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PROSTATE CANCER

Prostate cancer is a frequent pathology that affects 25% of men over 50 and 80% of men over 80. The origin remains unknown, but it may respond to hormonal, age, race and specially, genetic factors (if a first-degree relative suffers from this disease, the risk of showing it is increased). Unlike other cancer types, prostate cancer is a slow development disease.

DIAGNOSE

Prostate cancer has a slow development, showing symptoms only at advanced stages; however, it can be diagnosed beforehand.
Prostate cancer screening consists of a digital rectal exam and a test blood measuring PSA levels to detect the cancer before symptoms appear. Today, we count with new diagnostic tests to facilitate our work: pro-PSA, 4kalicreina and PCA-3.

After a physical examination, your doctor will ask you questions concerning your symptoms and your medical history. He will also run one of the following tests:

  • Digital rectal exam: : the doctor will insert a finger into the man’s rectum to feel the prostate, searching for any irregular or abnormally firm area (swelling or protuberance) that might be a cancer.
  • Blood test: it is useful to detect “silent cancers”. It is also known as Prostate-Specific Antigen (PSA) test. Blood will be taken in order to measure PSA levels, which are proteins produced by the prostate.
  • Urine test: an urine sample will be examined to search for hematuria or any other anomaly that may cause infections, prostate hyperplasia or cancer.
  • Transrectal ultrasound: sound waves are used to create a prostate image to detect small tumours. A small probe is inserted in the rectum. The test is performed in the doctor’s office and lasts 10-20 minutes. It allows examining the shape and size of the prostate and taking samples for biopsies. However, its performance detecting tumours is not as good as in other tests.
  • Prostate biopsy: a biopsy is decisive to confirm or rule out a prostate cancer diagnose. A needle will be inserted in the prostate to collect cellular tissue for it to be analysed in detail.

TREATMENT

For the most cases, prostate cancer treatment takes a long time, as it is a slow-development disease. The treatment will depend on the stage of the cancer.
There are several methods to reduce or remove prostate cancer:

En muchos casos el tratamiento del cáncer de próstata se efectúa durante un largo plazo de tiempo, dado que es un tipo de cáncer que se desarrolla de forma muy lenta. El tratamiento de la próstata dependerá sobretodo del estado evolutivo de la enfermedad.

Existen distintas formas de intervenir para reducir o extraer el cáncer de próstata :

  • Active surveillance: as some tumours are non-aggressive, we do not always treat the tumour, but we keep continuous close monitoring. Treatment will only be provided if we detect a rise in the cancer aggressiveness.
  • Surgery: it is performed to remove the prostate gland and the surrounding tissues. Lymph nodes may also be removed from the pelvic area. There are several surgical methods: open surgery, laparoscopy or robotic. None of them has proven to be better than the others in terms of oncological control or to preserve the void and sexual functions.
  • Radiotherapy: it can be performed alone or complemented with surgery. Brachytherapy, the insertion of radioactive seeds in the prostate gland or radiations may be applied by using extern equipment.
  • Hormonal therapy: testosterone, a masculine sexual hormone, is directly related to the tumour evolution. Hormonal treatment is used to decrease testosterone levels or to block its effects on the prostate.
  • Focal therapy: it is used for localized, small tumours. Only the tumour area is treated, which avoids possible complications or secondary effects.
  • Other therapies: there are many other alternative treatments for prostate cancer, such as cryotherapy, HIFU, focal therapy and others.

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