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Prostate cancer is one of the most common malignancies in men. Research shows that one in eight men can be diagnosed with this type of cancer at some point in their lives. If it is detected at an early stage, complete healing can be achieved. But he wants good information and vigilance, because in most cases he is asymptomatic.
Risk factors
Although we don't know exactly what causes prostate cancer, there are three important risk factors that are good for a man to know and check.
- Age
The risk of prostate cancer increases with age. Mostly, it occurs in men over 50 years of age, with a higher probability of occurrence between 60-65 years of age.
- Family history
A man is 2.5 times more likely to develop prostate cancer if his father or brother has been diagnosed with the same disease than a man who has not had a family history of the disease.
It has also been shown that there is an increased chance of prostate cancer in a man who has a mother or sister who has been diagnosed with breast cancer.
- Nationality
In black men, the chance of developing prostate cancer is increased.
Symptoms
Most men with early stage cancer have no symptoms. This is because, usually, the cancer grows on the outer surface of the prostate, so it does not press on the urethra. On the other hand, if it develops internally, there are usually changes in the way you urinate, which can be:
- Difficulty urinating
- Small flow
- Feeling of incomplete bladder emptying
- More frequent urination
- Sudden urgent need for bladder emptying
These changes may also be due to non-cancerous causes, such as prostatitis. So it is important that they are assessed by the right doctor.
Diagnosis
Specific protective antigen ( PSA) testing
PSA testing is widely used for early detection of prostate cancer. It is a blood test, which is done in men over the age of 50. If there are risk factors in a patient, it is recommended that PSA testing be done at an earlier age.
But what is the PSA antigen? It is a protein produced by the prostate and secreted in the semen. An increase in PSA is seen in benign prostatic hyperplasia, in prostatitis and in case of malignancy. It is not a specific indicator of prostate cancer, because it may be elevated but not be the cause of a malignancy and vice versa. In any case, it is the urologist who will evaluate the PSA value, but also the rate of change over time and decide whether a finger test and further testing is needed.
Treatment
The choice of treatment, as with most cancers, depends on many factors, including:
- The stage of cancer
- The rate of evolution
- The disadvantages and advantages of each treatment
- The possible side effects
- Practical issues, such as how often treatment needs to be given and in which hospital
- The general state of the patient's health, etc.
Treatment options include: surgical treatment with radical prostatectomy, radiotherapy, hormone therapy, continuous monitoring, and other new localised treatments.
Bibliography
Barber L, Gerke T, Markt SC, Peisch SF, Wilson KM, Ahearn T, et al. Family History of Breast or Prostate Cancer and Prostate Cancer Risk. clin Cancer Res. 2018 Dec 1;24(23):5910-7.
Cancer Research UK. prostate cancer incidence statistics: prostate cancer incidence by age (2011-2013) [Internet]. [cited 2018 Dec 12] Available from: http://www.cancerresearchuk.org/health-professional/cancer-statistics/statistics-by-cancer-type/prostate-cancer/incidence
Aaron L, Franco O, Hayward S. Review of Prostate Anatomy and Embryology and the Etiology of BPH.Urol Clin North Am. 2016 Aug;43(3):279-88
Preston MA, Batista JL, Wilson KM, Wilson KM, et al. Baseline prostate-specific antigen levels in midlife predict lethal prostate cancer.J Clin Oncol Off J Am Soc Clin Oncol. 2016;34(23):2705-2711. doi:10.1200/JCO.2016.66.7527.
Albertsen PC, Hanley JA, Fine J. 20-year outcomes following conservative management of clinically localized prostate cancer. jama. 2005;293(17):2095-2101.
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