Pay attention to male vital glands and actively deal with staying away from prostate cancer

Prostate cancer is one of the most common malignant tumors in elderly men. In China, the incidence rate of diseases is growing rapidly.

However, the symptoms of early prostate cancer are not obvious, and patients are often found accidentally during physical examination; When a patient seeks medical attention due to symptoms such as difficulty urinating (such as frequent urination, interruption of urination, inability to urinate), hematuria, and bone pain, the condition often progresses to an advanced stage, with bone and other site metastases that are difficult to cure through surgery or radiotherapy.

Studies have found that prostate cancer and its metastatic cells require androgen dependent growth. Therefore, endocrine therapy based on androgen removal and inhibition of androgen activity is one of the main treatments for advanced prostate cancer.

1. "Number" Reading Prostate Cancer

"The second largest malignant tumor in men": Prostate cancer is the second largest malignant tumor in men worldwide. With the westernization of lifestyle, the aging of population and the popularization of early screening for prostate cancer, the incidence rate of prostate cancer has risen sharply in China, and now it has ranked first in the incidence rate of male urinary system tumors.

"The incidence rate of men over 60 is high": prostate cancer tends to occur in elderly men over 60. 1 The incidence rate increases with age, and the older the age, the higher the incidence rate. Among prostate cancer patients, about 1/3 of them have cardiovascular and cerebrovascular diseases, and 20% of them have diabetes, which brings many difficulties to follow-up treatment. 2.

"Nearly 60% of patients are in advanced stage": Prostate cancer is known as the "silent killer". In the early stage of the disease, there are usually no symptoms. When patients develop symptoms such as bloody urine, painful urine, and bone pain, prostate cancer has progressed to advanced stage. The proportion of patients with advanced prostate cancer in China is far higher than in Europe and the United States, with nearly 60% of patients already in advanced prostate cancer.

2. Prostate cancer is closely related to androgens

Androgen is the "nourishment" of prostate cancer

Prostate cancer is a hormone dependent tumor, whose occurrence and development are closely related to androgens. Cancer cells grow, metabolize, and maintain survival under the action of androgens. The vast majority of male androgens are synthesized by the testis, while the remaining androgens are mainly synthesized by the adrenal gland. At the same time, prostate cancer cells also synthesize a certain amount of androgens for their own use.

Studies have shown that further reductions in androgen levels can further prolong the survival period of patients. Therefore, endocrine therapy can inhibit the progression of prostate cancer by blocking androgen synthesis through castration (surgery or drugs).

According to the size of the tumor, the location of invasion, and whether there is metastasis, prostate cancer can be staged from stage I to stage IV.

The tumor is localized in the prostate.

The tumor grows further but does not exceed the prostate gland.

The tumor breaks through the prostate and may have invaded the seminal vesicle but not spread to the lymph nodes.

The tumor may have invaded the bladder, rectum, or nearby tissue. And may have spread to lymph nodes, bones, or other parts of the body; Patients may be metastatic, trend resistant, or both.

Prostate cancer that "tenaciously grows" at low androgen levels

Androgen deprivation therapy (ADT) did not block all androgen production pathways. After approximately 18 to 24 months, the condition progressed to castrated resistant prostate cancer (CRP C). 4 In patients, the serum testosterone level was less than 50 ng/dl or less than 1.7 nmol/L, and 2) PSA levels rose three consecutive times a week, increasing by more than 50% from the lowest value, indicating that the tumor remained "tenacious growth" at low androgen levels.

It is worth noting that patients with metastatic castration resistant prostate cancer (mCRP C) suffer from symptoms such as pain and sleep disorders, and their survival period is usually less than 2 years.

3. Early Detection of Prostate Cancer: Three Points

A Have symptoms before seeing a doctor? too late! Adhere to standardized physical examination and PSA examination, and early detection of prostate cancer is not difficult. To diagnose prostate cancer, ultrasound and puncture should be performed

In summary, standardized physical examination is crucial for detecting early prostate cancer. Therefore, it is recommended that men over the age of 60 or with a family history undergo PSA screening every year for physical examination to detect the potential risk of prostate cancer as early as possible.

Prostate cancer affects all aspects of patients' lives

The early symptoms are not obvious: 90% of early prostate cancer is limited to the prostate gland 5, which does not affect urethral function and has no significant impact on patients' lives.

Difficulty in urination: Prostate cancer is progressing further, causing various urinary tract symptoms such as difficulty in urination, nocturnal urination, painful urination, hematuria, and many other urination problems to bring many inconvenience, even pain, to patients' daily lives.

Difficulty in movement, severe pain.

Bone metastases from prostate cancer can lead to bone pain and pathological fractures, with a pain index of 8 to 10 (equivalent to female labor pain), making it difficult for patients to move or even stay in bed for a long time.

Systemic asthenia: After prostate cancer metastasis, it may also cause various discomfort such as impotence, fatigue, decreased appetite, and especially symptoms of systemic fatigue, which seriously affect the daily activities of patients.

Paralysis, incontinence: If cancer metastasizes to the spinal column and compresses the nerves, it is likely to cause weakness and numbness in the lower limbs, loss of control of the bladder and intestines, leading to paralysis, incontinence.

Depression: Due to the long course of advanced prostate cancer, patients often experience depression, insomnia, and depression, which further degrade the overall quality of life of patients.

Therefore, prostate cancer requires early diagnosis and treatment, with an early cure rate of up to 95%. If the patient enters an advanced stage of illness, it is necessary for the doctor to choose appropriate treatment methods and actively deal with severe symptoms of pain, fatigue, sleep disorders, and other diseases. With the continuous improvement of treatment concepts, the treatment goals for advanced prostate cancer are no longer limited to extending the survival time of patients, but also need to focus on reducing the symptoms of patients and improving their quality of life.

5. Multiple means for treatment. Quality and quantity guaranteed!

Observation+monitoring: Although the incidence rate of prostate cancer is high, its progress is slow, and only a few are directly life-threatening. Therefore, considering multiple factors such as the risk of disease, the patient's own health level, and willingness to undergo surgery, prostate cancer can also be temporarily observed and monitored at regular hospital visits

Surgical treatment; Radiotherapy; Chemotherapy; Endocrine therapy.

Through comprehensive evaluation of tumor staging and their own health status, patients with prostate cancer can choose radical prostatectomy for treatment, which is one of the most effective methods to cure localized prostate cancer.

External radiation therapy is also one of the radical treatments for prostate cancer, which can achieve similar effects to surgical treatment. In addition, radioactive particle implantation (brachytherapy) is also a promising method for the radical treatment of localized prostate cancer, especially for elderly patients who cannot undergo surgery.

Chemotherapy is one of the treatment methods for castrated resistant prostate cancer (CRP C). These patients still need endocrine therapy to maintain low testosterone levels in the body, chemotherapy to improve symptoms and prolong survival, and the use of bisphosphonates for bone metastases to prevent bone related events.

Endocrine therapy is the main treatment method for patients with advanced prostate cancer. Through medication or surgical castration, it can block androgen synthesis and reduce androgen levels. However, traditional endocrine therapy, such as androgen deprivation therapy (ADT), cannot completely block androgen synthesis, and the condition can further develop into castrated resistant prostate cancer (CRP C), or even metastasize to other organs other than the prostate, becoming metastatic castrated resistant anterior prostate cancer (mCRP C).

The Chinese Guidelines for the Diagnosis and Treatment of Urological Diseases (2014 Edition) for the Diagnosis and Treatment of Prostate Cancer points out that the new androgen biosynthetic enzyme inhibitor, Abiterone Acetate, has added new drugs and treatment methods to endocrine therapy. "By inhibiting the key enzyme CYP17 in the androgen synthesis pathway, abiolone acetate tablets inhibit androgen synthesis in testicular, adrenal, and prostate cancer cells themselves, minimizing androgen levels in the body and even in tumor cells.". Currently, abiolone acetate has also been recommended by foreign treatment guidelines, including the American Association of Urology (AUA), the European Association of Urology (EAU), and the National Comprehensive Cancer Network (NCCN) of the United States.

6 Daily care

·In addition to active treatment, prostate cancer patients should also adjust their lifestyle and maintain a pleasant mood:

·Exercise appropriately to enhance resistance

·Develop good dietary habits and take multiple vitamins and dietary fiber

·Join the hospital patient club, actively communicate with doctors and other patient friends, and encourage each other

·Cultivate interests and divert attention

·Reasonable venting and obtaining support from family and friends

·Alcohol restriction and smoking cessation