The prostate is located in the lower part of the bladder and wraps around the urethra, making it a uniquely male organ. Prostate diseases mainly include prostatitis, benign prostatic hyperplasia and prostate cancer. Benign prostatic hyperplasia is a common disease in elderly men, while prostate cancer has become a serious threat to the health of the elderly due to its increasing incidence year by year.
The early detection of prostate cancer depends on rectal examination, prostate specific antigen (PSA), transrectal ultrasonography and transrectal prostate puncture biopsy.
1. Rectal examination
Prostate examination is the easiest way to check the size, texture and nodules of the prostate. If the prostate is hard or nodules are palpable, a transrectal prostate puncture biopsy should be performed.
2. PSA
PSA is a prostate tissue-specific antigen, not a prostate cancer-specific antigen, and many factors can affect PSA levels. These factors mainly include genitourinary diseases (such as prostatitis, benign prostatic hyperplasia, etc.) can cause an increase in PSA levels; many tests (such as rectal examinations, transrectal prostate ultrasound) can also cause an increase in PSA levels; drug factors, such as Prolotherapy, can reduce PSA levels by 50% after six months of continuous use.
PSA has a free and bound state in the serum, the common test method to detect total serum PSA and free PSA, and reference while this ratio. If the total PSA is greater than 10 ng/ml, one should be alert to the possibility of prostate cancer and further transrectal prostate puncture biopsy should be performed to clarify; if the total PSA is between 4 and 10 ng/ml, the free PSA/total PSA ratio should be referred to, and if the ratio is less than 15%, transrectal prostate puncture biopsy should be performed; if the ratio is greater than 15%, the PSA should be reviewed periodically to observe the rate of PSA elevation. The rate of increase in PSA.
3. Transrectal prostate ultrasonography
Transrectal ultrasonography is used in many clinical applications and can help in the early detection of prostate cancer. Transrectal prostate aspiration biopsy is a method to confirm the diagnosis of prostate cancer.
4.Pelvic MRI
Pelvic MRI can clarify the size of the prostate gland, the presence of nodules, whether the prostate cancer has invaded the surrounding tissues and whether there are lymph node metastases in the pelvis, so pelvic MRI is more helpful to the staging of prostate cancer.
5.Transrectal prostate aspiration biopsy
Transrectal prostate puncture biopsy is the only way to confirm the diagnosis of prostate cancer. The standard prostate puncture biopsy should be performed with 13 stitches through each lobe of the prostate under the guidance of transrectal ultrasound probe. Based on the pathological findings, the proportion of cancerous tissue volume to the total volume of the puncture specimen is calculated and microscopically observed for Gleason grading, which provides the basis for clinical treatment.
The American Cancer Society and the Society of Urology recommend that men over 50 years of age who have a life expectancy of at least 10 years and men over 40 years of age who have a significant family history of prostate cancer should have annual rectal examinations and PSA measurements. If one of the rectal examinations and PSA measurements is abnormal, transrectal prostate ultrasound testing may be the next step, but the only way to confirm the diagnosis is transrectal prostate biopsy.
Risk factors for prostate cancer include genetics, sexual activity, weight, and diet. For men with a family history of prostate cancer, it is especially important to prevent prostate cancer and detect it at an early stage. after the age of 40, regular physical examinations should be performed to check PSA and transrectal prostate puncture biopsy if necessary, and even repeated transrectal prostate puncture biopsies can be performed.
The most significant in the prevention of prostate is the dietary factor. The American Cancer Society has reported that the risk of prostate cancer in overweight men is about 30% higher than in men of ideal weight. Regarding dietary factors, the following points should be noted.
1. Low-fat diet
Clinically, the incidence of prostate cancer is much higher in the West than in the East. One of the main factors is related to the different dietary structure between East and West: Westerners have more fatty food intake and less fiber intake, while Easterners have the opposite. According to the calculation of starch, animal fat and other components in the diet, Westerners have about 35%, 40% and 25% respectively, while Easterners have about 80%, 6% and 14% respectively, which shows that the intake of fatty food is much higher in Westerners than in Easterners.
If there is too much fat in the body, the amount of cholesterol converted into androgens in the body will increase, and the increase of androgens is closely related to the occurrence of prostate cancer. Therefore, the incidence of prostate cancer in western countries is higher than that in eastern countries. However, with the improvement of people’s living standard, the change of diet structure and the increase of fat intake, the incidence of prostate cancer in China is also gradually increasing, which must attract the attention of the elderly, especially medical workers.
2.Eating more beans
The low incidence of prostate cancer in the East is also related to the higher intake of soy protein in the East. The chemical structure of phytoestrogens is similar to that of estrogen in human body, which has a certain inhibitory effect on androgens, therefore, eating more soy-based foods can help prevent prostate cancer.
3.Other
Catechic acid in green tea or vitamin E and selenium in fresh fruits and vegetables can help prevent the occurrence of prostate cancer.