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Prostate cancer is a very common type of cancer in men, especially after the age of 50.
In general, this cancer grows very slowly and most of the time it does not produce symptoms in the initial phase. For this reason, it is very important that all men have regular checkups to confirm prostate health. These tests should be done from 50 years old, for the majority of the male population, or from 40 years old, when there is a history of this cancer in the family.
Whenever symptoms appear that may lead to suspicion of a change in the prostate, such as pain when urinating or difficulty maintaining an erection, it is important to consult a urologist to perform diagnostic tests, identify the problem and start the most appropriate treatment. Check out the 6 tests that assess prostate health.
In this conversation, Dr.Rodolfo Favaretto, urologist, talks a little about prostate cancer, its diagnosis, treatment and other male health concerns:
Main symptoms
Symptoms of prostate cancer usually appear only when the cancer is at a more advanced stage. Therefore, the most important thing is to have cancer screening tests, which are the PSA blood test and digital rectal examination. These tests must be done by all men over 50 or over 40, if there is a history of cancer in other men in the family.
Still, to know if there is a risk of having a prostate problem, it is important to be aware of symptoms such as:
- 1. Difficulty starting to urinate No Yes
- 2. Very weak stream of urine No Yes
- 3. Frequent desire to urinate, even at night No Yes
- 4. Feeling full bladder, even after urinating No Yes
- 5. Presence of urine drops in the underwear No Yes
- 6. Impotence or difficulty maintaining an erection No Yes
- 7. Pain when ejaculating or urinating No Yes
- 8. Presence of blood in the semen No Yes
- 9. Sudden urge to urinate No Yes
- 10. Pain in the testicles or near the anus No Yes
To find out if you are at risk of having a prostate problem, check the list in the previous list for what you are feeling.
The fact that you are at risk for a prostate problem does not mean that it is cancer, since other problems, such as prostatitis or benign prostatic hypertrophy, are more frequent. Still, if any of these symptoms appear, a urologist should be consulted.
Watch the following video and check which symptoms indicate prostate problems and which tests can be done:
Symptoms of advanced cancer
In more advanced cases, where the prostate is very large and the cancer is more developed, other more serious symptoms may appear, such as:
- Pain when urinating or ejaculating;
- Presence of blood in the urine or sperm;
- Weak stream of urine;
- Difficulty having an erection;
- Urinary or fecal incontinence.
In addition, if the cancer has spread to other parts of the body, other less specific symptoms such as constant back pain, leg weakness or kidney failure are also common.
In more advanced stages, treatment is more difficult, but it is still important to see the doctor to assess the extent of the disease and whether other organs have been affected, adapting the treatment.
How to confirm the diagnosis
Since this cancer does not cause symptoms at the beginning of its evolution, the best way to assess whether there is cancer developing in the prostate is to have a digital rectal exam and a PSA blood test.
If, during rectal examination, the doctor palpates a lump or if the PSA blood test is severely altered, the prostate should be investigated by means of a biopsy, which will remove small pieces of the prostate and then be analyzed in the laboratory. Understand how the biopsy is done and when it is indicated.
Prostate cancer stages
If the existence of prostate cancer is confirmed, it is essential to identify the stage of the cancer to guide the treatment.
The main stages of prostate cancer are:
- T0: there is no evidence of tumor;
- T1: tumor that was not identified by palpation or image examination;
- T2: primary tumor that is limited to the prostate;
- T3: tumor that besides the prostate also affects the prostatic capsule and that can affect the seminal vesicles;
- T4: tumor that invades other nearby structures, such as sphincter, rectum or muscles;
- N0: there are no metastases in the lymph nodes near the prostate;
- N1: there are metastases in the lymph nodes near the prostate;
- M0: there are no distant metastases;
- M1: there are metastases in other organs, bones or lymph nodes further away from the prostate.
The degree of cancer allows to define the best treatment and understand the chances of cure.
Possible causes of prostate cancer
There is no specific cause for the development of prostate cancer, however, some factors are associated with an increased risk of having this type of cancer, and include:
- Having a first-degree relative (father or brother) with a history of prostate cancer;
- Be over 50 years of age;
- Eat an unbalanced diet and very rich in fats or calcium;
- Suffer from obesity or being overweight.
In addition, African-American men are also twice as likely to have prostate cancer as any other ethnicity.
How the treatment is done
Treatment for prostate cancer should be guided by a urologist, who chooses the best form of treatment according to the age of the patient, severity of the disease, associated diseases and life expectancy.
The types of treatment that are most commonly used include:
- Surgery / prostatectomy: it is the most used method and consists of the complete removal of the prostate through surgery. Learn more about prostate cancer surgery and recovery;
- Radiotherapy: consists of the application of radiation to certain areas of the prostate to eliminate cancer cells;
- Hormonal treatment: it is used for the most advanced cases and consists of the use of medicines to regulate the production of male hormones, relieving symptoms.
In addition, the doctor can also recommend only the observation that consists of making regular visits to the urologist to assess the evolution of the cancer. This type of treatment is most used when the cancer is at an early stage and evolving very slowly or when the man is over 75 years old, for example.
These treatments can be used individually or in combination, depending on the degree of evolution of the tumor.