Editor's Note: Due to factors such as early screening, drug accessibility, and genetic differences, prostate cancer characteristics in China differ from those in Western countries. In recent years, with China's aging population, the incidence and mortality of prostate cancer have risen significantly, increasing the disease burden. At the recent CSCO Annual Meeting, Urology Frontier invited Dr. Yao Zhu from Fudan University Shanghai Cancer Center to share insights on the characteristics of prostate cancer in China, the latest research progress at Fudan, and the value of clinical research by physicians.

Urology Frontier: In your clinical experience, what aspects of prostate cancer diagnosis and treatment in China need improvement?

Dr. Yao Zhu: Prostate cancer is relatively “new” in China. About 15 years ago, it was not a common malignancy among men. However, in recent years, its incidence has increased rapidly, now ranking as the third or fourth most common male malignancy in Shanghai, with a significant growth in cases.

Additionally, the current situation for prostate cancer diagnosis and treatment in China is not optimistic. Advanced cases dominate, and even at major cancer centers like Fudan University Shanghai Cancer Center, nearly half of the patients present with metastasis at the time of diagnosis, limiting their treatment options.

Moreover, prostate cancer treatment in China largely relies on data from Western clinical trials. Given the rapid increase in cases and the late-stage diagnosis trends in China, these differences are not adequately reflected in Western studies. Therefore, there is considerable room for improvement in clinical research on prostate cancer in China, necessitating a multidisciplinary effort to enhance the current treatment landscape.

Urology Frontier: Recently, your team presented several prostate cancer research advancements at international conferences like ESMO. Could you share some of the findings and their significance for clinical practice?

Dr. Yao Zhu: Under the leadership of Dean Dingwei Ye, the urology team at Fudan University Shanghai Cancer Center has achieved remarkable progress in prostate cancer research, including breakthroughs in neoadjuvant therapy for early-stage prostate cancer, intensified treatment for advanced cases, and new drug research for castration-resistant stages. These achievements have garnered attention and discussion from peers domestically and at ESMO. Overall, we are at the forefront of prostate cancer research internationally. The research findings can be summarized into three key aspects:

Firstly, our team focuses on China’s specific context, conducting in-depth research on drug development and multidisciplinary treatment for high-risk localized and metastatic prostate cancer. This patient-centered approach aims to maximize benefits for patients in China.

Secondly, leveraging the unique advantages of a cancer hospital, our team has developed a disease-focused diagnostic and treatment system rather than the traditional division by treatment methods (surgery, medical therapy, radiation, etc.). At the cancer hospital, we integrate resources from all departments to focus on a single disease, such as prostate cancer. This enables me to function not just as a surgeon but as a prostate cancer specialist, assembling resources to optimize comprehensive treatment strategies for patients.

Lastly, we stay at the forefront of precision medicine by using advanced gene testing and imaging as two essential tools to guide personalized treatment. The application of these technologies has led to several breakthroughs in prostate cancer research, aiming to ensure that patients receive the most appropriate treatment at the optimal time for the best outcomes and longest survival.

Urology Frontier: How do you balance research and clinical practice, and what experiences can you share?

Dr. Yao Zhu: At the CSCO meeting, we witnessed numerous clinicians who excel in both research and practice, including our mentors, predecessors, and peers. Each of them contributes uniquely to the medical field. We aspire to see a positive feedback loop between clinical work and research, where continuous exploration and practice lead to knowledge accumulation and skill enhancement, driving progress for both individuals and the healthcare industry.

In clinical practice, we often encounter patients’ suffering and challenges, which serve as entry points for in-depth research. Addressing these real-world problems not only provides patients with better treatment experiences and expected outcomes but also fosters innovations in treatment strategies, creating new therapeutic models and positive cycles. Research should not be viewed as a heavy burden; rather, finding enjoyment in the interplay between clinical work and research can turn it into an important tool for benefiting patients.

Dr. Yao Zhu:

Chief Physician, Professor, PhD Supervisor Deputy Director of Urology, Fudan University Shanghai Cancer Center (Pudong Campus Head)

• Vice Chair, Young Council of the Chinese Anti-Cancer Association
• Council Member and Secretary-General, Prostate Cancer Committee, Chinese Society of Clinical Oncology (CSCO)
• Shanghai Oriental Talent Program Recipient
• Leading Academic Figure in Shanghai
• Distinguished Professor, Shanghai Higher Education Institutions (“Oriental Scholar”)
• Outstanding Young Medical Talent, “Medical Rising Star” Program in Shanghai
• Expert Group Member, Global Testicular Cancer Study Group (GTCSG)
• Editorial Board Member, Prostate Cancer and Prostatic Diseases, and Leader of the MDT Perspective Section
• Advisor, GUCast Podcast, International Urology News

Specializes in the early diagnosis and radical treatment of prostate cancer, as well as precision diagnosis and treatment of refractory cases. He performs over 400 prostate cancer surgeries annually and was the first in China to conduct precision imaging-guided extended radical prostatectomy and salvage surgery for recurrent cases. His primary research focus is on precision diagnosis and treatment of prostate cancer resistance, having published key academic papers as corresponding author in European Urology, Med, Journal of the NCCN, Clinical Cancer Research, and EJNMMI over the past five years. He was also invited to write a review for Nature Reviews Urology on precision subtyping and treatment strategies for prostate cancer in Asia (2021) and the biological mechanisms and clinical management of prostate cancer liver metastasis (2024).

Professor Zhu has led five projects funded by the National Natural Science Foundation and has received numerous accolades, including the Shanghai Youth Science and Technology Star Program, Top Ten Young Physicians of Fudan University, the Shanghai Municipal Health Commission Youth May Fourth Medal, and the “Top Ten Outstanding Young Doctors” award at Fudan University.