Singapore Prime Minister Lee Hsien Loong: two weeks after prostate cancer surgery, recovering and returning to work Iranian leader Khamenei: six months after prostate cancer surgery, tumor spread worrying Not that celebrities are more likely to get prostate cancer, but there is no doubt that celebrities who have it tend to be more likely to stir up public attention and discussion. After Singapore Prime Minister Lee Hsien Loong underwent robotic prostate cancer surgery before Chinese New Year, CNN reported on March 4 that Lee returned to work two weeks after the surgery. Just as people are jawing at the wonders of today’s medical technology, another less optimistic “prostate cancer” story has come to light. The Iranian spiritual leader Khamenei was hospitalized for emergency treatment for a tumor that had spread six months after his surgery for prostate cancer, and his health was in jeopardy. The same leader, great man, and the same first-class treatment technology, why the treatment results of Lee Hsien Loong and Khamenei are very different in the face of the common enemy of “prostate cancer”? The most important thing is that there is no “high level” or “new technology” for the prevention and treatment of prostate cancer. The reader’s heart will certainly be stirred by the “prostate cancer” again a thousand waves. The prostate is a unique male genital organ located deep in the pelvic cavity, the size of a chestnut. If cancer cells develop inside this “chestnut”, it is prostate cancer. Like other cancers, prostate cancer is divided into early and late stages. In early stage prostate cancer, the cancer cells are concentrated inside the prostate gland, while in advanced stage prostate cancer, the cancer cells have penetrated the “coat” of the prostate gland and metastasized to other places (the most common site of metastasis is the bone). Modern medicine has proven that early stage prostate cancer can be “eradicated” by certain methods, including radical prostate cancer surgery, radical radiotherapy, etc. After receiving such treatment, the cancer cells in the body are completely “eradicated”, so that the patient’s life expectancy is no longer affected by prostate cancer. These include radical prostate cancer surgery and radical radiation therapy. In the case of advanced prostate cancer, especially metastatic prostate cancer, the tumor cells have spread to all parts of the body and cannot be completely cured by these methods, and these patients’ lives are often shortened by prostate cancer. The reason for the very different treatment results between Lee Hsien Loong and Khamenei must be because of the different stages at the time of diagnosis. It goes without saying that getting prostate cancer diagnosed as early as possible is crucial. As prostate cancer is a highly prevalent malignancy in older men, it is important for the general public to have regular prostate examinations at regular hospitals over the age of 60. During a physical examination, doctors will screen for prostate cancer through simple methods such as ultrasound, rectal examinations, and blood sampling (to check for prostate-specific antigen PSA). With the development of medicine, scientists have discovered many new and better diagnostic markers for prostate cancer, especially in Europe and the United States, and some of these new markers have been successfully used to screen patients for prostate cancer. However, in reality, it is not possible to copy and apply foreign indicators, because prostate cancer has great racial variability. In our study, we found that these new markers, which are routinely used in foreign clinics, did not show better diagnostic results in Chinese patients, while some of our own “new molecules” were found to be more effective than the traditionally used PSA (and those new foreign markers) in the diagnosis of prostate cancer. The new tumor markers are now in the national validation phase. After the above screening, if cancer is suspected in the prostate, it is usually determined by prostate puncture and pathological biopsy. In this regard, there are many new techniques that have emerged in recent years. For example, our team has developed targeted localization puncture combined with multiparametric MRI (magnetic resonance imaging) image fusion, which has improved the accuracy of the traditional puncture technique to a higher level and has enabled many patients who had previously undergone multiple punctures without a clear diagnosis to finally obtain an early diagnosis and a chance for cure. So, does a confirmed prostate cancer diagnosis have to be treated very aggressively? Many readers may think, “Of course, how can we not treat cancer? In fact, the mystery of prostate cancer is that even in the same early stage of prostate cancer, the growth characteristics of the tumor itself may be completely different. This feature is called “heterogeneity” of cancer in medical science. Some prostate cancers are like “monkeys”, jumping up and down and making trouble everywhere, and if they are not subdued as soon as possible, they will eventually become a big disaster; some prostate cancers are like “turtles”, moving slowly and never moving. The prostate cancer itself can grow very slowly and even stay with the patient for the rest of his life, rarely metastasizing or endangering the patient’s life. “The most important thing is that you should be aware of the fact that you have to be very careful with your treatment. It is a big clinical problem to identify whether the prostate cancer belongs to the “monkey”, “hare” or “turtle”, but only in this way can the doctor classify the prostate cancer patients. This is the only way that doctors can classify prostate cancer patients, “eliminate monkeys, control rabbits, and monitor turtles”, and minimize the cost of treatment while obtaining the best results. In this regard, our initial research results are only a glimpse of what is to come, and it will take repeated clinical validation to make the existing results benefit the majority of patients.