There are two phenomena that have to be said about prostate cancer. First, in Europe and the United States, the highest incidence of tumors in men is prostate cancer; in addition, in China, the incidence of prostate cancer has shown a surge in the past few years. In January 2015, the National Cancer Institute, in conjunction with the National Center for Disease Control and Prevention and the North American Cancer Registry, released a report on the incidence and prognosis of cancer in all parts of the body since 1975 (Cancer statistics, 2015). The report, which covers 40 years of human cancer data, shows that prostate cancer has been the most prevalent cancer among men, with 200 out of every 100,000 men detected with prostate cancer, but surprisingly, the 5-year survival rate for prostate cancer is over 99%, ranking first. What does this 99% mean? In layman’s terms, it means that 99 out of 100 people with prostate cancer live beyond 5 years. (In contrast, the worst prognosis is Pancreatic Cancer, which has a 5-year survival rate of only 4-5%. That is, no more than 5 out of 100 people live beyond 5 years, which is really the king of cancer!) Prostate cancer, pancreatic cancer, liver cancer, etc., all carry the hat of cancer, but their risk of death is very different, do not judge people by their appearance, talk about cancer, hear cancer scared, as a specialist, I will talk to you today about prostate cancer, even if you have prostate cancer, do not become that 1%. In my personal opinion, it is more appropriate to change the so-called incidence rate to detection rate. In a nutshell, people’s health awareness (medical checkup awareness) has increased and the means of examination has diversified, which has led to a higher detection rate of prostate cancer. The most convenient means of examination is the blood PSA, which is a very sensitive indicator of prostate cancer, called PSA (Prostate Specific Antigen). Once the standard is exceeded, we should be highly suspicious, and then combine it with MRI, anal examination and puncture biopsy to confirm the diagnosis. In recent years, the incidence of prostate cancer in China has been rising year by year. 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. It can be said that prostate cancer is not far from us. On the flip side, in many rural areas of our country, there are very few prostate cancer patients. This is not to say that there are fewer people suffering from this disease, but the detection rate is low – either no medical checkups or no checks for this item. Many patients with prostate cancer do not go to the hospital until they are at an advanced stage, with symptoms such as bone pain, wasting, localized pain in the prostate and difficulty in urination, which seriously affects the quality of life. 2.With prostate cancer, why are you still alive for so many years? 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, it is late stage. We can see that Murdoch, who has been treated for many years, can still fight with Wendi Deng in court, and Warren Buffett is still a “stock god” who is swimming in the ocean of capital. As an example, we can compare prostate cancer to three animals: the tortoise, the hare and the bird of prey. The tortoise, which may lie motionless for the rest of its life, coexists with the patient; the hare, which lurks in the body, waiting for an opportunity to move. The three completely different states of prostate cancer, which we should clinically give different treatment options to, are also hot spots of academic research. 3. There is really nothing to fear when suffering from prostate cancer? Surgery is an important means to treat prostate cancer, especially for early stage patients, which can achieve the purpose of radical cure. Of course, for those patients who cannot have surgery or do not want to have surgery, they can also be treated by radiotherapy, which can also achieve the purpose of tumor control. The general tumor can grow as long as there is a blood supply, while the growth of prostate cancer is also related to androgens. This is because the androgen production is inhibited by drugs that inhibit the binding of androgens to receptors, so that the cancer cells are deprived of the nutrients they need to grow and naturally stop growing. This treatment is often called “endocrine therapy”. However, the degree and duration of dependence on androgens varies from one prostate cancer to another. We currently have no way to predict the degree and duration of dependence. In advanced stages, once the prostate cancer is free to grow without androgens, the malignancy is very high and patients usually die from this hormone-independent prostate cancer. Therefore, early detection, early diagnosis and early treatment are particularly important, even for “bird of prey” or “rabbit of prey” prostate cancer.