1.What is prostate cancer?
Prostate cancer is a malignant tumor occurring in the male prostate tissue, which is the result of abnormal and disorderly growth of prostate alveolar cells. It is one of the most common malignant tumors in men in developed countries and regions such as Europe and the United States, and has been increasing year by year in China in recent years.
2.What are the causes and risk factors of prostate cancer?
The exact cause of prostate cancer is still unclear and may be the result of a combination of genetic and environmental factors. Its risk factors are
① Age. The risk of prostate cancer in men aged 50-59 years is 10%, while the risk of prostate cancer in men aged 80-90 years can increase to 70%.
②Androgen level. High androgen level in the body is also one of the possible causes of prostate cancer. Androgens can promote the growth of prostate cancer.
(iii) Family history. When there is an immediate male relative in the family who has prostate cancer, the incidence of the disease is significantly higher in men in that family.
④ Ethnicity. The incidence of prostate cancer is highest in African Americans (i.e., black Americans).
⑤ Diet. High calorie and high animal fat intake, etc.
⑥Other. For example, long-term exposure to chemical substances such as cadmium, change in diet and other lifestyle habits, etc.
3.How to detect prostate cancer in time?
Prostate cancer is often asymptomatic in the early stage and is often detected by chance during rectal examination, ultrasound or prostate enlargement surgery. Therefore, it is usually believed that men should start prostate cancer screening at the age of 50. If there is a family history of prostate cancer, screening should begin at age 40. It is now accepted that the easiest way to screen for prostate cancer is to combine a rectal examination of the prostate with a serum PSA test, both of which play an important role in screening. The vast majority of prostate cancers are detected by PSA abnormalities, while nodal abnormalities are found on rectal exam in 20% of cases. The frequency of prostate cancer screening should ideally be once a year. If progressive elevation in PSA levels and/or abnormalities on rectal exam are found during screening, further testing is needed. Through prostate cancer screening, the incidence of prostate cancer-related complications and prostate cancer mortality can be reduced, which can effectively improve the survival rate.
4.What should the doctor inform during the prostate puncture diagnosis?
(1) When is a prostate puncture biopsy necessary?
Systematic puncture biopsy of the prostate is the most reliable test to diagnose prostate cancer. Prostate puncture is an invasive test and its indications are
① Rectal examination reveals a nodule and any PSA value.
(ii) Ultrasound finding of hypoechoic nodules in the prostate and/or MRI finding of abnormal signal, any PSA value.
③PSA >10ng/ml, any f/tPSA and PSAD values.
(iv) PSA 4 to 10 ng/ml, abnormal f/tPSA or abnormal PSAD values. (Note: f/tPSA – ratio of free prostate-specific antigen to total prostate-specific antigen; PSAD – prostate-specific antigen density, which is the ratio of serum prostate-specific antigen to the whole prostate volume)
(2) What are the risks of prostate puncture?
① Bleeding: including rectal bleeding, hematuria, hematochezia, hematospermia, etc. In severe cases, blood transfusion or endoscopic hemostasis is required.
②Infection: including fever, urinary tract infection, tissue infection (prostatitis or abscess), and in severe cases, sepsis.
(iii) Pain: rectal and perineal pain after puncture, painful urination and defecation.
(iv) Urinary symptoms: urinary frequency, urgency, painful urination, difficulty in urination and urinary retention.
⑤ vasovagal reaction: bradycardia, sweating, dizziness, convulsions and loss of consciousness in severe cases.
(vi) Cardiopulmonary and cerebrovascular accidents during and after puncture.
(7) Pathological examination after puncture is still unable to make a clear diagnosis, requiring repeat puncture or other examinations. Patients understand the risks and cooperate with the doctor for timely treatment in order to minimize the risks.
(3) What do I need to pay attention to when I have a prostate puncture?
① Discontinue anticoagulants such as aspirin for 1 week before performing the puncture biopsy.
(ii) Enemas are usually required to cleanse the bowel before puncture and prophylactic antibiotics are required, and oral antibiotics are required for 3 to 5 days after puncture.
③Prostate puncture usually does not require hospitalization, and you can go home after 20 minutes of puncture without any special discomfort.
④If repeat puncture is needed, it is recommended that the interval should not be less than 3 months.
(4) What is the meaning of Gleason score in pathology results?
Gleason score is expressed as A+B. A refers to the most common form of cancer growth in the tissue sent for examination, and B refers to the next most common histologic grade, if the cancer has only one uniform form of histologic growth, the A and B scores are the same. 10, the worst prognosis.
5.What is penile rehabilitation after radical prostate cancer surgery?
Erectile dysfunction is the most common complication after radical prostate cancer surgery and is an important issue that affects the quality of life of patients. Therefore, clinicians will make a reasonable assessment of the prostate cancer patient’s age, preoperative sexual function, the extent of intraoperative nerve preservation and pathological stage. Penile rehabilitation should be emphasized after radical prostate cancer surgery, with the aim of preserving penile smooth muscle, protecting vascular endothelial function and promoting cavernous nerve recovery. Specific methods are: oral drug therapy (phosphodiesterase inhibitor), intraurethral drug drip, intracavernosal drug injection, vacuum negative pressure device or penile prosthesis implantation, etc.
6.How can prostate cancer be prevented?
Certain dietary factors can increase the risk of developing prostate cancer, such as a high-fat diet. Conversely, fruits, vegetables and a low-fat diet may help reduce the risk of prostate cancer. These healthy foods include soy (tofu and soy milk), tomatoes, pomegranates, green tea, red grapes, strawberries, blueberries, peas, watermelon, rosemary, garlic and citrus. Recent studies have found that crimson pomegranate juice also has an anti-prostate cancer effect. In addition, green tea may also be a preventive factor for prostate cancer.