How to detect prostate cancer early? Regular physical examination Regular physical examination is the only way to detect prostate cancer in early stage. Anal finger examination: prostate nodules, hard as stones. This was the only way to diagnose prostate cancer before ultrasound was available. At that time, the only equipment doctors had to diagnose prostate cancer was their own index finger. Ultrasound: Hypoechoic nodules of the prostate. CT and MRI are also helpful in the diagnosis of prostate cancer. PSA (prostate-specific antigen) >4ng/ml, which is more pronounced in prostate cancer, especially in prostate cancer with bone metastases. The PSA is also elevated in normal people who have a blood test, especially after constipation or anal examination, due to the prostate being squeezed, resulting in the illusion of an elevated PSA. Therefore, in clinical practice, blood sampling for PSA is best done two weeks after anal finger examination. Prostate puncture: to detect cancer cells. When a doctor highly suspects that a patient has prostate cancer, he or she will often recommend a prostate puncture. Prostate puncture is usually not as dangerous or painful as the patient may think. Prostate puncture is often performed under local anesthesia, and safety is assured; individual patients may experience fever. Prostate cancer – a health killer for older men Prostate cancer is one of the most common malignancies in men. The incidence of prostate cancer in the United States ranks first among malignant tumors in men. The mortality rate is second only to lung cancer. With the aging of our population, the incidence of prostate cancer is also increasing year by year and its impact on the health of older men is coming to the fore. Prostate cancer is the malignant tumor most prone to bone metastasis, and more than 80% of prostate cancer patients will have bone metastasis. Bone metastases can be found in the ilium, vertebrae, ribs, skull and proximal long bones. It is characterized by a constant dull pain, which often affects the patient’s appetite and the rhythm of daily life, resulting in the patient losing weight and suffering. Secondly, as the bones are “eaten” by the tumor cells little by little, the metastatic bones are prone to pathological fractures. If the tumor cells invade the vertebral body of the spine, the collapse of the vertebral body will cause compression of the spinal cord and eventually lead to paralysis. There are three main specific treatments for prostate cancer for general malignancy: surgery, radiotherapy, and chemotherapy. Because prostate cancer is an androgen-dependent tumor, there is an additional specific treatment for prostate cancer – endocrine therapy (androgen resistance therapy), such as surgical debulking (orchiectomy) or pharmacological debulking. Surgical treatment – radical prostate cancer surgery. Because prostate cancer progresses slowly and is often effective for endocrine therapy, radical prostate cancer surgery is not necessary for patients who are too old to perform it. Radical prostate cancer surgery is only indicated for patients with prostate cancer who are young and whose tumors have not metastasized. The main complications of surgery (radical prostate cancer surgery) are bleeding and urinary incontinence. In recent years, with the improvement of surgical methods especially laparoscopic techniques, the incidence of surgical complications has been significantly reduced. Radiotherapy: Modern radiotherapy techniques have made the effectiveness of radiotherapy (for early stage prostate cancer) almost comparable to surgery. Chemotherapy: It is effective for patients with advanced extensive metastases especially those with insignificant effect of endocrine therapy. However, chemotherapy has a large number of side effects and is not tolerated or accepted by every patient. Endocrine therapy – surgical debulking (orchiectomy) or drug debulking. Prostate cancer is an androgen-dependent tumor. By reducing and removing androgens, prostate cancer will become a source of no water and slowly dry up for treatment. Surgical debulking can significantly reduce the production of androgens. Unfortunately, however, in men androgens do not come exclusively from the testes; androgens can also be produced outside the testes (such as the adrenal glands), especially after the testes have been removed. Pharmacological depot + androgen receptor antagonists can block androgens to the maximum extent, but are expensive. The effectiveness of endocrine therapy in the treatment of prostate cancer is well established: it controls tumor progression and may relieve pain due to prostate cancer. Since prostate cancer is the malignant tumor most prone to bone metastasis, metastatic bones are prone to pathological fractures. Bisphosphonates can reduce the degree of bone destruction and relieve bone pain by inhibiting the activity of osteoclasts. Other cutting-edge treatments, such as immunotherapy and gene therapy, are still in the experimental research stage and have few clinical applications, but they have a very broad application prospect.