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Disclosure photo of the booklet of the Cancer Institute (Inca), one of the most important bodies when it comes to the topic in Brazil. (Photo: reproduction / INCA)
It is a cancer silent and aggressivehence the importance of maintaining routine preventive examination for 50 years. Any signs of symptoms can indicate this the disease has advanced. We are talking about the prostate cancer, the second type of cancer that most affects people with prostate, which is a gland located in the lower abdomen. It is a small, apple-shaped organ located just below the bladder and in front of the rectum (the final part of the large intestine).
The prostate surrounds the initial portion of the urethra, the tube through which urine stored in the bladder is eliminated. The prostate produces some semen, a thick liquid that contains sperm, released during sex. Prostate cancer occurs when there are mutations in the cells that make up this gland. These changes cause abnormalities, which still start in the prostate, but can spread to other parts of the body.
Clinical oncologist Aurillo Rocha warns of an extremely important tip in the prevention of prostate cancer: preventive examinations. From the age of 50, it is essential that this monitoring is carried out. Because it’s a silent cancer, it almost never has symptoms and, when you are in this stage, it can mean that the disease is advanced, which makes it difficult to care for the patient.
“The question is to diagnose early, put an end to this male taboo of not going to the office. As the person ages the tendency is to have changes in the prostate. They can be benign changes. These are exceptions that cause cancer, “Aurillo explains. Unfortunately this exception is quite common and in Ceará this year alone, 471 people have died from the disease, according to data from the State Department of Health. There were 657 deaths in 2019.
According to the National Cancer Institute (Inca), prostate cancer is considered a cancer of the elderly more than any other type. About 75% of cases in the world occur from the age of 65. “The observed increase in incidence rates in Brazil can be partially justified by the evolution of diagnostic methods (examinations), the improvement in the quality of the country’s information systems and the increase in life expectancy”, says an organ in a brochure.
Some of these tumors can grow rapidly, spread to other organs, and can lead to death. Most, however, grow so slowly (it takes about 15 years to reach 1 cm³) that they show no signs during life or even threaten the person’s health. In Brazil, the estimate is 65,840 new cases, according to INCA data. In Ceará, that number reaches 3,500. Aurillo Rocha says it can be even bigger, as some diagnoses can be confused with other health problems, such as urinary tract infection. Therefore, digital rectal examination is essential, as it can detect cancer with greater certainty. “The second type of diagnosis is PSA, a blood test. It doesn’t detect cancer, but it warns you,” strengthens the doctor.
Inca highlights: Neither exam is 100% accurate. Therefore, further testing may be required. Biopsy is the only procedure that can confirm cancer. In this procedure, tissue samples are taken from the gland for analysis, which is performed with the help of ultrasound. There may be discomfort and blood in the urine or semen in the days following the procedure and there is a risk of infection, which clears up with the use of antibiotics.
Other imaging tests may also be ordered, such as computed tomography, MRI, and bone scan (to see if the bones have been affected).
> Understand the two types of diagnosis:
1. PSA assay: blood test that evaluates the amount of prostate specific antigen.
2. Digital rectal exam: Since the gland is located in front of the rectum, the exam allows the doctor to palpate the prostate and see if there are any lumps (nodules) or hardened tissues (possible early stage of the disease). The touch takes place with the finger protected by a lubricated glove. It is quick and painless, although some men report discomfort and have tremendous stamina to perform the exam.
How is the treatment?
Oncologist Aurillo Rocha brings good news: today the treatment of prostate cancer is more modern and less toxic for patients, favoring the quality of life and the importance of trying to maintain a normal life routine even with the disease. “Treatment today is more appropriate because it is multidisciplinary. This approach is much more effective, because it involves other doctors such as nutritionists, psychologists,” says Rocha.
According to the Cancer Institute (Inca), for localized diseases (which have only reached the prostate and have not spread to other organs), surgery, radiation therapy, and even vigilant observation (in some special situations) may be offered. For locally advanced disease, radiation therapy or surgery in combination with hormone treatment has been used. For metastatic disease (when the cancer has already spread to other parts of the body), hormone therapy is the most suitable treatment.
The choice of the most appropriate treatment must be individualized and defined after the doctor and patient have discussed the risks and benefits of each. “The diagnosis of cancer is aggressive. It is a disease that even the family gets sick. But yes, it has a cure,” concludes Aurillo Rocha.
> Treatment in Fortaleza:
The first step in starting prostate cancer treatment is to go through primary care. The exams can be taken free of charge by the Unified Health System (SUS) in all health centers of the capital and also in polyclinics.
The final treatment can be carried out (even free of charge) in the following locations: Fortaleza General Hospital (GHF), Dr. César Cals General Hospital (HGCC), Regional Integrated Oncology Center (Crio) and Ceará Cancer Institute (ICC).
Here are some signs and symptoms:
In its early stage, prostate cancer has a silent evolution. Many patients have no symptoms or, when they do, are similar to those of benign prostate growth (difficulty urinating, needing to urinate more often during the day or night). In the advanced stage, it can cause bone pain, urinary symptoms or, if more severe, generalized infection or kidney failure.
According to the Ministry of Health, some risk factors can increase the chance of cancer:
1. Age is an important risk factor, as both incidence and mortality increase significantly after age 50.
2. Father or brother with prostate cancer before age 60, which may reflect both genetic (hereditary) factors and the risky eating or lifestyle habits of some families.
3. Excess fat increases the risk of advanced prostate cancer.
4. Exhibitions aromatic amines (common in the chemical, mechanical and aluminum processing industries) arsenic (used as a wood preservative and pesticide), petroleum products, vehicle exhaust engines, polycyclic aromatic hydrocarbons (HPA), soot and dioxins are associated with prostate cancer.
Blue November
Psychologist Mariana Teófilo comments on the importance of Blue November, awareness month on the prevention and treatment of prostate cancer. For the professional, the context involving men’s health is often characterized by a lack of self-care, by the idea that they are not vulnerable to adverse contexts, which results in a low demand for care. “These elements are configured as one of the main challenges for the care of this population, considering chronic diseases as the greatest vulnerability. Therefore, Blue November aims to pay attention to prevention,” says Mariana.
The Blue November really wants to underline the importance of self-medication. Therefore, maintain healthy habits, often consult a doctor, have a adequate food and do not leave out the vaccination card are precautions that can prolong the life of this public.
> Click here and read the Cancer Institute (Inca) full brochure on Blue November
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