Chen Xianqi, specialist in urology; Liang Guangquan, specialist in clinical oncology
Cancer is a serious and fatal disease1 that can have an inestimable impact on patients’ physical and mental health2. Even slow-growing prostate cancer3 can still cause unimaginable damage to patients3. Therefore, during the diagnosis and treatment process, doctors need to carefully assess the patient’s condition and listen to and understand the patient’s thoughts in order to recommend treatment that suits their needs. program to achieve the goals of helping patients obtain the desired therapeutic effects and maintain their quality of life1.
The treatment of prostate cancer is not simple. Please share your experience with urology specialist Chen Qianqi and clinical oncology specialist Liang Guangquan!
Cancer treatment is changing rapidly. What are the current treatment options for prostate cancer?
Dr. Chen Xianqi: There are really many treatments for prostate cancer. Which treatment to use depends on the stage of the disease, the patient’s condition and needs and other factors4. Taking early-stage prostate cancer as an example, surgery and electrotherapy are the main treatment considerations4. Some patients do not even need treatment as long as regular follow-up is enough4.
Dr. Liang Guangquan: As for more advanced prostate cancer, hormonal therapy is the main treatment method. Testicle removal or injections can be used to suppress male hormones4. If the condition is more severe, chemotherapy, targeted therapy, immunotherapy, internal radiotherapy, etc. 5 & 6 can be added to achieve better disease control effects. In addition, bone metastasis is very common in prostate cancer7, and bone-preserving acupuncture treatment can help reduce bone pain and other sequelae8.
Faced with numerous treatment options, how should prostate cancer patients choose?
Dr. Liang Guangquan: Cancer is a serious disease1. Patients will inevitably feel anxious and worried, but they should not make hasty decisions because of this. As doctors, we need to understand the patient’s pathology and physical and mental status, and we also need to help the patient understand the nature of the patient, identify whether the goal of treatment is cure or relief, and then work together to find a suitable plan.
Dr. Chen Xianqi: Everyone’s needs are very unique. Doctors need to understand the true thoughts of individual patients and use this as a starting point to help patients formulate and choose treatments that suit their needs. For example, there was a patient who could not accept that the prostate was still in the body, so he still chose surgery to remove the tumor even though electrotherapy could remove the tumor. There were also patients who were not suitable for surgery after evaluation, but because their friends said that electrotherapy was not effective, they insisted on surgery. As a result, the last thing he wanted to have was urinary leakage, which is a common problem after surgery. 9 As a result, he was unable to continue participating in his favorite sports. Not only was he depressed for several months, he felt that his life was ruined, and he regretted his choice. .
Unfortunately, when a patient is diagnosed with prostate cancer, how should he face it?
Dr. Chen Xianqi: Regardless of whether the patient is in the early stage or in the later stage, facing the unknown future, the mood will inevitably be heavier and the person may become fragile. However, my experience shows that patients can slowly rebuild and return to normal after completing treatment. pace of life. In fact, prostate cancer is generally a slow-growing cancer3, and the life expectancy of patients is quite optimistic10. It can be seen that prostate cancer is only one chapter of life, not the whole life.
Dr. Liang Guangquan: I think patients can be more frank and express their inner thoughts, such as their opinions and worries about treatment, as well as financial considerations, etc., because some drug subsidy programs may provide assistance, so this is the most important thing. It’s about having an honest conversation with your doctor and then finding a solution. At the same time, I also recommend that patients share it with their family and friends to face and solve various difficulties together, which can also provide patients with strong psychological support.
Dr. Chen Xianqi: The support of family and friends is very important, but some patients may not want their family and friends to know about their illness because of their personality, and would rather bear all the pain alone. I respect and understand the patient’s approach and will continue to follow up. Usually We will reconsider after his condition stabilizes.
Cases of prostate cancer seem to be increasing in recent years. Is there any way to reduce the threat to patients?
Dr. Chen Xianqi: Hong Kong and even Asia have seen a clear upward trend in prostate cancer11 & 12. Men really need to pay attention to it. Prostate cancer is the third most common cancer in men13, with more than 2,300 new cases every year13. However, there is currently no prostate cancer screening program in Hong Kong14, and symptoms such as urinary problems are similar to those of prostatic hypertrophy14, making it easy to take it lightly.
Dr. Liang Guangquan: Early-stage prostate cancer can cause no symptoms14, and some patients even experience bone pain15. After further investigation, it was discovered that the disease was caused by the spread of prostate cancer. This is not uncommon because the chance of prostate cancer metastasizing to the bones is as high as 97%.
Dr. Chen Xianqi: Even though the cause of prostate cancer is unknown and there is no specific prevention method, the risk of the disease can be reduced through a healthy lifestyle16. If high-risk individuals have a family history of early-onset prostate cancer, they need to discuss appropriate prevention with their doctor. Measure 14.
Finally, Dr. Chen Qi and Dr. Liang Guangquan reminded all men that urinary system problems may be difficult to talk about, and may even be considered an inevitable phenomenon of old age. However, as long as they are diagnosed and treated early, from a positive and positive perspective, they can use methods that suit their condition and needs. With proper treatment, the body and mind can regain health as soon as possible.
References:
WHO, Cancer. Available at: https://www.who.int/news-room/fact-sheets/detail/cancer.
Accessed 18 July 2023.
Lewandowska A, et al. Int J Environ Res Public Health. 2020;18(1):87.
NHS, Living with Prostate Cancer. Available at: https://www.nhs.uk/conditions/prostatecancer/
living-with/. Accessed 18 July 2023.
HKSAR Cancer Online Resource Hub, Prostate Cancer, Treatment. Available at:
https://www.cancer.gov.hk/en/hong_kong_cancer/common_cancers_in_hong_kong/prostat
e_cancer.html#4. Accessed 18 July 2023.
American Cancer Society, Treating Prostate Cancer. Available at:
Accessed 18 July 2023.
Cancer Research UK, Brachytherapy for prostate cancer. Available at:
https://www.cancerresearchuk.org/about-cancer/prostatecancer/
treatment/radiotherapy/brachytherapy. Accessed 18 July 2023.
Bubendorf L, et al. Hum Pathol. 2000;31(5):578-583.
American Cancer Society, Treatments for Prostate Cancer Spread to Bones. Available at:
https://www.cancer.org/cancer/types/prostate-cancer/treating/treating-pain.html.
Accessed 18 July 2023.
Cancer Research UK, Bladder problems after treatment for prostate cancer. Available at:
https://www.cancerresearchuk.org/about-cancer/prostate-cancer/practical-emotionalsupport/
bladder-problems. Accessed 18 July 2023.
Johns Hopkins Medicine, Prostate Cancer Prognosis. Available at:
https://www.hopkinsmedicine.org/health/conditions-and-diseases/prostatecancer/
prostate-cancer-prognosis. Accessed 24 Aug 2023.
HKSAR Cancer Online Resource Hub, Prostate Cancer, Cancer Facts. Available at:
https://www.cancer.gov.hk/en/hong_kong_cancer/common_cancers_in_hong_kong/prostat
e_cancer.html. Accessed 18 July 2023.
12.Chung BH, et al. Prostate Int. 2019;7(1):1-8.
Hong Kong Cancer Registry, Prostate Cancer in 2020. Available at:
Accessed 18 July
2023.
Cancer Expert Working Group on Cancer Prevention and Screening Recommendations on
Prevention and Screening for Prostate Cancer For Health Professionals.
Mayo Clinic, Prostate cancer. Available at: https://www.mayoclinic.org/diseasesconditions/
prostate-cancer/symptoms-causes/syc-20353087. Accessed 18 July 2023.
HKSAR Cancer Online Resource Hub, Prostate Cancer, Prevention.
https://www.cancer.gov.hk/en/hong_kong_cancer/common_cancers_in_hong_kong/prostat
e_cancer.html#2. Accessed 18 July 2023.
Information provided by Dr. Chen Xianqi and Dr. Liang Guangquan and supported by Amgen Hong Kong
HKG-162X-0823-80001 Oct 2023
2023-10-23 00:00:00
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