How to prevent prostate cancer?

  Sun Simiao once said in the “Thousand Gold Essential Formula” that “the top doctor cures the disease that is not yet sick, the middle doctor cures the disease that wants to be sick, and the bottom doctor cures the disease that is already sick”; Thomas Adams in the West also said that prevention is far better than cure because it prevents people from suffering from illness. All these illustrate that prevention is far better than cure.  Globally, the incidence of prostate cancer is increasing, and its incidence in Europe and the United States is among the highest of all malignant tumors in men. Some sources indicate that since 1993, more than 160,000 men in the United States have been diagnosed with prostate cancer each year, and more than 40,000 people die from prostate cancer each year. The incidence of prostate cancer in other countries is as follows: Canada, South American countries, Northern European countries and Australia, etc., 30 to 50 per 100,000 men; most European countries have 20 per 100,000 men; some Asian countries have about 10 per 100,000 men. The incidence of prostate cancer is increasing rapidly at a rate of 5% per year worldwide, especially in economically developed European and American countries. Although the incidence of prostate cancer in China is lower than that of other western countries, the rapid increase in recent years has drawn the attention of the medical profession. The survey shows that the incidence of prostate cancer has increased nearly three times compared to 30 years ago, approaching the high incidence in Europe and the United States.  The molecular mechanism of tumorigenesis includes a slow process of a series of events such as activation of oncogenes, inactivation of oncogenes, loss of repair-related gene functions, abnormalities in apoptotic mechanisms, overexpression of telomerase and disruption of cellular signaling to regulatory mechanisms. Generally speaking, carcinogenic factors act for 30-40 years to enter the pre-cancerous stage, then after about 10 years to enter the in situ cancer stage, and then after 3-5 years to enter the invasive cancer stage, the course of invasive cancer stage is generally about 1 year, but the longer one can be about 10 years. Tumorigenesis is a longer process, which provides an opportunity to take interventions to prevent tumors. In addition, prostate cancer brings many adverse effects to patients, even after taking radical prostate cancer surgery patients still have urinary incontinence and sexual dysfunction (studies show that 18 months after radical prostate cancer surgery 8.4% of patients still have urinary incontinence and 41.9% still have moderate to severe sexual dysfunction), and also prostate cancer treatment brings heavy economic burden to the society, so prostate cancer The study of prostate cancer prevention has become more important.  I. Risk factors for prostate cancer Prevention of disease occurrence and control of disease progression can be achieved by improving lifestyle habits. For prostate cancer racial heredity, advanced age and other risk factors are not easy for us to change, while high-fat and high-calcium diet, early sexual maturity, history of sexually transmitted diseases, smoking, alcoholism, excessive exposure to cadmium and rubber are all risk factors that can be changed, and we can prevent and control the disease progression by changing the poor lifestyle. The survey proves that the incidence of prostate cancer is also decreasing with the improvement of living habits.  Second, change the bad lifestyle 1 , reasonable diet: the occurrence of prostate cancer is closely related to the dietary structure and frequency of consumption. The isoflavones in soy, the lignans in cereals, and the flavonols in green tea contain phytoestrogens that inhibit cancer. Vegetables and fruits are rich in vitamins C, D and E as protective factors. Lycopene has anti-cancer and anti-cancer effects, especially for advanced prostate cancer. The prevention of prostate cancer should be based on the medical and food perspective and strengthen the intervention of dietary habits. The first step is to reduce the intake of red meat, eggs and high-fat dairy products, and increase the intake of soy products and vegetables, especially for the high-risk groups, they should change the European and American dietary tendencies and maintain the traditional Chinese diet. Pay attention to the diet mix, try to meet the needs of the body with beans and other plant proteins, and choose natural foods to supplement vitamins. Nursing staff should strengthen people’s awareness of disease prevention, guide and urge high-risk groups to choose foods that are good for health, and help people develop good eating habits so as to reduce the risk of prostate cancer.  2 .Strengthen sex education: Some scholars believe that the traditional view of marriage and strict sexual relationship may be the reason for the low incidence of prostate cancer in China. Studies have shown that the increased risk of prostate cancer is related to sexually transmitted diseases, especially gonorrhea, condyloma acuminata, etc. Although the pathogenesis of prostate cancer has not been clarified, it is generally believed to be related to imbalance of sex hormone regulation, but recently suggests the correlation between some inflammatory diseases and prostate cancer. Therefore, it is important to establish a healthy sexual morality, abstain from sex, and have a stable sexual life partner to ensure a happy marriage. Medical professionals actively promote, guide and carry out sex education in a serious and scientific manner so as to improve people’s ability to understand sex correctly, know sexual hygiene, maintain a normal and healthy sex life and prevent prostate cancer from occurring.  3. Quit smoking: Tobacco is another important risk factor for prostate cancer. Health care workers should first set an example of non-smoking and advise to quit smoking to reduce the harm of tobacco to human body.  4. Protect the environment: In economically developed areas, prostate cancer is highly prevalent in heavily polluted areas of industry and agriculture, while it is less prevalent in areas with simple people and good natural ecological environment. We should awaken public awareness of environmental protection, reduce environmental pollution, purify living space, and protect our living environment together.  5.Regulate life rhythm and delay aging: Medical professionals should guide people to choose a healthy and active lifestyle, eat reasonably, exercise moderately, quit smoking and limit smoking, maintain psychological balance, enhance physical fitness, keep endocrine stability, and delay aging so as to reduce the incidence of prostate cancer, slow down the incidence of prostate cancer and improve the quality of life.  6.Regular physical examination: For men over 40 years old, regular blood sampling for prostate-specific antibody (PSA) is required for early detection of prostate cancer. In China, prostate cancer is characterized by a long latency period (20-30 years), insidious onset, and not easily distinguished from prostate enlargement and other diseases, and most clinically diagnosed cases have distant metastases. The early detection of prostate cancer is particularly important, and it is important to seize the opportunity for early diagnosis and early treatment. When the disease is confined to the prostate, the chances of complete cure are extremely high. It is the responsibility of health care professionals to educate the public about the science and raise awareness of the population to prevent the disease. In conclusion, although prostate cancer is not a common disease in China, the number of patients is increasing year by year and it has become an important disease that threatens the lives of older men. There are more risk factors affecting prostate cancer, but changing people’s poor lifestyle through health education and health promotion is an important measure to prevent prostate cancer. Nursing staff should establish a broad view of health, actively explore, research and use the most effective nursing means to intervene in the incidence and death rate of prostate cancer and improve the quality of life of patients.  III. Food and drugs 1 , 5a reductase inhibitors Humans have two types of 5α reductase, divided into type I and type II. Type I 5a reductase is mainly found outside the prostate, such as the skin and liver; type II 5α reductase is mainly found in the prostate, but also in tissues outside the prostate. Finasteride is an inhibitor of type II 5α reductase; dutasteride inhibits both type I 5a reductase and type II 5α reductase.  The publication of the results of the 2003 trial of finasteride for prostate cancer prevention was a very important event in the history of prostate cancer prevention research. Because androgens are required for the development of prostate cancer and men with congenital 5a reductase deficiency do not develop prostate enlargement and prostate cancer, this trial was designed: Finasteride reduces the risk of prostate cancer by inhibiting the conversion of testosterone to the more biologically active dihydrotestosterone by inhibiting type II 5α reductase. The main results of the trial were as follows: the incidence of prostate cancer decreased from 24.4% to 18.4% in the finasteride group compared to placebo; there was no significant difference in the magnitude of the risk reduction of prostate cancer with finasteride between the different risk groups by age, family history and race; sexual hypogonadism was more pronounced in the finasteride group and urinary tract symptoms were more pronounced in the placebo group; tumor Gleason score 7 to The proportion of tumor Gleason score 7 to 10 was higher in the finasteride group than in the placebo group (6.4% and 5.1%, respectively). However, because the prostate volume was 25% smaller in the finasteride group than in the placebo group, a higher proportion of prostate tissue volume was punctured relative to the whole gland volume, which may have increased the probability of tumor detection and may have produced overdetection bias. Since then, several other clinical trials have also confirmed that finasteride reduces the risk of prostate cancer.  Vitamin E is a family of naturally occurring fat-soluble vitamins whose primary role is to act as an antioxidant in cell membranes. The most active form of vitamin E is alpha tocopherol, which is widely found in nature and is the main form found in humans.  The results of a 1995 trial of alpha tocopherol and beta carotene for cancer prevention showed that alpha tocopherol could reduce the incidence of prostate cancer by 32% and mortality by 41%.  3, Cyclooxygenase-2 blocker Cyclooxygenase-2 is the rate-limiting enzyme for arachidonic acid synthesis of prostaglandins and is expressed in many human tumors; it is highly expressed in prostate cancer and may be involved in the pathogenesis of prostate cancer by promoting inflammatory responses, inhibiting tumor cell apoptosis and oxidatively damaging tissue. The prevention of prostate cancer through cyclooxygenase-2 blockers is one of the current directions in prostate cancer prevention research.  4, Selenium Selenium is one of the essential trace elements in human body, and current research has found that selenium and its products may play an important role in the prevention of prostate cancer.  5.Soybean and other phytoestrogen-rich foods Beans, which are rich in phytoestrogens, play an important role in the traditional diets of Asian countries, while they are secondary in Western countries; the incidence of prostate cancer is the lowest in Asia and the highest in Western countries, which may be related to the high intake of phytoestrogens by men in Asian countries.  6, green tea Green tea is rich in polyphenols, which have free radical scavenging and antioxidant effects; and may specifically kill tumor cells, while having no effect on normal cells.  7 .Foods rich in lycopene Lycopene is an orange-red carotenoid, mainly found in tomatoes and their products and other red fruits and vegetables. Lycopene is a highly unsaturated fatty acid isomer of beta carotene, the predominant carotenoid in human plasma, and has strong antioxidant activity. Studies have found that men who consume two or more servings of ketchup per week have a 23% lower risk of prostate cancer than men who consume one serving of ketchup per week.  8, red wine The main anti-tumor component of red wine is resveratrol, which is found in the epidermis of grape leaves and berry skins, and resveratrol has a strong antioxidant effect. Studies suggest that the anti-prostate cancer effect of red wine is mainly due to resveratrol.  Although the current evidence is not enough for us to recommend any food or nutrients as a routine preventive measure for prostate cancer, these studies have given a glimpse of a bright future for prostate cancer prevention research.