What is the role of early prostate cancer prevention and why is it important?
Prevention of prostate cancer from the age of 50 years (45 years in men with a family history of prostate cancer) is of enormous importance in prolonging the lives of men in the 21st century.
Similarly to breast cancer in women, it is recommended that men visit their urologist at least once a year for check-ups, since from the age of 50 onwards, there is a considerable risk of developing prostate cancer.
How can we make the population aware of the importance of going to the urologist for regular check-ups and leave taboos behind?
One way to raise public awareness is to learn about cases of men who did not go to the urologist and died at an early age from prostate cancer:
Several famous musicians from groups such as The Ramones, Frank Zappa, or even the singer of Mötorhead did not perform such checkups and are no longer here to tell the tale. An annual analysis and a rectal examination would have possibly prolonged a few years of life, and due to its high incidence (it can affect up to 2 out of 10 men) it is advisable to have it checked.
It is important to note that with values below 0.8 ng/mL of PSA there are no prostate cancers, that is to say that sometimes with an analysis, the consultation to the urologist could be enough.
Nowadays people want to live for many years and with a good quality of life, and for this it is important to detect the most common health problems as early as possible.
Currently, there are several non-invasive methods with which we can assess the risk of a patient having prostate cancer or not; hence, compared to previous years, urology is gradually trying to be less traumatic for the patient.
What are the warning signs of possible prostate cancer?
The patient does not have any symptoms in the curable stages, hence the importance of performing these check-ups periodically, even if there are no complaints.
How can prostate cancer be diagnosed with certainty?
With 100% certainty there is only the microscopic analysis of a prostate sample.
The methods that have appeared in recent years have not been able to reach 100% of the diagnosis, being used to assess when there would be a greater or lesser risk of having prostate cancer and if the risk is high, we will perform a prostate biopsy.
Novel methods in this regard would be the SELECT/MDX blood test, or with the PIRADS scale on a prostate MRI, followed by FUSION BIOPSY if necessary.
How is prostate cancer treated?
Surgical treatment of prostate cancer can be performed by open, laparoscopic or robotic surgery. In the latest published studies, the three approaches in expert hands achieve similar results, giving some advantage in less bleeding, and a slight improvement in functional outcomes for robotic prostatectomy with the da Vinci system.
According to the latest 2019 study by the Martini-Klinik in Hamburg, where 10790 patients operated on for prostate cancer with open and robotic surgery were compared, they obtained the following results:
Urinary continence (use of 1 safety pad, or no pad) at 12 months: 88-90% overall. And if we separate it by age groups: 68 years: 81%.
With respect to the preservation of sexual potency, they observed globally that when both vascular-nerve structures were preserved, 50% of the patients had erections.
In general, except in tumors of high or very high aggressiveness, the prognosis of prostate cancer is very good. The survival rate is between 77% and 98% at 10 years, depending on the stage of the tumor.
The important thing to try to be left with the least possible sequelae and to be able to safely preserve continence and sexual function is to have a diagnosis in the earliest stages of the disease.
For more information about prostate cancer and its possible treatments, contact a specialist in Urology.