Men susceptible to prostate cancer fear late detection the most. Our scholars are proposing solutions in "UTD"!

Despite the rapid development of medicine in recent years, people still “turn pale” when hearing doctors mention cancer. Many draw parallels between having cancer and a death sentence.

In fact, not all cancers are life-threatening with high mortality rates. For example, there is a type of cancer that progresses so slowly that some patients may never even be aware of having it and will be living a normal life.

Prostate cancer ranks sixth in the list of high-incidence diseases among men in China, yet, fortunately, has a low mortality rate.

So, do the statistics entail that prostate cancer is not something to worry about? - Not true. On the contrary, the tricky thing about prostate cancer is that although the mortality rate is low, once it worsens, patients will be at an elevated risk of dying.

Some may say, “Just do the surgical operation as soon as possible to completely eliminate the danger!” But practice shows that patients at minimal risk of early cancer, who opt for surgical removal of the prostate capsule likely will suffer long-term postoperative side effects.

The actual best way is early screening and treatment which involves long-term surveillance, and tracking cancer progression through regular physical examinations to provide necessary and timely treatment.

However, the examination for monitoring the possible deterioration of cancer also has a certain accuracy error, which may lead to missed detection and delayed treatment. This accuracy error, which is endangering peoples lives, has attracted the attention of ZHANG Zheng, a researcher in the School of Management of Zhejiang University, and his collaborators Brian T. Denton and Todd M. Morgan.

ZHANG Zheng’s study and the original article can be accessed  here 

After a long time of in-depth research, scholars have proposed a more accurate and efficient monitoring strategy, which can significantly improve the prognosis of patients with prostate cancer.

Recently, their research results got published in the highly reputed international journal “Production and Operations Management” (one of the UTD24 journals of management and one of the FT50 journals).

This breakthrough augments the "one size fits all" treatment strategy and it eliminates the long-term pain caused by excessive medical treatments.

Cancer is terrible, not only because it is difficult or sometimes even impossible to treat, but also because it is expensive to treat, and every treatment is a “nightmare” for patients.

Moreover, prostate cancer hurts not only when treated but also when examined.

In order to avoid the harm caused by "one size fits all" treatment strategy, the medical community is now promoting the "coexistence with cancer" model for patients with early prostate cancer, that is, the long-term cancer monitoring strategy. This means that regular examinations for prostate patients are indispensable.

However, doctors cannot arrange a large number of examinations without any limitations. The most effective and commonly practiced examination technique for prostate cancer is a biopsy test, which is excruciatingly painful for patients, enduring this procedure repeatedly can be strenuous.

Therefore, the monitoring strategy of determining the patients examination frequency or examination time is a key variable affecting the effectiveness of cancer monitoring, a major research problem focused on by the International Association of Urologists.

“How can patients avoid this painful examination procedure, and simultaneously, and not risk a delay in treatment?”

To answer this question, ZHANG Zheng’s team created a mathematical model for the onset and deterioration process of prostate cancer.

His team succeeded in achieving a more accurate description of the detection rate of cancer deterioration by basing their mathematical model on data that included patients of diverse age groups and risk factors.

Their research has proven that their optimization strategy can significantly improve the existing screening process, i.e., under the same screening time, the use of this optimization strategy can improve the prognosis of patients.

It is estimated that each prostate cancer patient monitored through this optimization strategy can extend his life by 0.06 years (about 21 days) on average, which is a significant amount of time for cancer prevention and treatment.

ZHANG Zheng’s team also discovered in the study that "a more personalized screening program" can further improve the prognosis of patients, however, this improvement will show a significant marginal diminishing effect.

The two types of optimized monitoring strategies designed through their models can rigorously cover more than 50 different types of patients. This, in turn, can efficiently simplify the detection of cancer deterioration.

The reason ZHANG Zheng’s team was able to develop such an efficient prostate cancer monitoring optimization strategy is that they conducted a stochastic programming mathematical model for the optimization problem of monitoring strategies for such complex cancers and designed an efficient solution algorithm for this model. (To view relevant details, click "Read the original paper" at the bottom left corner of the end of the paper to view the original paper).

Using a two-stage stochastic programming mathematical modeling technique, ZHANG Zheng’s team developed an algorithm that can efficiently determine a patient’s need for cancer detection, missed detection, and the cost of monitoring them; therefore, recommending strategies that have different intensities according to a patient’s affinity to the risk posed by a disease, which is a major milestone in the field of cancer monitoring.

This technique is not only applicable to prostate cancer monitoring. According to ZHANG Zheng’s team, the mathematical model and related algorithms they developed, have certain universality and can be applied to other types of cancer screening and monitoring strategy optimization in addition to prostate cancer.

"At present, we are working with the Second Affiliated Hospital of Zhejiang University School of Medicine, Mr. Run Shaw Hospital, etc. to design a screening scheme for breast cancer and colorectal cancer based on this mathematical model and algorithm. Please look forward to our follow-up research results." ZHANG Zheng said.

The living standard of people has significantly improved since the advent of modern medicine, but at the same time, as the population ages, all kinds of chronic diseases are likely to gain prominence among which cancer is the most feared with the highest treatment cost.

This research by ZHANG Zheng’s team can significantly improve the existing guidelines and strategies so that patients can effectively prevent the deterioration and spread of cancer promptly without having to sustain the pain caused by too many examinations, and significantly improve the prognosis and life of patients.

Moreover, the monitoring optimization strategy developed by them is efficient and simple enough, which has significant application value for improving the monitoring efficiency of prostate cancer. And because of the simplicity and efficiency of this optimization strategy, it can be brought into practice relatively quickly, boosting the monitoring efficiency of prostate cancer.

- We wish ZHANG Zheng the best of luck in his research and success in achieving set goals! 加油！

- ZHANG Zheng’s original publication can be accessed  here 

- The original article in Chinese is available  here