Although prostate cancer is the most common in men, and are diagnosed each year about 25,000 new cases in Spain, in 90% of cases it can be cured. Early diagnosis is vital for survival.
It is one of the most common types of cancer in men and is the second tumor with increased mortality in Western countries, after lung cancer. Prostate cancer is diagnosed with incurable metastatic disease in a significant number of cases, about 800 cases a year.
The good news is that most are diagnosed in stages in which it is potentially located in prostate (90%) and can be cured.
Prostate cancer diagnosis
Today most of the cases diagnosed are asymptomatic, that is, no obvious symptoms. In fact, two out of three are detected only following a blood test ordered by your urologist or family doctor, in which a PSA (prostate specific antigen) is observed high.
In the rest, the presence of urinary symptoms (difficulty urinating, having to urinate urgently, more frequent urination than usual, getting up at night to urinate, urinating blood, etc.), although often associated, can often result from benign problems , which requires a thorough assessment of the underlying prostate problem.
The risk of prostate cancer increases with age. In our country the average age at diagnosis is 69 years. However, each time it is diagnosed at earlier ages.
Prostate cancer screening
Today, it is possible to know about the risk of developing prostate cancer by PSA levels to 40-45 years. Therefore, the revisions after 45 years if they have direct family history and age 50 for those that do not have recommended.
When prostate cancer spreads outside of it, usually it affects the bones in over 80% of cases, with great impact on the quality of life for the pain and loss of function involved. In the later stages it can spread to other organs mainly liver and lungs.
When it has spread outside the prostate, today is considered not curable.
Management of prostate cancer
Treatment depends on the stage when it is diagnosed. If diagnosed early, when located within the prostate, some tumors can be followed for a while without being treated.
In others, it is possible to apply focal therapy techniques in order to control the tumor without risk of impotence or incontinence, which are the main complications of radical treatments that apply to the entire prostate.
The radical treatments are (open, laparoscopic, or robot-assisted laparoscopic) radical prostatectomy, external radiotherapy, or brachytherapy. Each of these techniques has a different side effect profile. Impotence, incontinence and rectal problems in case of radiotherapy, are the main complications. They occur much less the more experienced the surgeon or radiation oncologist.
When the tumor has spread beyond the prostate hormonal treatments that cause chemical castration they are commonly used. After a response time, usually something greater than one year, the tumor becomes resistant to castration and begins to progress. In this final phase they are emerging new treatments capable of prolonging life with excellent quality of life.
Prostate cancer prognosis
Survival rates depend on how early the disease is diagnosed. Survival when diagnosed early is very high (over 80% at 15 years) and to adapt the treatment to be applied so that those who allow greater survival with fewer side effects.
In cases of advanced metastatic disease, today we can achieve survival averages over 4 years. Therefore, again, it is necessary to emphasize early diagnosis.
We can not prevent because they know its root causes. Therefore, we are only able, and strongly recommend, to diagnose it as early as possible in a very simple form consisting of performing a digital rectal examination and a simple blood test to determine the PSA.
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