The day I went to interview Prof. Xue, he happened to be in the clinic, and there were a lot of people sitting outside the clinic, occasionally exchanging something, and the corridor was full of nervous faces coming and going. The promised interview time was long gone, and the endless stream of patients gave us no chance to see each other. An old aunt next to me was frothing at the mouth to introduce her and her partner’s journey of coming all the way to see Director Xue. I heard that Director Xue was a good doctor, so we came here. I was worried that he wouldn’t operate on us personally, but I didn’t expect that he would come back from abroad at the time he had scheduled, and he came to operate on my old man himself without any rest. After the surgery, he personally showed me the specimen and reassured me that he was doing well after the surgery.” The old aunt said with emotion that she came here specifically to thank him. I thought to myself, “This is the style of a great surgeon, so I wonder what the next interview will be like. When I saw Director Xue again, our interview position had moved to the director’s office. He apologized slightly and said, “Sorry for making you wait so long.” Although this was the first time I met him, he did not have the feeling of not being angry, as I expected, but was instead a person with a friendly manner and a wise gaze. When it comes to prostate cancer (PCa), one of the most common malignant tumors of the male genitourinary system, Prof. Xue opened the door and pointed out, “This is one of the priorities that is currently of great concern in the field of urology worldwide, and many physicians who have studied abroad share the feeling that as long as the research related to prostate cancer The participation of doctors in research related to prostate cancer, both basic and clinical, is quite high and the progress over the years has been rapid.” In China, prostate cancer has ranked fifth in the incidence of malignant tumors in men in China, and is still on the rise year by year. The actual fact is that you can find a rather interesting phenomenon in the early 1990s when you could only encounter at most 1 or 2 cases of prostate cancer a year. A retrospective analysis done at Renji Hospital in ’05 impressed Director Xue: “We had one case in ’93, one case in ’94, none in ’95, but since ’00 this amount has started to explode massively.” The reason for the gradual increase in the incidence of prostate cancer, which is even on the verge of catching up with bladder cancer, is inseparable from the progress of our social development level, the aging and urbanization of our population, the westernization of our dietary structure, and the advancement of PCa detection technology. The initial one is the best The early stage of prostate cancer hardly shows any clinical symptoms, usually the symptoms are similar to those of prostate enlargement, and it is not uncommon to see people with difficulty in urination and obstruction when they reach the age of “the more you look at the newspaper, the more you urinate”. It is very rare to see a patient with prostate cancer who has difficulty urinating. The reason for this is that many patients come to the doctor with bone pain, because the symptoms of bone metastases are persistent bone pain. Rectal examination is the basic physical test for early detection of prostate cancer. Professor Xue Wei said, “For surgeons, rectal examination should not be neglected, as this initial screening method determines whether we can do surgery and how the patient will heal after surgery.” In those years when there were no other “high tech” tests, a urologist’s finger had to be 80 percent accurate to be considered qualified. The first is the best, do not ignore this earliest and most basic screening tool. Of course, the strong combination of rectal finger examination and PSA examination is the best way to screen for the disease, and the final diagnosis can be confirmed only after pathological results are obtained through puncture biopsy. Professor Xue Wei pointed out that many patients in the clinic have “PSA anxiety” during the examination, and once the index is high, they strongly request the doctor to “prescribe it for me first”. But as a doctor, must grasp the principle, must have the support of pathological results before opening, otherwise the patient will suffer a lot more unnecessary suffering. “The actual fact is that there are a lot of people who are not able to get a good deal on a lot of things. But what is happening is that most doctors still prefer aggressive treatment.” Does a high PSA mean prostate cancer? PSA is an indicator that can help a large number of prostate cancer patients to be detected early, so when this indicator should be checked and for what group of people has received a lot of attention. Nowadays, it is recommended that men over the age of 50 should be checked, and if there is a family history, it may be better to do so five years earlier, at the age of 45. But does a high PSA mean that it is prostate cancer? The reason for this is that there are so many factors that can affect PSA, so Professor Xue Wei repeatedly emphasized that “the cause of the elevation must be clear. There are times when the PSA will be low when you are taking a Paulette, and we have to do a multiplication; there are times when the person has inflammation of the prostate, for example, and the PSA will be high.” Speaking of this, Director Xue also remembered an elderly gentleman he met two days ago who was going to have radical prostate cancer surgery and was in the same situation. The company’s main business is to provide a wide range of products and services to the public. The patient’s PSA was so high because he had frequent urination and fever at night, and he had an acute prostatitis attack. In addition to this, rectal examination, cystoscopy and catheter insertion may also cause a high PSA, so the doctor should analyze the situation comprehensively and not let the patient be too frightened. The chances of finding a high PSA in Chinese people are higher compared to people from western countries because of the high incidence of prostatitis in Chinese people and the fact that Chinese people also like to ride bicycles for walking, which can also have an impact. The result of the puncture is the gold standard of diagnosis “Diagnosis of prostate cancer no matter if you look at the film, do a rectal finger test or check PSA, the result you get is still a ‘guess’, to get the exact result you can only do a puncture, the puncture is the gold standard of diagnosis of prostate cancer.” The actual results are only available after the actual contact. As prostate puncture bleeding may imaging staging, so biopsy should follow imaging examination. The number of needles is now around 10 to 12, but of course some doctors will wear more than 20 needles, the complication rate of “10 plus X” penetration method will not significantly increase, but the positive rate will increase, so the balance of “10 plus X” is a better choice. Therefore, “10 plus X” is a good choice. The most important thing to remember is that you should feel the prostate gland before you have a puncture, because some patients with acute prostatitis have a lot of trouble with punctures. But prostate cancer is completely different, you get 10 doctors and there may be 13 or 4 solutions out there because its so individual.” In previous years, advanced prostate cancer was not advocated for open surgery and endocrine therapy was generally advocated, especially for some progressive prostate cancers. But now the latest philosophy is to advocate aggressive treatment, and in some advanced prostate cancer patients, open surgery will work better. “Previously, stage IV prostate cancer was definitely not advocated for open surgery, but now new clinical evidence suggests that patients can benefit from doing surgical treatment. So there are many changes in the treatment of prostate cancer. Each doctor’s opinion is not quite the same, and it mainly depends on the outcome.” At the end of the interview, Director Xue told us, “The imperative for doctors to detect prostate cancer early and get patients standardized treatment is to be ‘sparse’, not that we need to screen everyone in groups all over again, and then there is no clinical or medical funding to support that. What we need is to follow the natural course of the disease, screen out those patients who are suspicious and give him a suitable treatment plan. This is in line with the concept of ‘precision treatment’ that is now being promoted internationally.”