What is the most effective way to cure limited prostate cancer?

       Radical prostatectomy is the most effective way to cure limited prostate cancer, but early prostate cancer mostly has no obvious symptoms, and most patients have lost the chance of radical surgery when diagnosed; moreover, elderly patients are mostly contraindicated to surgery, and many complications such as bleeding, rectal injury, postoperative penile erectile dysfunction, urinary incontinence, and urethral stricture can occur after surgery, making the surgical population smaller.  Radiation therapy can play a local control effect to a certain extent for early stage patients; and can improve the clinical symptoms of those with distant metastases and relatively improve the quality of survival. However, radiotherapy for prostate cancer can increase the risk of rectal and bladder cancer in patients, with a 1.7-fold increased risk of rectal cancer compared to radical surgery; and a 2.34-fold increased risk of bladder cancer compared to healthy individuals.  Early endocrine therapy inhibits the growth of prostate cancer cells, which are relatively hormone-sensitive at this time, but after a period of endocrine therapy (median time about 14-30 months), the tumor eventually adapts to the low-androgen environment and is no longer sensitive to anti-androgen therapy, developing into AIPC and hormone-refractory prostate cancer (HRPC ), with a median survival of less than 20 months.  Because the biological characteristics of AIPC and HRPC are extremely complex and the mechanism of their transformation is not clear, there is still no effective and standard treatment plan in clinical practice, and patients’ disease progresses rapidly and eventually die from tumor metastasis.  Based on the clinical experience and practice of Chinese medicine, Chinese herbal medicine is a promising drug for the treatment of prostate cancer. On the one hand, herbal medicines have the effect of improving the immunity of the body, such as Astragalus, Radix Codonopsis and Poria, which can promote the phagocytosis of macrophages and regulate the humoral and cellular immune functions to a certain extent; on the other hand, they have anti-tumor effects, such as curcumin and bitter ginseng alkaloids, and can reduce the toxic side effects of other treatments.  Therefore, combining endocrine therapy with TCM is a promising treatment modality. Some scholars have used crow’s nest in combination with endocrine treatment for mid- to late-stage prostate cancer, and the efficacy is better than that of endocrine treatment alone.  There is a report of treating prostate tumors with Liu Wei Di Huang Tang plus flavor, which prolonged the survival of patients. Some observed the treatment of prostate cancer with Zhi Bai Di Huang Tang plus flavor and concluded that Zhi Bai Di Huang Tang plus flavor was effective in the treatment of early stage prostate cancer, slowing down the disease process and improving the quality of life of patients.  In addition, some scholars have used the basic formula of Fu Zheng and Tumor Suppression, Prostate Dissipating Y Tang, and Zi Shui Qing Liver Drink with added flavor to treat prostate cancer or in combination with Western medicine, all of which can reduce symptoms, improve physical strength, lower serum PSA, and delay the onset of non-dependence after anti-androgen therapy, improving the efficacy and quality of life of patients.  Therefore, it is appropriate to take full advantage of the advantages of Chinese medicine and Western medicine to control prostate cancer.