Over 100,000 New Cases Annually: Early Screening and Comprehensive Management Strengthen Prostate Cancer Defense

September is “International Prostate Cancer Awareness Month” every year.On September 17 this year, Liu Chuan, Deputy Director of the Department of Urology at the Second Affiliated Hospital of Chongqing Medical University, attended a prostate cancer science popularization and exchange event co-organized by Astellas. He provided public education on early screening, treatment, and rehabilitation of prostate cancer, introducing scientific intervention strategies to improve patient prognosis.

VCBeat took this opportunity to engage in an in-depth discussion with Professor Liu Chuan on the prevention and rehabilitation of prostate cancer.

Liu Chuan

Deputy Director, Department of Urology, The Second Affiliated Hospital of Chongqing Medical University

Professor, M.D., Master’s Supervisor

Data from the National Cancer Center show that,In 2022, there were approximately 134,000 new cases of prostate cancer and 47,500 deaths in China., and with the aging population, the incidence rate continues to rise. This trend echoes global data—prostate cancer, as a globally prevalent malignant tumor in men, ranks second in the global male cancer incidence rate (after lung cancer).

From a clinical perspective, there is a significant contradiction between its high incidence and the insidious nature of early symptoms. As a common malignant tumor of the male urinary system, prostate cancer often lacks typical symptoms in its early stages.As Professor Liu Chuan pointed out: “Early-stage prostate cancer often remains latent in the body without obvious signs. When symptoms such as urinary frequency, urgency, and difficult urination appear, they are easily confused with benign prostatic hyperplasia. This insidious nature causes many patients to miss the optimal window for diagnosis and treatment.”

The key to breaking this dilemma lies in scientific screening.Professor Liu Chuan Recommends Establishing a “Three-Tier Screening Timeline”: Average-risk men should begin screening at age 50; those with a family history should start earlier, at age 45; if there is a BRCA gene mutation (a genetic variant highly associated with cancer risk) in the family, screening should commence at age 40.

Scientific management during the treatment and follow-up phases is equally critical after abnormalities are detected through screening and a diagnosis is confirmed.Professor Liu Chuan stated that during treatment and follow-up, the assessment of therapeutic efficacy should not rely solely on tumor size but must be evaluated using three “rulers”: the magnitude of decline in prostate-specific antigen (PSA) levels, changes in imaging lesions, and improvement in symptoms such as dysuria and bone pain. Meanwhile, drug selection should comprehensively consider efficacy, adverse reactions, and cost-effectiveness, aiming to ensure therapeutic effectiveness while minimizing side effects and maintaining affordability for patients.

Historically, although androgen deprivation therapy (ADT) has been commonly used to control metastatic prostate cancer, most patients eventually progress to castration-resistant prostate cancer (CRPC) as the disease advances, resulting in diminished therapeutic efficacy. Currently, novel systemic treatment paradigms for metastatic hormone-sensitive prostate cancer (mHSPC) have overcome this limitation: early combination or intensified therapy not only induces rapid declines in prostate-specific antigen (PSA) levels and alleviates symptoms but also delays the progression to CRPC, thereby achieving long-term disease control.

Clinical data from the ARCHES trial (NCT02677896), a randomized, double-blind, placebo-controlled, international, multicenter Phase III study that enrolled 1,150 patients with metastatic hormone-sensitive prostate cancer (mHSPC) across centers in the United States, Canada, Europe, South America, and the Asia-Pacific region, demonstrated that among patients receiving next-generation therapies and adhering to comprehensive management, the median overall survival exceeded 8 years, and the risk of disease progression or death was reduced by more than 60%. The objective response rate reached 87%, with 37% of patients achieving complete radiographic disappearance of lesions. The rate of undetectable prostate-specific antigen (PSA) was 76%, and some studies indicated a reduction in progression risk of up to 87%. Importantly, these treatments were associated with lower discontinuation rates due to adverse events and better patient adherence.

Throughout the entire course of disease management, these therapies demonstrate significant safety advantages. Lower discontinuation rates due to adverse events and higher patient adherence contribute to greater stability in long-term treatment, reduce the uncertainty risks associated with frequent medication changes, and enhance patients’ sense of security in their treatment.

Professor Liu Chuan emphasized that the prevention and treatment of prostate cancer are forming a multi-dimensional collaborative landscape, ranging from lifestyle modifications to medical technologies.Looking ahead, the prevention and treatment of prostate cancer are entering a new phase empowered by technology.

From the perspective of prevention and control,Lifestyle intervention is a foundational component of the comprehensive prevention and control system for prostate cancer, offering simple and practical dietary strategies. Current research indicates that lycopene, as a natural antioxidant, helps reduce oxidative damage in prostate tissue, while soy isoflavones found in legumes exert protective effects on prostate health. Professor Liu Chuan recommends that residents adopt a predominantly plant-based dietary pattern.

From the perspective of research and development,Current research focuses on two key areas: On one hand, the industry is accelerating the development of innovative drugs for refractory populations, such as patients with metastatic castration-resistant prostate cancer (mCRPC) and metastatic hormone-sensitive prostate cancer (mHSPC). On the other hand, the industry is driving continuous iteration and upgrading of surgical techniques, from traditional open surgery to laparoscopic surgery, robot-assisted surgery, and finally telesurgery. Each technological innovation enhances the precision and accessibility of treatment. Taking telesurgery as an example, leveraging the low-latency characteristics of 5G technology, physicians can achieve precise cross-regional control of surgical instruments, enabling high-quality medical resources to break through spatial limitations and benefit more patients.

From a clinical perspective,A Model of Multidisciplinary Collaboration and Whole-Process Management Is Building a Scientific System for Prostate Cancer Prevention and Control. In this model, early screening serves as the key link for disease warning, treatment relies on precision medicine approaches, and the rehabilitation phase provides targeted lifestyle guidance. These three components are organically integrated to form a whole-process management chain, facilitating the transition of prostate cancer from a high-risk malignancy to a manageable chronic disease.

As next-generation therapies become more widely available and public awareness increases, a growing number of men will emerge from the shadow of prostate cancer and embrace long-term health through scientific disease management.