The incidence of prostate cancer ranks second in the world's male malignant tumors, and even ranks first in some developed countries in Europe and the United States that endanger men's health. Although the incidence of prostate cancer in Asia is much lower than in Europe and the United States, it has also shown an upward trend in recent years.
Multiple studies have shown that after radical treatment, the 10-year survival rate of early prostate cancer can be as high as more than 85%. But early prostate cancer usually has no obvious clinical symptoms.
How can I detect and treat it early? Experts recommend that men over the age of 50 or men over the age of 45 with a family history of prostate cancer increase prostate-specific antigen (PSA) screening for annual physical examinations. Once prostate cancer-specific antigen abnormalities are detected, even if there are no symptoms of urination discomfort, it should not be careless, and a professional doctor should be consulted as soon as possible to further check whether there is a potential prostate cancer risk.
Cases
Received treatment for focal areas of prostate cancer
He was discharged from the hospital the next day after surgery
Jiang Bo (pseudonym), 75, attended a free community prostate cancer screening led by the Department of Urology of the First Hospital of Guangdong Medical University a few months ago, and doctors found that his prostate-specific antigen (PSA) was 5.63 ng/ml (ng/ml). Normal reference values for PSA are: 0 to 4.0 ng/ml, and greater than 4.0 ng/mL suggests the presence of prostate cancer. Although Jiang Bo found PSA abnormalities, there were no abnormal symptoms of urination. After 3 months of re-examination, the Results of Jiangbo PSA were still abnormal, and the indicators were further increased to 6.58 ng/ml.
GuDi, deputy director of the Department of Urology of the First Hospital of Guangdong Medical College, suggested that after he underwent prostate MRI and puncture examination, the result was diagnosed with prostate acinar carcinoma, and the pathological score Gleason was 3 + 4 = 7 points.
"Due to the timely discovery, the tumor is still in the early stages, combined with Jiang Bo's age and pathological stage, our team decided to use irreversible electroporation technology to treat him with prostate cancer focal points after detailed discussion." Goody introduced.
The urology expert team of the First Hospital of Guangdong Medical College is in surgery.
Faced with an unknown operation, Jiang Bo and his family are very worried. Unexpectedly, on the day of the operation, the urology team of the First Hospital of Guangdong Medical College took only more than 30 minutes to successfully complete the treatment of prostate cancer focal points for Jiang Bo. After the operation, Jiang Bo only retained one urinary catheter, and after 4 hours, he resumed his diet and was able to get out of bed and move, and he was successfully discharged from the hospital on the 2nd day.
After being discharged from the hospital, Jiang Bo returned to the hospital for follow-up, and all relevant indicators returned to normal and his physical condition was good.
remind
Prostate cancer is asymptomatic in the early stage, and PSA is abnormal
"Many male patients have a misunderstanding that there must be no prostate problem without urinating symptoms. In fact, for patients with elevated prostate-specific antigens (PSAs), even if there are no symptoms of discomfort with urination, they need to pay attention. Professor Zeng Guohua, vice president of the First Affiliated Hospital of Guangzhou Medical University and leader of the department of urology, explained that because early prostate cancer usually has no obvious clinical symptoms. Of course, a significant increase in PSA does not necessarily mean that it is prostate cancer, it may also be affected by other factors, such as prostatitis, benign prostatic hyperplasia can cause it to rise, but these latter two conditions are often accompanied by symptoms of urination, prostatic hyperplasia common urinary frequency, urgency, increased nocturia (2 times and more) and other symptoms, prostatitis common painful urination and even pelvic area pain or discomfort and other symptoms, but prostate tumors are often no symptoms in the early stage. Therefore, it is even more careless when the PSA test results are elevated and there are no symptoms of urination.
In addition, in contrast, the clinical elevation of PSA in patients with prostate cancer is more pronounced and persistently elevated. Jiang Bo is a typical example, after the first detection of PSA abnormalities, every three months the review indicators not only did not drop, but also further increased. Therefore, even if there are no symptoms, it is still necessary to consult a professional doctor to consider whether it is necessary to do a prostate MRI or even a prostate puncture biopsy to further investigate the cause.
judgement
How "inert" is prostate cancer? Grading assessments give answers
Clinically, some patients are very anxious when they find prostate cancer, afraid of surgery and other treatments; some patients will find information on the Internet to "strengthen their guts", thinking that prostate cancer progresses slowly, is "inert cancer", the mortality rate is not high, do not have to pay attention.
"Neither of these extremes is advisable." Professor Liu Yongda, director of the Department of Urology of the First Hospital of Guangdong Medical College, said that at present, the treatment of prostate cancer is increasingly emphasizing individualization, and doctors will optimize the treatment plan according to the patient's pathological grade and personal physical tolerance.
The most widely used grading method for prostate adenocarcinoma in the world is the Gleason scoring system.
"Simply put, it is divided into five levels according to the degree of danger from low to high." Goody added that according to the Gleason scoring system, the higher the score, the greater the danger. The first degree is the best, the so-called "indolent carcinoma", which may not metastasize for life, so this part of the patient may not die of prostate cancer, but may still progress to the second or third grade. Patients with Gleason scores of grades four and five can develop bone metastases without active intervention, resulting in poor quality of life in advanced stages and most likely dying of prostate cancer.
"The key is to screen early and diagnose early, so that we can assess whether it is 'inert' or easy to progress and high risk based on the results, and develop an appropriate treatment plan accordingly." Goody said.
treat
There are more and more means, more and more precise and minimally invasive
Found prostate cancer, many patients and families will be very anxious, can not do surgery? If surgery is necessary, will the trauma be significant? Leave the urinary catheter after surgery, do not know how many days to lie in the hospital bed? Will the recovery process be lengthy and will there be complications?
"In fact, with the advancement of medical technology, there are more and more ways to treat prostate cancer, and the trauma can be made smaller." Goody analyzed that for the elderly, if the assessment results are very low-risk or low-risk prostate cancer, active monitoring can be done without surgery. Many patients' lesions can be found at a very limited time, and in the early stages, medium and low-risk, they can consult a professional doctor to determine whether it is suitable for "focal treatment".
"This treatment does not require the entire prostate to be removed, and the local lesions can be accurately eliminated." Liu Yongda said that the development direction of surgical surgery is also becoming more and more minimally invasive. Like the irreversible electroporation ablation focal treatment received by Jiang Bo, it is mainly a kind of "micro-trauma" treatment for early prostate cancer, which uses the voltage difference to induce irreversible electroporation of tumor cells and apoptosis, while stimulating the body's immune system. Compared with other focal treatments such as radiation irradiation, cryotherapy, and physical ablation, the use of irreversible electroporation techniques is less invasive, safer, and less complications, and provides more accurate protective and urinary control functions.
"However, for prostate cancer patients with high-risk and locally significant progression, relatively aggressive treatment should be taken and radical surgery considered." Zeng Guohua said. However, with the advancement of technology, robot-assisted laparoscopic radical prostate cancer resection has gradually become the mainstream surgical method, and patients no longer have to bear the pain and risks caused by traditional surgical large incisions. At present, the Urology Department of the First Hospital of Guangdong Medical University has been able to carry out more difficult single-hole robot surgery, and patients with good physical conditions can be discharged from the hospital the next day after surgery. Of course, follow-up and comprehensive treatment under the guidance of a professional doctor must also be adhered to in order to achieve better results.
suggestion
Men over the age of 50 do this screening annually
"Early screening, early diagnosis, and early treatment are effective ways to improve the 5-year survival rate of tumor patients." Coping with male-specific prostate cancer is the same, Goody said, not delaying until there are obvious symptoms and missing the opportunity for early treatment to intervene, which is often more difficult.
Goody suggests that men over the age of 50 or men over the age of 45 with a family history should increase prostate-specific antigen (PSA) screening by drawing blood each year, and if abnormalities are found, they should consult a professional doctor in time for further investigation. In addition to regular screening, male friends should also develop good living habits every day, quit smoking and limit alcohol, eat less high animal fat diet, avoid long-term sedentary, etc., and also help protect the prostate.
According to reports, since April 2019, the Department of Urology of the First Affiliated Hospital of Guangzhou Medical University has cooperated with the China Prostate Cancer Alliance to explore the public welfare screening of prostate cancer in the mode of hospital and community linkage under the cooperation of 35 community health service centers in Yuexiu District, Haizhu District and Liwan District of Guangzhou. At present, the project has screened more than 40,000 cases, found nearly 200 cases of early prostate cancer patients, and the prognosis is good after the timely radical prostatection surgery for prostate cancer.
Expert Profiles
Zeng Guohua
Second-level professor, chief physician, doctoral supervisor
Vice President of the First Affiliated Hospital of Guangzhou Medical University, Director of the Minimally Invasive Surgery Center, Leader of The Department of Urology, Director of the Key Laboratory of Urology of Guangdong Province, Member of the Standing Committee of the Urology Branch of the Chinese Medical Association, Vice President of the Urology Branch of the Chinese Medical Doctor Association, especially good at minimally invasive treatment of urological stones and etiology research, and is the inventor of super-mini-PCNL (SMP) technology.
Visiting hours: Monday afternoon in the Haiyin Branch of the First Hospital of Guangdong Medical College
Liu Yongda
Executive Director of Urology, Professor, Chief Physician, Doctor of Medicine, Doctoral Supervisor, Specialty of Minimally Invasive and Comprehensive Treatment of Urological Tumors, Transurethral Prostate Removal, Joint Localization Multichannel Percutaneous Nephrolithotomy and Urinary Laparoscopic Surgery.
Visiting time: Wednesday afternoon in the Haiyin Branch of the First Hospital of Guangdong Medical College
Goody
Doctor of Medicine, Chief Physician, Master Supervisor, Deputy Director of Urology Administration, Registered Physician of the Royal Society of Medicine, good at diagnosis and treatment of urological tumors and robotic surgery.
Visiting hours: Friday morning in the Haiyin Branch of the First Hospital of Guangdong Medical College, wednesday morning in the Yanjiang Branch
Text, photo/Guangzhou Daily, Xinhua city Reporter: Weng Shuxian Correspondents: Ru Zhina, Han Wenqing
Guangzhou Daily Xinhuacheng Editor: Li Jin