[Love Wants Sex Series 320]Early screening and early diagnosis of high-risk prostate cancer with family history over 65 years old is the key

Transcript: Liang Yingxiu

(KUALA LUMPUR) Prostate cancer is a fairly common cancer in men, it affects millions of men worldwide, it increases with age, most cases occur in men aged 65 or above, family history and genetics, can also affect The risk of prostate cancer is higher if a relative, such as a father or brother, has had prostate cancer.

Prostate function produces semen

Dr. Yang Weixuan, a urology consultant at the University of Malaya Medical Center, would like to share with you an important topic that affects many men, that is, prostate cancer-a subject that he has devoted himself to research and treatment for many years.

“The prostate is a small grape seed-sized organ located below the bladder in men. Its main function is to produce semen, which provides nutrition and transportation for the semen during ejaculation.”

Prostate cancer is an abnormal growth of cells that may multiply uncontrollably and form tumors. What are the prevalence and risk factors for prostate cancer?

In addition to the family history and genetics mentioned above, race and ethnicity also affect the likelihood of developing prostate cancer, with African-American men at higher risk than men of other ethnic backgrounds, he said.

When a patient is diagnosed with prostate cancer, what kind of treatment should he have to be cured?

“Treatment options for prostate cancer vary by disease stage and individual patient. For low-risk cancers, active observation may be an appropriate option. It involves close monitoring of cancer progression without immediate treatment. When the cancer is confined to the prostate, local treatments are used, such as surgery, which is radical prostatectomy, or radiation therapy, which is external burst or seed radiation.”

He pointed out that there are many types of radical prostatectomy. Traditionally, the abdomen and pelvic cavity are opened on the operating table, but now more advanced methods can be done with minimally invasive surgery, laparoscopic surgery or even robotic surgery. When cancer cells have spread beyond the prostate, systemic treatments, including hormone therapy, chemotherapy, immunotherapy and targeted therapy are all options. Therefore, it can be seen that there is not only one way to treat prostate cancer, but many options.

Multidisciplinary cooperation and joint decision-making

He revealed that usually if a patient has been diagnosed with prostate cancer, as urologists in their practice, there is a need for shared decision-making.

“Shared decision-making is very important because it is a process of shared decision-making between patients and medical providers, and sometimes requires a multi-disciplinary approach, which will help ensure that the treatment plan is comprehensive and comprehensive. At this time, involving To discuss with a team of doctors including urologists, oncologists, radiation oncologists and other professional doctors and the patient’s family members, and finally choose the most suitable plan for each patient.”

Yang Weixuan said that prostate cancer in the early stage usually does not cause obvious symptoms, but some symptoms may appear as the disease progresses.

“Symptoms include frequent urination, difficulty urinating, decreased urine flow, blood in the urine or semen, pain or discomfort in the pelvic area, including pain in the back, kidneys and pelvis, bone pain, and erectile dysfunction. Possibly related to prostate cancer.

Early detection, which is critical to improving treatment outcomes, allows patients to be intervened and diagnosed in a timely manner, which can increase the chances of successful management.

He said that in order to diagnose prostate cancer, doctors use several diagnostic procedures, two of which are commonly used are the prostate-specific antigen (PSA test), which is a blood test, and the other is a rectal examination (DRE).

“Prostate Specific Antigen Test,

can measure PSA protein levels in the blood,

Elevated PSA levels, which may indicate the presence of prostate cancer,

Although other conditions can also cause elevated PSA levels,

At that time, the doctor will also do a rectal examination,

Includes a medical professional performing a physical examination of the prostate,

They’ll put on gloves, lubricate them, insert them into the anus, and feel for any abnormalities in the prostate. “

“If the PSA test and rectal examination raise concerns, further diagnostic tests may be warranted or recommended, such as a rectal ultrasound (TRUS), or a prostate biopsy, which involves inserting a needle through the rectum or through the skin of the perineum. Some prostate cells were taken out for testing.”

Timely intervention increases cure rate

After the biopsy, the result will be staging and grading. Staging is to determine the extent and spread of front-line cancer, which will help doctors formulate the most appropriate treatment strategy.

How should it be divided into installments? Patients will need imaging tests like MRI or CT or bone scans to assess the stage of the cancer and to detect if the cancer has spread to other sites.

The Gleason scoring system is used to grade prostate cancer. It evaluates the appearance of fibrous cells that determine the appearance of cancer cells and can help determine the aggressiveness of the disease. Higher Gleason scores indicate that the cancer is more aggressive, so early Discovery is critical to improving treatment outcomes, allowing timely intervention and increasing chances of successful treatment.

avoid overtreatment

Low-risk individuals should be actively observed

Once the diagnosis of prostate cancer is confirmed, different treatment options must be further discussed.

Patients must be actively observed with PSA and digital rectal examination every 3 months and biopsy every year.

“Treatment options depend on several factors, including the stage and grade of the cancer, the patient’s overall health, and their individual treatment preferences. For low-risk prostate cancer, active observation may be an appropriate option, including regular monitoring of the condition The progress of the disease is not treated temporarily. This method is only to avoid the side effects of over treatment, but also to ensure timely intervention when necessary.

Receive regular PSA tests

Yang Weixuan pointed out that when the cancer is limited to the prostate gland, local treatment such as surgery is used, that is, radical prostatectomy, and radiation therapy includes external radiation and seed therapy. The most common type of surgery for prostate cancer is radical prostatectomy, a surgery that removes the entire prostate gland, along with the stem capsule and surrounding tissue.

This can be done with traditional laparotomy or minimally invasive surgery, including laparoscopic or robotic surgery.

“Radiation therapy is usually given in the form of external beam radiation therapy, which uses high-energy radiation to kill cancer cells. These treatments aim to remove or destroy cancerous tissue while preserving as much of the prostate as possible.”

“In cases where the cancer has spread, that may require systemic treatment, which includes hormone therapy, chemotherapy, immunotherapy and targeted therapy.”

or have erectile dysfunction

Hormone therapy works by blocking the production of the hormone testosterone that prostate cancer cells need to grow and can be used alone or in combination with other treatments such as radiation or chemotherapy, he said. Systemic treatments target cancer cells throughout the body and help control the growth and spread of the disease.

“Chemotherapy is a treatment option used when prostate cancer has spread beyond the prostate gland. Chemotherapy uses drugs to kill cancer cells. In prostate cancer it is often combined with other treatments, such as hormone therapy. And it uses other methods to address the disease. question.”

He said there could be some side effects from the treatment, such as erectile dysfunction, urinary incontinence and rectal problems. The degree of these side effects varies, depending on the severity of the disease as well as the state and medical condition of the patient and the medical treatment chosen.

“Urinary incontinence, for example post-operatively, is often severe but improves over time with physical therapy, and despite that, there are treatments for many of these side effects that can be used to help and manage them.”

Monitor once recovered

He pointed out that in the management of prostate cancer, shared decision-making is very important. It is a cooperative decision-making process between patients and medical providers, which will help ensure that the treatment plan is comprehensive and comprehensive. Multiple specialist teams of oncologists, radiation oncologists, etc., determine the best course of action.

In addition, a prostate cancer support group can provide emotional support and information to men with prostate cancer and their families, as well as supportive care and resources throughout treatment to address the physical, emotional and psychological needs of patients and their families aspects of demand.

“After prostate cancer has been treated, there is still the possibility of disease recurrence once recovery, so monitoring is essential. So far, there is no way to prevent prostate cancer, so early detection is the key to treatment.”

He concluded by saying that prostate cancer research is still ongoing and a range of new treatments for prostate cancer are currently being developed.

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