This type of cancer in men is often treated as inflammation

As men age, it is difficult to get rid of the troubles of chronic prostatitis and prostate hyperplasia. However, urologists point out that symptoms such as difficulty urinating, increased nocturia, and incomplete urination are not necessarily due to prostatitis and hyperplasia. Prostate cancer may also be hidden behind them.

Prostate cancer, known as the "most manly cancer", has seen a rapid increase in incidence in recent years. In Guangzhou, for example, the incidence has doubled in the past decade. Since the incidence of prostate hyperplasia is very high among elderly men in my country, the symptoms are easily confused with prostate cancer. In addition, prostate cancer develops slowly and is hidden in the early stages. If it is not checked, it is also difficult to be discovered in time, resulting in more than half of the patients being diagnosed at an advanced stage.

Experts call for men over 50 to undergo annual screening, which includes a blood test for prostate-specific antigen (PSA) and a digital rectal examination.

alert:

Prostatic hyperplasia can easily "cover" the traces of cancer

Prostate cancer is more common in men over 60 years old. "Twenty years ago, the incidence of prostate cancer was about 2-3 per 100,000. The statistics in 2008 were about 10 per 100,000. Last year, screenings in Beijing, Shanghai and Guangzhou showed that the incidence of prostate cancer was close to 20 per 100,000, and the incidence has increased rapidly." Professor Gao Xin, chairman of the Guangdong Urology Association and professor of urology at the Third Affiliated Hospital of Sun Yat-sen University, pointed out that the main reason for the rapid increase in the incidence of prostate cancer is the arrival of an aging society. Secondly, people have adopted a Western diet and consume excessive amounts of fat and red meat, especially grilled meat, which is also believed to be the cause of the increase in the incidence of prostate cancer.

The cure rate for early prostate cancer is very high, up to 90%. About 6% to 10% of patients will develop metastasis, and the 5-year survival rate for metastatic prostate cancer is less than 10%. Like many cancers, most prostate cancer patients in my country are already in the late stage when diagnosed.

"About half of the patients come to the hospital for symptoms such as difficulty urinating, but it is too late at this time, and many have metastases." Gao Xin said that the reason for this problem is that most of the general health examinations in my country do not include prostate cancer screening, and elderly men lack the awareness of doing "annual inspections" for the prostate, so they cannot be screened out early. On the other hand, it is related to the characteristics of prostate cancer. "Statistics show that 40% to 50% of men over 60 years old suffer from prostate hyperplasia, which rises to 50% when they are 70 to 80 years old. Among people over 80 years old, the proportion of prostate hyperplasia is 100%." ​​Gao Xin pointed out that early prostate cancer has no specific manifestations. Some patients will show difficulty urinating, which is very similar to the symptoms of prostate hyperplasia. If the patient himself has hyperplasia, it is equivalent to "covering" the cancer, often letting the patient relax his vigilance.

treatment:

Prostate cancer is not always a “lazy cancer”

As we all know, cancer can be divided into "good" and "bad". Some cancers, such as thyroid cancer, progress slowly, while others, such as lung cancer and liver cancer, grow very fast. Prostate cancer is generally mild, but not all of them are "lazy cancers". "'Good' prostate cancer is very lazy, also known as inert cancer, just like hibernating animals, and has not moved for many years. But 'bad' prostate cancer is more active in biological behavior and progresses very quickly." Gao Xin said that some patients will have tumor metastasis in half a year. Prostate cancer is a tumor that is sensitive to hormones, and the effect of endocrine therapy is better. For patients who are prone to metastasis, the tumor is not sensitive to hormones, and the effect of endocrine therapy is poor. Just like ordinary tumors, they are more likely to metastasize throughout the body.

Treatments for prostate cancer include active monitoring, surgical treatment, radiotherapy, endocrine therapy, immunotherapy, chemotherapy, and palliative treatment. Surgical treatment of prostate cancer refers to surgical removal of the prostate, which is the best way to cure cancer. Early prostate cancer has a chance to be cured by surgical removal of the prostate. Although surgical treatment has risks such as urinary incontinence, erectile dysfunction (ED), bleeding, and infection, these risks are controllable in most cases. Therefore, you should not be afraid to undergo surgery because of concerns about surgical risks. Gao Xin pointed out that in foreign countries, about a quarter of patients adopt active monitoring treatment plans. When PSA is less than 10 and the number of puncture needles is less than 2, active monitoring can be adopted instead of removing the tumor. If the patient is older and the cancer is well differentiated and not highly malignant, active monitoring can also be used. Gao Xin pointed out that for local high-risk patients with PSA greater than 20, more than 6 puncture needles, and tumors that have penetrated the prostate but have not metastasized to distant sites, surgical resection was generally not performed in the past, but conservative radiotherapy and endocrine therapy were used.

Relapse prevention:

PSA should be checked every month after surgery.

The most classic screening method for prostate cancer is the prostate digital rectal examination combined with the serum PSA (prostate specific antigen) test. Gao Xin emphasized that both tests play an important role in screening, and any abnormality in either test requires further examination. Most prostate cancer patients are discovered by abnormally elevated PSA, and about 25% are discovered by abnormal digital rectal examination.

Qiu Jianguang pointed out that PSA is not only an indicator for prostate cancer screening, but also a predictive indicator for the effectiveness of prostate cancer treatment. Prostate cancer patients should have their PSA checked every month after surgery for monitoring. Six weeks after radical prostatectomy, if PSA can still be detected in the body and the value is still elevated, it means that there are residual prostate cancer lesions in the body and PSA is still being produced. After surgery, if the serum PSA level exceeds 0.2ng/ml for two consecutive times, it indicates biochemical recurrence of prostate cancer. If serum PSA rises slowly, it indicates that the tumor is likely to have a local recurrence. If the serum PSA value rises rapidly, it also means that the tumor may have metastasized to distant sites.

However, PSA often reveals "false information". Prostatitis, sexual intercourse, local massage and even riding a bike can also cause PSA to rise. "Not all lesions of prostate cancer can be found in imaging examinations. The PSA index of some early tumors is not high. By the time the PSA value increases, the disease may have progressed to the second stage." Qiu Jianguang said that in recent years, with the progress of research, fusion gene detection has also been introduced into the screening of prostate cancer. When PSA is found to be elevated, or when PSA values ​​are not elevated and nodules have been found in prostate rectal examination, or when imaging examinations such as ultrasound, CT, and MR suspect prostate tumors, patients need to undergo a prostate puncture biopsy. Once cancer is found in the biopsy, the pathological wax block can be used to detect the fusion gene, and the treatment effect can be predicted based on the test results to tailor a personalized treatment plan.

Screening:

Four types of men should have an "annual check-up" early

Gao Xin emphasized that men over 50 should have a blood test for serum PSA combined with a digital prostate examination every year. People at high risk of prostate cancer should start regular screening earlier, including men with a family history of prostate cancer, i.e., fathers, uncles or brothers who have had prostate cancer, those who are often exposed to carcinogens such as nitrosamines, lead, X-rays, ultraviolet rays, those who have prostate hyperplasia with severe symptoms, and those who have long-term uncoordinated sexual life.

Compared with blood test for PSA, many people are more reluctant to do rectal examination, thinking it is painful. In fact, for a skilled doctor, rectal examination only takes a few minutes and the patient does not feel much pain.

To prevent prostate cancer, you should eat less red meat, avoid high-fat diets, eat more foods rich in dietary fiber, supplement with foods rich in antioxidants such as vitamin E, selenium, lycopene, exercise regularly, ensure adequate sleep time, and often relieve psychological stress.

There are some foods that are said to be “prostate protectors” circulating in the market. Are they reliable?

"Tomatoes and other foods rich in lycopene can indeed protect prostate tissue." Gao Xin pointed out that studies have shown that lycopene has significant effects on preventing prostate cancer, colon cancer, and rectal cancer. However, lycopene is a fat-soluble nutrient, so eating tomatoes raw is useless and it is best to cook them.

Soy products are not only rich in protein, which can enhance resistance and immunity, but also contain an antioxidant called trihydroxyisoflavonoids, which has anti-cancer properties. Broccoli, radish and other cruciferous vegetables and walnuts can also help inhibit the growth and spread of prostate cancer cells.

Maybe you are also troubled by urinary urgency, frequent urination, and waiting to urinate, but you really should pay attention. Maybe it is just inflammation, but it is best to check it carefully to rule out cancer in time. You know, if it is found to be cancer at the first time, then the possibility of cure will be much greater.