people. A high-animal fat diet is a relatively certain risk factor, and patients often consume a lot of animal fat for a long time.

3. What are the signs and symptoms of prostate cancer?

Although prostate cancer has the characteristic of hidden onset, as long as you are a careful person, you can still detect some "clues".

1. Early prostate cancer may not have any warning symptoms, except for the discovery of elevated PSA or abnormal prostate during rectal examination during physical examination.

2. Urinary dysfunction, manifested as frequent urination, urgency, incomplete urination, or even urinary retention or incontinence. These urinary difficulties are similar to prostate hyperplasia and are easy to misdiagnose.

3. Fatigue, weight loss, and body pain may be signs of advanced prostate cancer.

4. Bone pain, fractures or paralysis may indicate that prostate cancer has metastasized to the bones. 5. Leg swelling may indicate lymph node metastasis, which may cause compression and blood circulation disorders in the lower limbs.

4. How to detect prostate cancer early?

Rectal examination and PSA are currently recognized as simple and convenient screening methods for early detection of prostate cancer. It is recommended that men over 50 years old undergo routine rectal examination and PSA examination every year. However, those with a family history of prostate cancer should start annual examinations at the age of 45. The following tests can be performed when prostate cancer is suspected.

(1) Prostate-specific antigen test (PSA);

(2) Digital rectal examination (DRE);

(3) Transrectal ultrasonography (TRUS);

(4) Ultrasound-guided prostate biopsy.

5. When is it necessary to have a PSA test?

The "Guidelines for the Diagnosis and Treatment of Urological Diseases in China" recommends:

(1) Men over 50 years old should undergo routine PSA testing and digital rectal examination every year.

(2) For men with a family history of prostate cancer, annual examinations should be conducted starting at age 45.

(3) Men with abnormal rectal examination and clinical signs (such as bone pain and fracture) should undergo PSA testing.

(4) Re-examination is recommended for those with an initial abnormal PSA test.

(5) Reminder: PSA examination should be performed one week after prostate massage, 48 hours after cystoscopy or catheterization, 24 hours after ejaculation, and one month after prostate puncture. At the same time, there should be no diseases such as prostatitis and urinary retention.

6. What should we pay attention to in our daily life to prevent and treat prostate cancer?

(1) Eat a healthy diet with a variety of foods. Pay attention to eating more plant foods. Cereals, vegetables, fruits, and beans should account for more than 2/3 of your daily food. Eat a combination of coarse and fine grains, and both meat and vegetables. Eating tomatoes, tomato products, and soy products (low-fat soy milk, tofu, soy protein powder, etc.) can reduce the risk of prostate cancer.

(2) The high-protein food in the diet should mainly be fish, and beneficial fatty acids should be consumed, while high animal fat intake should be avoided as much as possible.

(3) Drinking more green tea is beneficial.

(4) Quit smoking and limit alcohol intake.

(5) Maintain a proper weight, engage in appropriate activities, and have a positive attitude.

(6) Adequate amounts of calcium and vitamin D can prevent osteoporosis.

7. Is there any relationship between prostate cancer, prostatic hyperplasia and prostatitis?

Although prostate cancer, prostatic hyperplasia and prostatitis are all diseases that occur in the prostate organ, they are three completely different diseases, and there is no necessary connection between the three. Prostate cancer and prostatic hyperplasia mostly occur in men over 50 years old, and they can be distinguished by whether they have symptoms or not, and whether they are mild or severe. However, prostatitis mainly occurs in young and middle-aged men, and its symptoms are also different from those of cancer and hyperplasia. From the perspective of the location and nature of the lesions, the three are also different. The main lesion site of prostate cancer is in the peripheral zone of the prostate, which is a malignant lesion of glandular cells; the lesion site of prostatic hyperplasia is in the transitional zone and central zone of the prostate, which is mainly prostatic interstitial hyperplasia, while prostatitis is an infection of the reproductive system, not a separate disease, but a prostatitis syndrome. Clinically, after surgery for prostatic hyperplasia, prostate cancer can still occur, which also proves the difference between the two. Therefore, there is currently no symptomatic medical basis for whether prostate cancer is related to hyperplasia and inflammation.