It is often said that men are very hard-working, working hard outside to worry about their careers, and taking care of their wives and children at home.
Even on physiological data, men's suffering is well documented. According to the World Health Organization's list of life expectancy by country published in May 2016, women in the top 20 countries have a life expectancy of 3 to 6 years higher than men [1].
World Health Organization's 2015 list of life expectancy by country Image source: Wikipedia
In addition, men's health often lights up red lights, enduring some inexplicable unspeakable secrets. Since October is Pink Ribbon Month, the world pays attention to women's breast health and prevents breast cancer. Then, in November, there should also be a healthy month for men - Movember.
Don't think it's a misspelling, the new term is a combination of "Mustache" (beard) and "November" (November) to represent a global "beard" charity event every November to raise awareness of men's health and raise funds to fight men's worst enemy, prostate cancer.
"Stop men dying too young" Image source: Global Prostate Cancer Foundation official website
Why are there more and more people with prostate cancer? Who is prone to prostate cancer? Today, we will talk about the "number one killer" of this elderly male who has been lurking in the body of men for a long time.
1. 60% of prostate cancer patients in China are found to have advanced stages and spend at least 400 to 1 million yuan
"The biggest problem with prostate cancer is that we discovered it too late!"
Wang Zhihua, deputy chief physician of the Department of Urology of Tongji Hospital affiliated to Tongji Medical College of Huazhong University of Science and Technology, pointed out the current situation of prostate cancer patients in mainland China.
In fact, prostate cancer is common in Western countries, and in Northern Europe and the United States, lung cancer has surpassed the first malignancy to occur. The American Cancer Society estimates that nearly 200,000 new prostate cancers were added to the United States in 2009, nearly 30,000 deaths, an average of 1 diagnosis every 3 minutes, and 1 in 9 U.S. men [2].
What is even more frightening is that many elderly men, although they already have cancer cells in the prostate, are difficult to detect. According to one survey, 50% of older men aged 70 to 79 have cancer cells in the prostate, compared with 67% of 80- to 89-year-old men, which could threaten the lives of patients at any time [2].
On the mainland, prostate cancer has become the most rapidly growing malignancy. In 2015, there were about 60,300 new cases of prostate cancer in mainland China and about 26,600 deaths [3]. Compared with rural areas, the growth trend of prostate cancer in large cities is particularly obvious. For example, the incidence of prostate cancer in Beijing has risen from 5.53/100,000 in 2001 to 16.62/100,000 in 2010, an increase of more than three times [4].
However, it is worth mentioning that unlike European and American countries, prostate cancer patients in mainland China are often diagnosed at an advanced stage.
According to the Expert Consensus on Prostate Cancer Screening released by the Chinese Anti-Cancer Association in 2017, nearly 81% of new prostate cancer cases diagnosed in the United States are clinically localized prostate cancer, with a five-year survival rate of nearly 90%[5], while only 30% of new cases in mainland China are clinically localized patients, and the rest are locally advanced or extensive metastases, and these patients cannot receive local radical treatment and have poor treatment effects [6].
Wang Zhihua explained that this is because most of the early prostate cancer has no obvious symptoms, even if the tumor grows to a certain volume of compression of the urethra, it only causes some non-specific manifestations similar to prostatic hyperplasia such as poor urination, frequent urination and urgency, resulting in most of the newly diagnosed prostate cancer patients in mainland China have reached the middle and advanced stages.
"At present, the situation of prostate cancer in mainland China is that 60% of patients who come to the hospital for treatment are in advanced stages (5% in the United States and developed countries in Europe), have lost the opportunity for radical treatment, and need lifelong endocrine therapy-based comprehensive treatment (costing about 80,000 to 100,000 per year)." Zhou Fangjian, director of the Department of Urology at Sun Yat-sen University Cancer Hospital, once said that according to the general survival time of advanced prostate cancer of 5 to 10 years, the total medical cost of each patient is at least 400,000 to 1 million, while only 40% of prostate cancer patients belong to the early stage and can be treated radically [7].
2. Prostate cancer specifically picks four types of people to start with one of them!
The average annual incidence rate increases by 12%, why is the number of prostate cancer patients in China increasing?
This has to start with the high risk factors for prostate cancer.
age
This is the biggest risk factor for prostate cancer, and men over the age of 50 have a significantly higher risk of prostate cancer than men under 50. The older a patient with prostate cancer is when diagnosed, the less aggressive the prostate cancer usually becomes.
Image source: Stand Cool Helo
heredity
If there is a prostate cancer patient among family members, the risk of prostate cancer is higher. If one of your immediate family members (father/son or brother) has been diagnosed with prostate cancer, your risk will be 2 times higher than that of the average person, and if 2 to 3 immediate family members have been diagnosed with prostate cancer, the risk of this disease will be increased by 5 to 11 times. At present, several genetic genes have been identified that may increase the risk of prostate cancer, but it is estimated that hereditary prostate cancer accounts for only 5% to 10% of all prostate cancer cases. [2]
race
The risk of prostate cancer in black Americans is about 60% higher than that of white people, and the degree of malignancy is generally higher, but Asians and men living in Africa have a very low incidence of prostate cancer, and the incidence of prostate cancer increases sharply after immigrating to the United States, which also suggests that prostate cancer is not only related to race, but may also be related to environmental factors such as high-fat diet, excessive red meat intake and other factors.
diet
Studies have shown that a high-fat diet may be a risk factor for prostate cancer. Prostate cancer is more common in countries where meat and dairy are the staple diets than in countries where rice, soy products and vegetables are the basic diet.
Overall, the increase in the incidence of prostate cancer in mainland China is related to the aging of the population and the Westernization of lifestyles. For example, obesity due to a diet high in animal fat and lack of exercise is one of the important risk factors for prostate cancer.
Image source: Stand Cool Helo
Therefore, eating more fruits and vegetables, maintaining a balanced and healthy diet, and usually strengthening exercise are excellent for preventing prostate cancer!
3. There are three "magic weapons" for the arrest of prostate cancer, and the awareness of mainland PSA screening is too lacking!
As mentioned earlier, prostate cancer likes to be "latent" for a long time, clinically there can be no symptoms, it is difficult to find this "thief" based on personal subjective feelings, so how can it be detected at an early stage?
In fact, there are many ways to diagnose, but there are three main ones.
First, prostate-specific antigen (PSA) screening, the most sensitive marker of prostate cancer at present. PSA screening advances the diagnosis of prostate cancer by 5 to 8 years, and most patients are diagnosed with prostate cancer when the serum PSA concentration of general healthy men is 10 μg/L.
Image source: Stand Cool Helo
Secondly, there's the digital rectal examination (yes, yes, you know... This is the simplest commonly used method of diagnosing early prostate cancer.
The prostate is close to the front of the rectum, the normal rectal digital examination touches the prostate size of about 4cm * 3cm, the texture is soft, the surface is smooth, there is no nodular feeling, the two sides of the lobe are symmetrical, when suffering from prostate hyperplasia, the prostate volume is enlarged, but the texture is not very hard, and prostate cancer is very hard, like a stone block.
Finally, we also have a method of transctal ultrasound, which is a sophisticated "radar" of prostate cancer search, assisting doctors to determine tumor volume and clinical stage.
However, a few years ago, there was a debate about prostate cancer screening in China, which originated from a randomized controlled study in the United States and Europe, which concluded that PSA screening was insufficient, that patients had little benefit from survival, and that there was significant overdiagnosis and treatment [8][9][10].
Dr. Wang Zhihua introduced that after nearly 30 years of promotion and use, PSA screening for middle-aged and elderly men in Europe and the United States is mostly included in medical insurance, and has a full understanding of the early diagnosis of prostate cancer, and at this point, the domestic situation is very different, and the mainland is currently difficult to popularize PSA, "A PSA screening needs about 160 yuan, few units will take the initiative to join in the staff physical examination, and many patients have missed the diagnosis." ”
In 2017, domestic experts also reached a consensus on prostate cancer screening: men over 50 years old, older than 45 years old and have a family history of prostate cancer, and men older than 40 years old and a baseline PSA > 1 ng/ml should be tested for serum PSA as soon as possible, and should be tested every two years [11].
Overall, although prostate cancer is menacing, in fact, do not worry too much, it belongs to all malignant tumors in the type of treatment effect is better, the 5-year survival rate of localized prostate cancer patients is close to 100%, treatment also includes radical surgery, radiotherapy, chemotherapy, endocrine therapy and other means, but at the same time prostate cancer also has a certain heterogeneity, the degree of danger is very different, if it is delayed to the advanced stage, the immortals can not save you.
So, for the sake of your health, it's time to schedule a PSA test!
*The content of this article is a popularization of health knowledge and cannot be used as a specific diagnosis and treatment recommendation, nor is it a substitute for face-to-face consultation by a practicing physician, for reference only.
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