Have you ever been checked for prostate cancer?

Prostate cancer is the most common malignant tumor of the male urogenital system. Epidemiological studies have shown that the occurrence of prostate cancer is mainly related to factors such as age, race, family genetic background, geographical location and dietary structure. Worldwide, prostate cancer is the second most common malignant tumor in men, second only to lung cancer.

Compared with developed countries, China has a low incidence of prostate cancer, but the incidence has been increasing year by year in the past decade. The main reason is generally believed to be related to the widespread use of prostate-specific antigen (PSA) in tumor screening and the increase in the level of early prostate cancer diagnosis.

Prostate cancer has no specific symptoms. There is no discomfort in the early stage. When the tumor grows to a certain size, frequent urination, urgent urination, and difficulty urinating may occur. A few patients may have hematuria, which is exactly the same as the clinical manifestations of benign prostatic hypertrophy! When the tumor compresses or invades the surrounding lymph and blood vessels, causing lower limb edema, or bone metastasis and bone pain, it is too late - the chance of radical cure has been lost.

Radical prostatectomy is already a very mature technology. The key is how to detect it early.

The answer is screening.

At present, the outpatient screening method for prostate cancer is very simple: 1 physical examination - digital rectal examination, 2 blood draw - prostate-specific antigen (PSA), 3 imaging - transrectal B-ultrasound scan.

Digital rectal examination and B-ultrasound-guided prostate puncture

Based on our own clinical findings, most prostate cancers are in the late stages. Although we have seen 26-year-old prostate cancer patients, the vast majority of patients are over 45 years old. Therefore, we recommend that men over 45 years old should undergo prostate cancer screening at least once a year.

Once you suspect prostate cancer, don't hesitate, start preparing for a very minor operation immediately - prostate biopsy is the gold standard for diagnosing prostate cancer.

The puncture method can be transrectal or transperineal, usually under ultrasound guidance. Prostate puncture is required in the following situations:

① Nodules found during rectal examination

②PSA>10ng/ml or PSA between 4 and 10ng/ml and f/tPSA ratio less than 0.16

③B-ultrasound revealed hypoechoic nodules in the prostate

Doing a diffusion imaging MRI before surgery can help improve the positive rate of puncture. In the past, we could only puncture 8-12 needles, but now our hospital has mastered the saturation puncture method of more than 19 needles under the guidance of transrectal ultrasound: it has greatly improved the positive rate of prostate small tumor puncture and reduced the missed diagnosis rate to an extremely low level.

For prostate cancer that has lost the chance of radical cure, endocrine therapy, local radiotherapy or cryoablation therapy, chemotherapy and biological immunotherapy can be selected. Although the effect is better than other urinary tract tumors, the current 5-year survival rate is still only 48.8%, which means that more than half of the people may die within 5 years!

Early screening, early treatment and early surgery of prostate cancer are the key to cure. We should raise awareness of cancer prevention and fighting. There is no need to be afraid of cancer or worry about it, nor should we be careless and delay the treatment. We should believe in science, work together between doctors and patients, and defeat the disease!