Text/Yangcheng Evening News all-media reporter Chen Hui
Photo/Visual China
According to the Latest Global Cancer Report 2020, prostate cancer ranks 6th in the continent in terms of mortality among male malignancies, and more than 50,000 people die from prostate cancer every year on the mainland.
Lin Tianxin, vice president of Sun Yat-sen Memorial Hospital of Sun Yat-sen University and professor of urology, said in an interview with reporters that 70% of prostate cancer patients in the mainland are in the advanced stage when they are first diagnosed, and early diagnosis is the key to improving the overall efficacy of patients. Of course, with the continuous development of new treatments, the overall efficacy of advanced prostate cancer patients has been improved.
70% of prostate cancer patients are in advanced stages at the time of initial diagnosis
Middle-aged and elderly men are required to check PSA every year
Professor Lin Tianxin introduced that the incidence of prostate cancer in the mainland is getting higher and higher, mainly for the following two reasons: one is related to lifestyle changes, such as westernization of diet, increased intake of red meat, etc.; second, the promotion of prostate cancer screening, more and more units of physical examination to increase the "prostate specific antigen (PSA) test" project, so that more prostate cancer patients can be diagnosed at an early stage. If you wait until the patient feels symptoms such as difficulty urinating, bone pain, and easy fractures, it is likely that it is already advanced.
Therefore, Professor Lin Tianxin called for men over 50 years old to have one or two PSA tests per year, which is a protein secreted by prostate glands and duct cells, which is rarely found in the blood when it is normal, and the PSA value will generally rise after having prostate cancer.
However, if the physical examination finds that PSA is elevated, do not panic excessively, serum PSA can also be elevated in prostatitis, urinary retention, etc., not necessarily prostate cancer, you can go to the urology specialist for treatment, ask the doctor to help make a diagnosis.
Men over the age of 50 should have a PSA test once or twice a year
"New drugs + combination therapy" has multiplied survival
For early-stage localized prostate cancer, radical surgery or radiation therapy is usually recommended. Professor Lin Tianxin introduced that the 10-year disease-free survival rate of early patients after standardized treatment can even reach more than 90%, which can be said to be a very good prognosis.
Although more and more prostate cancer patients can be detected at an early stage, 70% of patients in the mainland are still in advanced stages at the time of initial diagnosis. In the past two or three years, many new drugs have come out, especially the emergence of new endocrine therapy drugs, chemotherapy drugs and targeted drugs, combined with local treatment, the survival time of advanced patients has been multiplied.
Professor Lin Tianxin
Castration resistance, attack weapons are no longer single
The occurrence and progression of prostate cancer is related to male male hormones, and using drugs to reduce the level of male hormones in the body or block its effect is one of the important treatment methods, called castration therapy. However, after a period of castration treatment, patients will have "castration resistance", which means that the treatment is ineffective.
Castration resistance is a difficult point in the treatment of prostate cancer, and statistics from European and American countries show that 5% to 10% of prostate cancer patients will have castration resistance during treatment.
"In the past, in the face of castration resistance, we have very few weapons", Professor Lin Tianxin introduced, in the past, the treatment of castration resistance was mainly chemotherapy, if the patient's physical condition is very poor, the blood toxicity of chemotherapy will lead to thrombocytopenia and easy bleeding, red blood cells are reduced and anemia occurs, leukopenia is prone to infection, etc. In addition to chemotherapy, there are also conventional drugs such as androgen receptor antagonists and endocrine therapy, but the treatment effect is not ideal, usually only 30% to 40% of patients are effective.
"There are a lot more weapons now!" Professor Lin Tianxin introduced that with the emergence of new endocrine therapy, the survival time of many patients with castration resistance can be extended by one or two years. If chemotherapy or targeted therapy and isotope therapy are combined, a small number of patients can also be added to immunotherapy, and the patient's life expectancy can be further extended.
New drugs into medical insurance: only 1,000 yuan per month out-of-pocket expenses
The emergence of more and more new drugs has brought hope to patients with advanced prostate cancer, but these new drugs are generally more expensive and not all families can afford it.
Professor Lin Tianxin took the new androgen receptor inhibitor darotamide as an example, which can reduce the risk of death of advanced prostate cancer patients with castration resistance by more than 30%, and it can also improve the quality of life of patients while prolonging the survival of patients, including reducing the risk of bone metastasis, reducing the chance of bone pain, fractures, paraplegia, and reducing the risk of urinary retention, dysuria, and cystostomy.
In addition, dalotamide entered the national medical insurance directory in 2021, in addition to the reduction of the price of the drug itself, it can also be reimbursed by medical insurance, taking the patients of Guangzhou employee medical insurance as an example, and now the monthly out-of-pocket cost is only more than 1,000 yuan.
"It is our great motherland that allows our people to obtain the best medicines in the world at a very low cost," professor Lin Tianxin said proudly. He introduced that now foreign patients who want to get the treatment of the drug need to pay additional insurance costs every year. At the same time, Professor Lin Tianxin called for more new drugs to enter medical insurance in the near future, so that every prostate cancer patient can enjoy ideal drug treatment without being trapped by costs. (For more news, please pay attention to Yangcheng Pie pai.ycwb.com)
Source | Yangcheng Evening News Yangcheng Pie
Editor-in-charge | Cui Wencan