The treatment of prostate cancer can be divided into radical prostatectomy radiation therapy endocrine therapy and chemotherapy. Various methods are chosen mainly according to the tumor stage. Radiotherapy is the radical treatment for limited stage and locally advanced PC. Radiotherapy and surgery are the treatments for locally early stage, more often radiotherapy at present. Currently radical surgery is limited to T1-2N0M0 (>70 years and life expectancy < 12< span=""> years, or invasion of the prostate acinus, should be radical), and the rest is radiotherapy and endocrine therapy as standard treatment. The main application of radical prostatectomy is for those whose prostate cancer is confined to the prostate but has not invaded the seminal vesicles and lymph nodes. The complications include lymphedema and other complications. External irradiation % to % AB stage prostate cancer can be controlled failure often because of metastasis. The highest tumor-free survival rate of stage B is % C. There are statistics that tumors invade the rectum, bladder, pelvic wall, ureter, and cancer-free survival of more than years. Untreated PCa cells are mostly androgen-dependent. Dihydrotestosterone binds to its surface androgen receptor and activates signal transduction into the nucleus to regulate cell growth. Surgical debulking (orchiectomy) is the gold standard of debulking treatment. It is a simple procedure with few complications and can be performed under local anesthesia. Since the main drawback of surgical denervation is the negative psychological impact on the patient, its use is becoming less and less widespread with the availability of equivalent pharmacological denervation drugs. However, since orchiectomy can bring testosterone to depot levels in the shortest possible time (3 hours to 12 hours), it can be used as an emergency treatment for patients with acute spinal cord compression due to bone metastatic lesions, thus providing relief as soon as possible. Estrogens Both natural and synthetic hormones can lower testosterone levels through the pituitary gonadal axis Commonly used hasenoestrol lmg~mg per month can bring testosterone to desmosterone levels but has more side effects with adverse reactions such as loss of libido, edema and breast development, and leads to complications such as deep vein thrombosis, myocardial infarction and temporary ischemic attack. In an in vitro androgen-independent PCa cell assay, estrogen can act on mutated androgen receptors. Therefore, estrogen may be considered as a second-line drug when endocrine therapy for PCa fails. GnRH analogue therapy is a more acceptable form of depot treatment than orchiectomy. Testosterone decreases to destructive levels after 4 weeks of treatment, and the initial treatment stimulates the release of stored GnRH in the body, resulting in a 10-fold increase in LH and a 5-fold increase in FSH, resulting in hot flashes for 10 to 20 days. Since a transient rise in testosterone may occur at the beginning of the injection, the first two weeks of the initial dose should be accompanied by an anti-androgen. This transient increase in testosterone may lead to increased clinical symptoms such as bone pain, acute urinary retention, obstructive renal failure, spinal cord compression, and fatal cardiovascular disease due to hypercoagulability, which are the main side effects of these drugs and cannot be completely eliminated with the addition of an anti-androgen at the beginning of the drug. The typical manifestation is a hot flash that starts on the head and face and spreads down to the neck and torso, accompanied by sweating, lasting 30 s to 5 min each time, and can occur more than 10 times a day. Androgen Antagonists (Antiandrogens) Treatment Androgen antagonists act directly on the AR to block the effects of androgens from any source. These drugs are divided into two categories according to their chemical structure: (1) steroids with hormonal activity in the body, such as chlormadinone acetate (CPA), which has progestational effects and has adverse effects similar to those of DES, but with fewer cardiovascular adverse effects than DES. The non-steroidal drugs that are inactive in the body, i.e., simple androgen antagonists, include flutamide (250 mg, tid), nilutamide (not yet available in China), and bicalutamide/casodex (50 mg/d). 1993 Kelly et al. found that flutamide was effective in the treatment of This phenomenon is called anti-androgen withdrawal syndrome. The incidence is about 44%-75%, and it occurs mostly 3 years after the drug is used. The occurrence of anti-androgen withdrawal syndrome may be related to the AR mutation, and the condition can improve for about six months after the drug is withdrawn. Therefore, in patients treated with androgen antagonists, if the disease deteriorates, it should be considered whether it is drug-related. After the development of the anti-androgen withdrawal syndrome, the following treatment options can be considered: ① Switch to other androgen antagonists, but similar syndromes may occur after long-term use. Since different drugs act on different sites of AR [androgen receptor], alternate use of drugs may delay the development of drug resistance. Adrenal androgen inhibitors, such as ketoconazole and cortisol preparations, are used. (iii) Estrogen therapy is used. The combination of maximal androgen blockade (MAB) depot treatment and anti-androgen drugs constitutes MAB, which can further block androgens of adrenal origin. Reports evaluating MAB in advanced prostate cancer have shown that MAB with nonsteroidal antiandrogens provided a survival benefit of 3% to 5%, while steroidal antiandrogens increased the risk of death. Slightly increased survival and expensive treatment costs limit the use of MAB. Survival was significantly improved after long-term (2-3 years) endocrine therapy in locally advanced and high-risk patients. For intermediate-risk patients, 4-6 months of adjuvant endocrine therapy is more appropriate. For patients with advanced primary disease, early endocrine therapy significantly reduces tumor-specific mortality, especially in M0 stage patients, and avoids serious complications caused by disease progression. Of course, for older patients with more co-morbidities and no symptoms, endocrine therapy can be postponed because the life expectancy is shorter and the side effects of treatment are more pronounced. Treatment after biochemical relapse is tricky, and it is important to first identify whether the relapse is localized or distant to consider whether local salvage therapy offers a chance of cure. In cases where salvage is likely to fail, early endocrine therapy is most advantageous. Second-line endocrine therapy, including anti-androgen drug withdrawal (serum PSA values generally decrease significantly in no more than 20% of patients, with some patients showing symptomatic improvement or tumor regression, but usually for a short period of 4-6 months), anti-androgen drug therapy, estrogen drug therapy, P450 enzyme inhibitor therapy, and corticosteroid drug therapy for cases where initial endocrine therapy has failed. The treatment of “hormone non-dependent” prostate cancer is still effective and should be used before systemic chemotherapy because of its less toxic side effects. Chemotherapy Since prostate cancer depends on androgens in about %-% of cases, endocrine therapy is preferred to chemotherapy after failure of endocrine and radiation therapy. In conclusion, chemotherapy for prostate cancer is not ideal, with objective tumor regression of %-% and a median survival time of about 6 months. Bone metastases occur in at least 65-75% of patients who die of PC, and 85-100% of patients who die of PC have bone metastases. High risk factors: bone pain or disease fracture, PSA >20, elevated AKP, high calcium, G8-10, T3-4. 19.2% false positive ECT, 12% false negative Treatment: diet hormone-sensitive endocrine anti-rejection chemotherapy bisphosphonates, radiotherapy Prognosis Overall survival: 73.1%, 51.8% and 35.3 % at 5, 10 and 15 years, respectively, The 5-year overall survival rates were 100.0%, 84.1%, 77.1% and 43.9% for T1~T4 stages, and the disease-specific survival rates were 100.0%, 95.7%, 87.9% and 59.7%, respectively. The 10-year overall survival rates of patients in grades I-III were 77.4%, 75.3% and 26.5% (P= 0.000), and the disease-specific survival rates were 88.9%, 82.7% and 56.0%, respectively. Prevention should be considered from various aspects, such as living environment, diet, mood and other factors to achieve harmony as much as possible, establish good lifestyle habits, stop smoking completely, reduce alcohol consumption, clean up the environment, avoid exposure to and inhalation of harmful carcinogens, and do not abuse the environment. The most important thing to emphasize is that abstaining from sexual intercourse can prevent the prostate from becoming congested for a long time, which is good for the prevention of this disease.