Prostate cancer: at what age and how often should we be screened?

Prostate cancer is an entity with an important prevalence in our society, and sometimes it is associated with a family genetic inheritance, predominantly in first-degree relatives, and especially those with a history of prostate cancer at an early age.

This is why certain patients require an early and exhaustive active search. If there are no relatives with prostate cancer, the age of onset is usually 50 years, unless the patient has previously presented urinary symptoms or if the patient expressly wishes to start controls before the aforementioned 50 years of age.

If, on the other hand, there is a genetic predisposition, the ideal is to start at least 5 years earlier, with PSA determination and digital rectal examination.

In patients with normal test results, an annual check-up can be scheduled.

What are the symptoms?

As a general rule, prostate cancer is asymptomatic, being mostly diagnosed by screening, which is usually performed in primary care consultations and with specialists in urology.

Only in very exceptional cases can it present symptoms such as hematuria, difficulty urinating or lumbar pain, for example. Although, as I have said, it is usually asymptomatic.

What are its causes and treatment?

Prostate cancer has a multifactorial origin, the most predisposing demographic factors are:

  • Age, 75% of cases are diagnosed in patients over 65 years of age.
  • Race, African-American patients have the highest incidence of prostate cancer.
  • Familial aggregation.

As risk factors:

  • Diet rich in fat and meat.
  • Smoking.
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As regards treatment, there are currently multiple techniques available, both surgical (radical prostatectomy, HIFU, cryotherapy, etc.) and medical or radiotherapeutic, which allow correct management with a high cure rate for prostate cancer.

What is the recovery rate?

The cure rate for prostate cancer is high, as long as the disease is diagnosed in its early stages, or when there is no involvement outside the gland or metastasis.

In cases in which the disease is high risk or has distant dissemination, there are new pharmacological therapies, associated with androgen deprivation, which allow a certain chronification of the disease.

Post-surgical recovery is usually good, being discharged in 2-3 days with bladder catheter, allowing a progressive reincorporation of the patient to his life habit. Although it should be noted that there is some early incontinence when the catheter is removed, which usually recovers with the passing of weeks.

The main sequelae of removal of the prostate gland are impotence or worsening of erection and urinary incontinence, although the Robot-assisted radical prostatectomy technique can reduce the percentage of sequelae.