Just a few months ago, Singapore’s former Prime Minister Goh Chok Tong (73) also underwent robotic-assisted surgery for early-stage prostate cancer and recovered well within two weeks after the surgery, going home to recuperate and now ready to resume all normal activities, according to Singapore’s Union-Tribune. The news has been a hot topic on the internet for a day, and the discussions on many health websites have reflected the confusion and doubts of many people about prostate cancer and its diagnosis and treatment: “Two prime ministers were found to have prostate cancer, how high is the incidence of prostate cancer? What is the reason for the high incidence of prostate cancer? Can MRI find prostate cancer? Why do we need general anesthesia for prostate puncture? Isn’t it scary? The robot can also operate on people and only need to rest for a week after the surgery? Is it really that amazing? Is the incidence of prostate cancer very high? The fact that two prime ministers of Singapore have been diagnosed with prostate cancer may be a coincidence, but it also reflects the fact that the incidence of prostate cancer is high. In fact, there are many other well-known “big names” who have had prostate cancer, including Warren Buffett, Murdoch, the former Secretary of State of the United States, and General Powell. The most important thing is that it is a very important disease for men. The incidence of prostate cancer is indeed a high incidence malignant tumor in men, especially in recent years, the incidence of prostate cancer in China is rising year by year, and the survey data from developed cities such as North, Shanghai and Guangzhou show that the incidence of prostate cancer has reached 32/100,000 men in recent years, making it the most common malignant tumor of the urinary system in men, a figure roughly comparable to the incidence in Singapore. There are about 600 new cases of prostate cancer diagnosed each year in Singapore, and due to factors such as the size of the population and the proportion of out-of-town patients in large medical centers, this number of 600 cases per year is basically equivalent to the diagnosis of a large urology center in China, so it can be said that prostate cancer is not far from us. How effective is the treatment of prostate cancer? Generally speaking, prostate cancer is divided into early stage and late stage. Early stage means that the cancer cells are still “wrapped” inside the prostate, but once the cancer cells break through the prostate envelope and metastasize to other parts of the body, this is late stage prostate cancer. If diagnosed at an early stage, prostate cancer can be cured through radical surgery or radiation therapy. The former Prime Minister of Singapore, who underwent radical surgery for prostate cancer, gradually started to resume his normal life two weeks after the surgery. The former Prime Minister of Singapore, who was diagnosed only at an advanced stage, has gradually started to return to his normal life. The treatment of advanced prostate cancer is relatively complicated and the prognosis is not as good as early stage prostate cancer, so it is quite important in clinical work how to diagnose prostate cancer at an early stage. What is the value of MRI and puncture in the diagnosis of prostate cancer? MRI and prostate puncture are indeed very important in the clinical diagnosis of prostate cancer, but there is also a blood test called PSA that is more widely used clinically (if the test result is above the normal range, you should also suspect cancer cells in the prostate), and these are important tools for early diagnosis of prostate cancer. MRI is very valuable in the detection of prostate cancer, but it is not enough to do an MRI, because MRI is a very complex test, which involves the adjustment of dozens of parameters, and different parameter adjustments will directly affect the sensitivity of the “detection” of prostate cancer. “The sensitivity of detecting prostate cancer is directly affected by the adjustment of different parameters. We also often encounter patients who come to the clinic with MRI report forms from other hospitals, and because of the unsuitable settings of the examination parameters, prostate cancer is misdiagnosed. So I hope here that you will take this test seriously, but never rely on the results of a particular MRI to think that you don’t have prostate cancer. The actual prostate puncture is an invasive operation that every patient must undergo before a pathological diagnosis of prostate cancer can be confirmed. The method is to remove some tissue from the prostate and look at it through a microscope to see if there are cancer cells. With the improvement of puncture technology, the accuracy of modern puncture technology has improved dramatically, and we can even spatially locate the suspicious location found in the MRI and navigate the puncture needle to “catch” the cancer cells at a specific site, so that the prostate cancer can be better diagnosed at a very early stage. It is reported that only one of the 38 puncture specimens was found to have cancer cells during the treatment of Lee Hsien Loong, which shows that advanced tumor localization puncture biopsy technology is quite important for early diagnosis of prostate cancer. Regular puncture operations do not require general anesthesia and are basically painless; if you do some special puncture techniques, such as the time-consuming template navigation puncture, you may use general anesthesia, mainly to increase the patient’s cooperation during the puncture procedure. What is robotic surgery all about? Robotic surgery is a minimally invasive surgical technique that has emerged in recent years and is accurately referred to as “intelligent robotic arm-assisted laparoscopic surgery. We have all heard of minimally invasive laparoscopic surgery. Take our radical prostate cancer surgery as an example, traditional open surgery requires a large incision in the lower abdomen, but with laparoscopic technology, the surgery can be completed with just a few holes in the stomach. However, this laparoscopic surgery also has some shortcomings, such as the lack of three-dimensional field of view resulting in less precise operation, the limitation of instrumentation equipment making the fine operation more difficult, and the tremor of the operator’s hand being amplified by the instruments, thus causing unnecessary side injuries, etc. Robotic surgery completely overcomes these disadvantages, thus making this surgery less traumatic and with faster postoperative recovery. At present, in our hospital, the pure operating time for this robotic-assisted radical prostate cancer surgery is only about 1.5 hours, and the patient is able to eat and get out of bed the day after surgery. However, robotic surgery also has its inherent disadvantage, which is that it is expensive. It costs 30-40,000 yuan more than ordinary minimally invasive laparoscopic surgery, and only a dozen centers in China are equipped with this equipment, which seriously limits the widespread development of this technology, so “robotic surgery” is not yet “available” to all patients. The “robotic surgery” is not yet available to all patients. In contrast, in the United States, traditional laparoscopic radical prostate cancer surgery has almost been replaced by “robotic” surgery.