The incidence rate of prostate cancer is increasing year by year, and it has become one of the major killers affecting the health of elderly men. At present, China has established clear prostate cancer screening standards, but it still needs to continue to promote the popularization of public screening awareness. Ye Dingwei, vice president of the Cancer Hospital affiliated to Fudan University and head of urology department, said at the recent prostate cancer innovation progress expert science popularization conference held in Guangzhou that China still needs to strengthen its leading role in the international innovative drug research and development clinical trials, in order to accelerate the expansion and introduction of more innovative drugs and benefit more patients in China.
Prostate cancer is an epithelial malignant tumor that occurs in the prostate and is the most common malignant tumor in the male urogenital system. Because it has no specific clinical symptoms in the early stage, it is often mistaken by doctors or patients for prostatic hypertrophy or hyperplasia, and even many patients do not come to see a doctor until they have metastatic symptoms such as bone pain. As a result, nearly 70% of prostate cancer patients in China are locally advanced and widely metastatic prostate cancer once diagnosed, with poor treatment and prognosis. Moreover, the incidence rate of prostate cancer increases with age, rising rapidly after the age of 50, and the incidence rate and mortality rate of 85 years old reach the peak. Under the background of deepening aging in China, the total number of people with prostate cancer in China will rise.
Ye Dingwei said that the increase rate of incidence rate of prostate cancer in China has exceeded that of other solid tumors, and the mortality rate is also rising sharply. At the same time, the five-year survival rate of prostate cancer in China is less than 70%, while in Europe and the United States, especially the United States, the five-year survival rate is close to 100%. “The main reason for this situation is that the awareness of nationwide screening in China is still weak, and there is no consensus on the awareness that high-risk groups should undergo PSA screening every two years; and some patients have not received standardized diagnosis and treatment, and the whole process management system of prostate cancer in China still needs to be improved.”
Like most cancers, early detection, diagnosis and treatment of prostate cancer can increase the survival rate. Zeng Hao, member of the Youth Research Group and Secretary-General of the Urology Branch of the Chinese Medical Association, said that the European and American people attach great importance to the prevention and treatment of prostate cancer, and the prostate cancer screening rate is relatively high, which allows many patients with early prostate cancer to get good treatment opportunities, while the Chinese public has a low awareness of disease screening, and the majority of patients are locally advanced and widely metastatic prostate cancer once diagnosed.
“There is still a big gap between China’s prostate cancer patients and Europe and the United States from onset to diagnosis to treatment to prognosis. Therefore, China’s prostate cancer prevention and treatment has a long way to go,” Zeng Hao said.
How to change the status quo? Ye Dingwei said that the first is to popularize the awareness of early screening. Prostate patients over 50 years old at high risk should be screened for prostate specific antigen (PSA) every two years. Second, the treatment of prostate cancer should pay more attention to the treatment of precision and whole-process concept. Third, in the treatment, we should pay attention to the multidisciplinary treatment (MDT) for patients with prostate cancer in the middle and late stages. Through the joint efforts of the above multiple means, the overall survival rate of prostate cancer in China may be significantly improved in the future.
“We still have a long way to go in improving the early diagnosis rate and accuracy rate of detection.” Zeng Hao said that the main difficulty in improving the early diagnosis and early treatment rate is that in clinical practice, the value of tumor markers is only an important reference index, and the diagnosis of tumor needs to be combined with imaging or puncture biopsy for comprehensive diagnosis, but the median age of prostate cancer patients is between 67 and 70 years old, This kind of elderly patients have low acceptance of puncture biopsy.
At present, the conventional treatment methods for prostate cancer include surgery, radiotherapy, chemotherapy and endocrine therapy, among which endocrine therapy is the main treatment method for prostate cancer.
Ye Dingwei said that the results of ASCO-GU just released this year showed that the combination therapy composed of the PARP inhibitor Talazoparib and enzalutamide has achieved positive results in the clinical phase III trial, and the overall survival period has also been significantly improved, with relatively good expected results, hoping to improve the overall quality of life of patients with metastatic castration resistant prostate cancer in the future.
“There are still market gaps and unmet treatment needs in the introduction of innovative drugs in our country.” Ye Dingwei said that he hoped to accelerate the introduction of innovative drugs, and also hoped that the Chinese medical team could participate in the clinical trials of global drugs, keep the same level with foreign research and development and market, and work together to bring more new treatment options for patients, improve the early diagnosis rate and overall survival.
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Post time: Mar-20-2023