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We are once again at the Blue November dedicated to actions related to human health; as we are in a difficult period of pandemic, we must remember the prevention of prostate and testicular cancer.
We take this opportunity to remind you that prostate cancer ranks third in terms of mortality in men in Portugal. It affects around 6,600 Portuguese per year and around 1,900 die. It is a silent pathology that does not give symptoms in the early stages and you cannot expect the first symptoms to appear to see a treating doctor or urologist.
When diagnosed early, prostate cancer has a cure rate of around 85%.
If an individual does not have prostate cancer in the family, prevention should be done from 45 to 50 years of age. When there are cases in the family, prevention should begin between the ages of 40 and 45.
Prevention and early diagnosis are carried out through two very simple procedures: a blood test with determination of the PSA (prostate specific antigen) and a digital rectal examination. PSA does not diagnose prostate cancer but selects the population at risk from a certain value (4 ng / ml). We know that the likelihood of cancer is higher the higher the PSA value. The analysis of this value combined with the examination of the digital rectal examination and the execution of the prostate biopsy obtain the diagnosis. Complemented by ultrasound and magnetic resonance.
We admit that men have some prejudice in consulting the urologist for fear of a rectal examination (palpation through the rectum which allows to verify the size, consistency, the possible presence of nodules).
Being one of the reasons that makes them postpone the consultation and delay early diagnosis. Although in recent years more and more those who are encouraged by their partners end up seeking specialized help.
Early diagnosis is to identify patients at a stage where there are no symptoms and the disease is potentially curable. The sooner it is performed, the better the treatment outcome and prognosis (evolution) will be.
In Madeira, the disease affects an average of 130 new cases per 100,000 inhabitants per year. This is one of the strongest reasons for recommending an early diagnosis. In fact, with the aging of the population and the improvement of health care, the incidence has been increasing, with the Urology Service adequately equipped for the treatment and monitoring of the disease.
For the treatment of prostate cancer, there are different therapeutic options, depending on the patient and the stage of the disease (localized or already disseminated). Surgery, or radical prostatectomy, is the treatment of choice in cases of localized disease. As postoperative complications, erectile dysfunction and urinary incontinence may arise, but are recoverable in most cases with currently available and appropriate treatments.
External radiotherapy is an option for patients with operational limitations, they have side effects similar to those of radical prostatectomy but with progressive onset. Prostatic brachytherapy, the most recent radiotherapy technique consists in implanting radioactive seeds directly into the prostate under ultrasound control. It is used in special cases in patients with mildly aggressive tumors. Complications, although uncommon, are similar and also appear gradually. In case of disseminated disease, hormone therapy can be used (complete androgen blockade, which can be subjected to castration). Chemotherapy is reserved for advanced cases.
It should be noted that early diagnosis and treatment are essential for greater therapeutic efficacy and final cure.
Maintaining healthy habits of life, i.e. a diet rich in fruit, legumes, cereals and with less fat, mainly of animal origin, helps reduce the risk of cancer as well as daily exercise, at least 30 minutes, fighting obesity and decreasing consumption of alcohol and not smoking.
As for testicular cancer, it is much less common than prostate cancer, affecting mainly between 15 and 40 years of age with an incidence of 5 cases per 100,000 inhabitants (per year).
We emphasize the importance of health education for the population, especially adolescents, young men, alerting the need for a testicular self-examination, looking for the presence of nodules, induration (swelling) which may or may not be accompanied by pain, thus allowing, with visit to the attending physician or urologist, early diagnosis and treatment.
Testicular cancer is currently considered one of the most treatable cancers if diagnosed early with treatment in the range of 90-95%.
The need for good family support is paramount due to the psychological impact these cancers have on patients.
If early diagnosis and treatment are not carried out, the mortality rate increases significantly, causing a large economic impact on health care costs.
This year, the Portuguese Cancer League, in collaboration with the SESARAM Urology Service, will raise awareness of male cancer with a conference (webinar) “Let’s talk about prostate cancer”, tomorrow 9 November at 18:30, in the Hall Lectures by the Dr. Nélio Mendonça Hospital. Interested parties should log into the sesaram website – www.sesaram.pt to access the preview link. This year, due to the pandemic, the “Men’s Race” will be virtual and RAM’s Regional League Against Cancer Core will provide the link to that end, with the support of the RAM Athletics Association.
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