Prostate Cancer Q&A
1.What is prostate cancer?
Prostate cancer is 98% adenocarcinoma, which originates from glandular epithelial cells. The structure of prostate gland is divided into peripheral zone, migratory zone and central zone. The prostate gland is like an orange cut into round slices, the orange peel part is equivalent to the peripheral zone, the orange core part is equivalent to the migratory zone and the central zone, the urethra runs through it, prostate cancer most often occurs in the peripheral zone. Due to the insidious location of the prostate, patients with early stage prostate cancer often have no or insignificant symptoms and the disease progresses slowly, but patients with advanced disease progresses faster and mainly present with symptoms of lower urinary tract obstruction or even seek medical attention with metastatic symptoms such as bone pain. The occurrence of prostate cancer may be related to race, genetics, environment, food, smoking, obesity and sex hormones.
2.Who is prone to prostate cancer?
Most people who develop prostate cancer are over 65 years old, with a high incidence at 70-74 years old, while a few patients are screened by the serum prostate-specific antigen (PSA) program during physical exams for men under 50 years old, and many for men over 80 years old. The risk of prostate cancer is twice as high in immediate family members who have prostate cancer as in others; if two have prostate cancer, the risk of prostate cancer is even higher in the individual and is more likely to develop at an early age, with the age of diagnosis being 6 to 7 years earlier than in the general population. In addition, a diet high in animal fat is a more definite risk factor, and patients tend to consume more animal fat for a long time.
3.What are the signs and symptoms of prostate cancer?
Although prostate cancer is insidious in its onset, you can still detect some “clues” as long as you are a careful person.
1. Early prostate cancer may not have any warning symptoms, but only elevated PSA or abnormal rectal examination of the prostate gland is detected during physical examination. 2. Urinary disorders may appear, such as frequent urination, urgent urination, incomplete urination or even urinary retention or incontinence. These symptoms of dyspareunia are similar to prostate enlargement and can be easily misdiagnosed. 3. Lack of energy, weight loss and generalized pain may be advanced progressive prostate cancer. 4. Bone pain, fracture or paralysis may be prostate cancer that has metastasized to bone. 5. Swelling in the legs may occur due to lymph node metastasis, lymph node enlargement and compression, which leads to impaired blood circulation in the lower extremities.
4. How to detect prostate cancer early?
Rectal finger examination with PSA is currently recognized as a simple and convenient primary screening method for early detection of prostate cancer. It is recommended that men over the age of 50 should undergo routine rectal examinations and PSA every year. However, if you have a family history of prostate cancer, you should have an annual screening test earlier, starting at age 45. The following tests can be performed when prostate cancer is suspected.
(1) Prostate-specific antigen test (PSA).
(2) rectal finger examination (DRE).
(3) Transrectal ultrasonography (TRUS);
(4) Ultrasound-guided prostate puncture biopsy.
5.When do I need to have PSA examination?
The Chinese Guidelines for the Diagnosis and Treatment of Urological Diseases recommend that
(1) Men over 50 years of age should undergo routine PSA testing and rectal examination annually.
(2) For men with a family history of prostate cancer, annual screening should be performed starting at age 45.
(3) For men with abnormal rectal examination and clinical signs (e.g., bone pain, fracture), PSA testing should be performed.
(4) Retesting is recommended for those with initial PSA abnormalities.
(5) Reminder: PSA examination should be performed 1 week after prostate massage, 48 hours after cystoscopy, catheterization operation, 24 hours after ejaculation, and 1 month after prostate puncture. Also should be free of prostatitis, urinary retention and other diseases.
6.What should I pay attention to in my life to prevent and treat prostate cancer?
(1) A reasonable diet, so that food diversification, pay attention to more plant-based food, daily food cereals, vegetables, fruits, beans should account for more than 2/3, the main food coarse and fine grains with a combination of meat and vegetables. The consumption of tomatoes, tomato products, and soy products (low-fat soy milk, tofu, soy protein powder, etc.) can reduce the risk of prostate cancer.
(2) A diet high in protein, mainly fish, and intake of beneficial fatty acids, avoiding as much as possible the intake of high animal fat.
(3) Drinking more green tea is beneficial.
(4) Quit smoking and limit alcohol.
(5) Maintain an appropriate weight, adhere to appropriate activities, and have a positive attitude.
(6) Appropriate amount of calcium and vitamin D to prevent osteoporosis.
7. Is there any relationship between prostate cancer, prostate hyperplasia and prostatitis?
Although prostate cancer, prostate hyperplasia and prostatitis are diseases of the prostate gland, they are three completely different diseases and are not necessarily related to each other. The majority of prostate cancer and prostate hyperplasia occur in men over 50 years of age, and the symptoms can be distinguished whether they are mild or severe, while prostatitis occurs mainly in young and middle-aged men, and the symptoms are not the same as cancer or hyperplasia. The main site of prostate cancer is in the peripheral zone of the prostate, which is a malignant lesion of the glandular cells; the site of prostate hyperplasia is in the migratory and central zone of the prostate, which is mainly an interstitial hyperplasia of the prostate, while prostatitis is an infection of the reproductive system, not a separate disease, but a prostatitis syndrome. The difference between the two is also evidenced by the fact that prostate cancer can still develop after surgery for prostate hyperplasia clinically. Therefore, there is no evidence-based medical basis for whether there is a correlation between prostate cancer and hyperplasia and inflammation.