Professor Sun Ting: From the beginning to the end, the optimization strategy of the whole process of prostate cancer management

"An "Medical" Leye" is a humanistic case collection project

There is a sentence in the Zhou Yi Zhi Ci that reads: "The change of the meaning of transformation and reduction; Pushing and doing is called the general, and the people of the world who take measures are called the cause

Expert Profiles

Professor Sun Ting

Grade II Professor Chief Physician Doctoral Supervisor

Chief Specialist of The Department of Urology, The First Affiliated Hospital of Nanchang University

Member of urology Society of Chinese Medical Association

Chairman of urology branch of Jiangxi Medical Association

Member of the Robotics Group of the Urology Society of the Chinese Medical Association

Member of the Minimally Invasive Group of the Urology Society of the Chinese Medical Association

Member of the Urological Endoscopy Professional Committee of the Chinese Medical Doctor Association

Member of the Standing Committee of the Committee of the Committee of The Doctors of Integrated Traditional Chinese and Western Medicine of the Chinese Medical Doctor Association

Deputy Director of Jiangxi Institute of Urology

Vice Chairman of Jiangxi Urology Specialist Medical Association

Cross-century academic and technical leader of the health system in Jiangxi Province

Leader of young and middle-aged disciplines in colleges and universities in Jiangxi Province

Young and middle-aged academic and technical leader of Jiangxi Provincial Health Department

Based on patients, from the beginning to the end, the whole process of prostate cancer management is three steps

In recent years, with the progress of clinical research and the strengthening of international exchanges, the level of prostate cancer diagnosis and treatment in China has been in line with international standards

The first part is screening

The second part is the diagnosis

The third part is follow-up of prostate cancer

Tailor-made, varies from person to person, personalized diagnosis and treatment benefits

Compared with other tumors, prostate cancer is obviously heterogeneous, the treatment system is more complex, and the treatment from metastatic hormone-sensitive prostate cancer (mHSPC) to metastatic castration-resistant prostate cancer (mCRPC) varies
from person to person.

Through the joint participation of doctors from different departments such as oncology, internal oncology, urology, imaging, chemotherapy oncology, pathology and radiotherapy, the MDT diagnosis and treatment model can develop the best individualized treatment plan for patients, which can effectively improve the survival benefits of
patients.

Based on the concept of personalized diagnosis and treatment, Professor Sun Ting shared a relatively special case
for us.

A young patient in his 30s, the initial PSA level is very high, the team through MDT discussion to determine the magnetic resonance, systemic bone scan and precision puncture diagnosis, so as to confirm that the patient has prostate cancer, and then through genetic testing found that the patient has some genetic mutations, which means that he may not respond well
to some treatment drugs.

Based on the diagnosis results and individual characteristics of patients, Professor Sun Ting and the diagnosis and treatment team formulated a personalized treatment plan
for first neoadjuvant treatment and then surgical treatment.

The treatment results showed that after 3 months of neoadjuvant therapy, the patient's PSA level had decreased by 99.
9%, and the benefit was very obvious
.

At present, the patient is still in neoadjuvant therapy, and if the subsequent tumor can be reduced to the level of tumor reduction, radical surgical treatment can be performed, and the patient will have a higher survival benefit
.

Professor Sun Ting said that individualized treatment plans should be based on guidelines for disease treatment
.

At present, foreign guidelines such as NCN, AUA, EAU, and domestic CSCO and CUA recommend androgen deprivation therapy (ADT) + new endocrine therapy (NHT) models
for patients with medium and high-risk prostate cancer.

Existing new endocrine drugs mainly include abiraterone, enzaluamine, apatamide and bicalutamide
.

The choice of NHT needs to be made according to the patient's physical condition, such as prostate cancer patients with cardiovascular diseases, in order to avoid the occurrence of cardiovascular adverse events, the use of Nzaluamine, which is safer and less cardiovascular side effects, is a good choice
.

Life is trusted, trust is attached, and doctors and patients work together to help each other

The importance of regular follow-up of prostate cancer patients is unquestionable
.

Professor Sun Ting said that in order to improve and maintain the cooperation of patients, the department team will regularly publicize and educate on the diagnosis and treatment of prostate cancer diseases, and organize different teams to be responsible for the physical examination and follow-up management
of different patients.

For patients or family members with poor compliance, the diagnosis and treatment team chooses to use meticulous and powerful communication to convey the correct treatment concept to patients, and help patients establish a healthy treatment concept
with real and vivid cases.

Even for patients who fall off during follow-up, the diagnosis and treatment team will not give up, but through patient explanation and guidance, try to re-establish contact with patients, and strive to guide patients to re-enter the
diagnosis and treatment system.

To maintain the long-term management model of prostate cancer follow-up, it is not only necessary to maintain the diagnosis and treatment team, but more importantly, the patient's own trust in the diagnosis and treatment team
from the heart.

Professor Sun Ting said that doctors under the MDT model always have a sincere sense of responsibility for patients, always hope to help patients with the best medical services to maximize survival benefits, and also hope to establish a due relationship of trust with patients, because mutual trust is the first step
in treatment.

A good doctor must start from his own profession, take the patient as the center to manage the entire disease, and strive
for patients to have a longer living space, greater treatment benefits and a higher quality of life.

Medical progress, prolonged survival, and the future of chronic diseases can be expected

With the breakthrough of medical technology, the living space of prostate cancer patients has become more and more extensive
.

Professor Sun Ting said that at present, the whole process of management of prostate cancer patients at home and abroad tends to achieve "chronic disease", that is, the whole process of management
to ensure the quality of life and survival of patients under the premise of long-term survival of patients.

If patients recover well, the follow-up frequency can be reduced to once every six months, and the underlying diseases that occur during the interval period can be handed over to the community primary hospital for treatment to improve the convenience of
the patient's life.

However, it should be noted that patients must still be followed up with the MDT team for initial diagnosis, and at least once a year, to maintain the continuity and effectiveness
of diagnosis and treatment.

Expert Hearts

With the implementation of the 2035 National Health Plan, Professor Sun Ting believes that there will be more advanced treatment concepts and drugs introduced into the clinic in the future, and the level of prostate cancer diagnosis and treatment in China will be further improved until it is developed in parallel with the international frontier, and prostate cancer patients will also get higher treatment guarantees and survival benefits
.

It is hoped that doctors and patients will work together to create a long-term harmonious and warm diagnosis and treatment environment and strive for a brighter tomorrow
for all prostate cancer patients.

Past period review

1.
Prof.
Zhu Yao: The revision of the guidelines is like building a giant ship that carries the hope of patients all the way forward

2.
Professor Easy To Discover | The "growth" of the guide is accompanied by a breakthrough in diagnosis and treatment, which guides a brighter and smoother path in the coming days

3.
Prof.
He Weiyang: The Development of Antiandrogenic Drugs: A Clinical "Revolution" Driven by Drug Resistance

4.
Director Li Rubing: White clothes, magic hands, red hearts - prostate cancer diagnosis and treatment concept and medical spirit

5.
Professor Ma Limin: The road of "medicine" is winding, and the waves are gushing

Special thanks: Beijing Astellas Pharmaceutical Co.
, Ltd

Edit: Wei Meng

Review: Bing Xin

Typography: Wang Mumu