The incidence of prostate cancer in China has increased dramatically in the last decade, with large cities being the “hardest hit” areas:
- The incidence of prostate cancer in Beijing rose from 5.53 per 100,000 in 2001 to 16.62 per 100,000 in 2010;
- The incidence of prostate cancer in Tianjin increased approximately fourfold over a 20-year period;
- The incidence of prostate cancer in Guangzhou increased from 6/100,000 in 2000 to 17/100,000 in 2013;
- The incidence of prostate cancer in Shanghai increased from 6/100,000 in 2000 to 17/100,000 in 2013;
- The incidence of prostate cancer in Shanghai increased more than 10-fold over 20 years.
The better you eat, the more likely you are to get it
It used to be that the incidence of prostate cancer in yellow people was not high. However, in the past few years, as people’s standard of living continues to improve, it has led to a higher incidence of prostate cancer, which has become one of the top 10 common malignancies.
Particularly as China is entering an aging society with more and more elderly people, there is likely to be a peak incidence in the next decade.
“Prostate cancer is related to the standard of living, the better the standard of living the higher the incidence, the worse the standard of living the lower the incidence. “Professor Li Hanzhong, director of urology at Peking Union Medical College Hospital, said this is because a high-fat, high-protein diet tends to lead to elevated androgen levels, which can cause prostate cancer.
Professor Li analyzed that there are three main reasons for the high incidence of prostate cancer:
- The increase of aging, prostate cancer is a malignant disease closely related to age;
- The diet is too refined, and prostate cancer tends to occur in more economically developed areas where people eat “too well”;
- Advances in testing have also greatly increased the detection rate of prostate cancer.
The “tortoise, hare, and monkey” theory for prostate cancer
“Prostate cancer is associated with sex hormones, especially androgens, and there is a clear causal relationship between the development of prostate cancer. The incidence of prostate cancer is higher in people with high androgens than in those with low androgens. “Professor Li Changling, director of urology at the Cancer Hospital of the Chinese Academy of Medical Sciences, said the incidence of prostate cancer in men increases with age.
The incidence of prostate cancer in men increases with age.
Prostate cancer is also described as the “silent killer” and is not easily detected in its early stages, but is usually diagnosed at an advanced stage, with the main symptoms being blood in the urine, pain in the urine and bone pain.
“Prostate cancer differs from other malignancies in its early and late stages. “Sun Yinghao, chairman of the Chinese Medical Association’s Urology Section, used the words “turtle,” “rabbit,” and “monkey. Sun Yinghao, a member of the Chinese Academy of Urology, used the words “turtle,” “rabbit,” and “monkey” to describe the characteristics of early prostate cancer staging and grading.
- The “turtle type” is mainly a non-progressive or very slow-progressing prostate cancer, the “unawakened sleeper”. As long as the bucket does not turn over, it may remain stationary at the bottom of the bucket, coexisting with the patient.
- The “rabbit type” is a type of prostate cancer that waits for the slightest disturbance. It lurks in the body and can come out when frightened.
- “Monkeys” are prostate cancers that jump up and down all the time and progress rapidly. “
- The monkey type is the one that keeps jumping up and down and progressing rapidly. The monkey, which goes around causing trouble, quickly endangers the patient’s life.
Specifically, the diagnosis of which type a patient has is confirmed by PSA (prostate-specific antigen) testing, imaging methods for clinical staging, transrectal puncture biopsy, and other indicators.
Does prostatitis increase the risk of prostate cancer?
Some men are concerned about the increased risk of prostate cancer if they have prostatitis. Professor Zhou Liqun, director of the Department of Urology at Peking University First Hospital, emphasized that prostate cancer has nothing to do with prostatitis or prostate enlargement; it is closely related to a high-fat diet, androgen levels, and genetic factors.
Advanced screening for PSA is recommended for men in their 40s
Professor Xu Yong, president of the Second Hospital of Tianjin Medical University, said that in developed countries in Europe and the United States, 90% of prostate cancers diagnosed are early because of the application of PSA screening, and the vast majority of early prostate cancers can be cured, so the incidence of prostate cancer in developed countries is high, but the mortality rate of prostate cancer patients is very low.
And in China, most patients go to the hospital only because the local tumor of the prostate is very large, causing symptoms of urinary obstruction, difficulty in urination or pain due to bone metastasis, only to find out that it is prostate cancer upon closer examination. At this point, most patients are already at an advanced stage and have lost the opportunity for radical treatment.
“Prostate cancer is a disease of the elderly, but the youngest prostate cancer patient we’ve ever seen was 37 years old. “Zhou Liqun revealed that men at the age of 40 should be concerned about their prostate, and PSA is a very good indicator to detect early prostate cancer. So far, no indicator has been able to replace PSA, and it’s now easy to get a PSA test – you just need to add a PSA test to your physical exam when you have your blood drawn. “If a high indicator of PSA is found, a puncture biopsy is then used to confirm the diagnosis. “
“Be as familiar with your blood pressure and blood sugar as you are with your PSA.”“Xu Yong emphasized that PSA should be included in physical exams for men over the age of 50, and rectal finger exams and transrectal ultrasound can be performed if available, often leading to early detection of prostate cancer patients, so regular physical exams should not The company’s main goal is to provide the best possible service to its customers.
It’s worth noting that genetics has a big role in the development of prostate cancer, especially in men with a family history of the disease, who are at higher risk than the general population. Experts recommend that these men get their PSA checked once a year after the age of 40 to screen more aggressively for prostate cancer.
Innovative therapies extend survival
“The development of prostate cancer in men must be related to the testes; without the testes there is no prostate cancer, and no prostate enlargement. ” Li Hanzhong pointed out that androgens are related to testosterone, which is the hormone that supplies prostate cancer, or “nutrients”. The most simple way to remove this hormone is to cut off the testicles, so that the prostate can shrink and become smaller to control the progression of the disease, thus reducing symptoms and prolonging life.
So, early stage prostate cancer can be treated radically, with surgical treatment such as removal of the testicles. However, once prostate cancer has progressed to an advanced stage, it cannot be cured and can only be treated with endocrine therapy, also called androgen blockade therapy. Although this therapy is effective, control of the tumor generally lasts only 1.5 to 4 years, followed by further progression to destructive resistant prostate cancer with metastases to organs other than the prostate.
“Metastatic desmoplastic-resistant prostate cancer has been a difficult area of treatment for prostate cancer. “Li Changling said that data show that patients with metastatic desmoplastic-resistant prostate cancer typically have a survival of less than 2 years. International studies suggest that patients’ survival could be further extended with further reductions in androgen levels.
To address this difficulty in the treatment of prostate cancer after tumor metastasis, in the clinic, physicians have turned to blocking androgens synthesized in the testes, adrenal glands, and the tumor itself as the latest thinking in prostate cancer treatment. Currently, a new generation of anti-androgen therapy drugs are available and widely used abroad.