What is prostate cancer and why does it occur?
Prostate cancer, like any or most cancers, we do not know why it occurs. What we do know is that it is the most frequent cancer in men over 50 years of age and, therefore, what we must do is to be a little more extreme in our search, or active search, for people or men who may suffer from prostate cancer, because like most cancers, if we diagnose it early we have a very high probability of curing it and that this cancer does not limit or reduce the life expectancy of the people who suffer from it.
Who is affected by prostate cancer?
As I have just mentioned, prostate cancer affects men, generally above the fifth decade of life, that is to say, it is exceptional to suffer from prostate cancer under the age of 50, although it sometimes occurs. And as I have also mentioned, it is a cancer that becomes the most frequent cancer in men from that age, from the fifth decade of life, and also after lung cancer the one that causes the most deaths in men from the age of 50 until the end of their lives. It is therefore a cancer that worries the medical community, the urological community, because it conditions or can condition the lives of thousands of people and can reduce the years of life that these people can have or enjoy.
How is prostate cancer diagnosed?
The diagnosis of prostate cancer has not changed much in recent years, although I will clarify later on that there are some very important things that have changed. In general it is very common, the most common, to suspect that a man has or may have prostate cancer, because in an analysis called PSA (prostate specific antigen) his levels are above a certain threshold. The threshold is not the same in all men, it depends on age, it depends on the volume of the prostate, it depends on whether the prostate has had inflammatory or infectious problems in the past. But what is true is that most of the time it is suspected because of this elevation of PSA. Once we suspect it, the identification of the tumor generally almost always involves a prostate biopsy, that is to say, urologists first perform a transrectal ultrasound that perfectly identifies that organ and from there and with that image we take a series of samples in different prostatic areas and those are, on the one hand the suspicions with the elevation of PSA and on the other hand, the confirmation through the biopsy, which will lead us to a diagnosis of prostate cancer.
What are the latest techniques for treating prostate cancer?
It is true that in medicine, in surgery and in prostate cancer we are seeing almost continuously a very significant evolution in diagnoses and treatments. We could say that there is a revolution in that we are able in many patients, not in all but in many patients, to identify exactly where the prostate cancer is located and we have tests that tell us whether that tumor can be more or less aggressive. In that sense, until recently most urologists, practically all urologists everywhere, offered radical treatments for prostate cancer: removal of the gland, radiotherapy, cryotherapy?
Today, little by little, but more and more, we are able to select patients where we are going to treat only and exclusively where the tumor is focused, where the tumor is located, and not to carry out a complete treatment of the rest of the organ. This has a great benefit, which above all is to reduce the side effects that these treatments have. After treatment, these patients will have less risk of impotence, less risk of urinary incontinence. If we achieve the same survival rate, it is a breakthrough, it is a paradigm shift, spectacular.