Prostate cancer: early diagnosis prevents aggressive treatment

In the 1980s, prostate cancer was diagnosed, most of the time, when the disease was already at an advanced stage. It was common to receive patients who had sought help for low back pain and that in the course of the investigation it was discovered that the pain was caused by a metastasis of this cancer to the lumbar spine vertebrae. There was little to do except palliative treatments that at best managed to keep the patient alive for no more than five years.

In that same decade, there was an enzyme produced by the prostate that could be dosed in blood tests , and also that this dosage was increased in patients with prostate cancer. In addition, it was found that this increase was proportional to the extent of the disease: in patients with the disease in the initial state the elevation was slight, and in patients with advanced disease the increase was very large. Knowing this, urologists began to recommend that men routinely perform the "preventive" examination of the prostate.

Always try to talk to your urologist, he is the best person to guide you.

Early diagnosis of prostate cancer allows treatments to be greater chance of curing the patient of the disease. The European Urological Association, in its guidelines, draws attention to the fact that early diagnosis of prostate cancer prevents 35% of deaths from the disease if this diagnosis were not made in screening programs. The diagnosis of tumors in the prostate is based on two tests: the rectal touch, whereby urologists can perceive the consistency of the prostate (regions of the prostate affected by cancer tend to have more hardened consistency) , and prostate specific antigen (PSA) blood test, which is increased in patients with this type of cancer.

From the altered findings in these two exams, biopsy of the prostate should be requested and with it the histopathological examination of the prostatic fragments, which seal the diagnosis. However, early stage prostate cancer will not always require treatment - this should only be done in patients whose life expectancy is long enough for them to effectively benefit from the treatment. Generally, patients who are very old or have other serious concomitant diseases, and therefore have a life expectancy of less than 10 years, should not be treated, since the death will happen before due to other causes. It is even recommended that routine prostate examination should not be performed in men with this profile. It is a general consensus that asymptomatic patients over 75 years of age should not undergo exams for the early diagnosis of this type of tumor.

In men with a longer life expectancy the situation is totally different: we should always think of not letting the reduce life expectancy, nor compromise the quality of life. Radical prostatectomy (so-called surgery for the treatment of prostate cancer) is considered the standard treatment for this disease. It should always be indicated in patients who may benefit from the procedure: those with a life expectancy of more than 10 years and whose cancer is more likely to progress.

On the other hand, in certain situations, localized prostate cancer will require treatment even in younger men. In some selected cases, when the tests show tumors of less aggressive behavior, or tumors that may take longer to progress, we can propose to the patient only the follow-up, and start the treatment later, but before the disease can progress to the point decrease the chances of cure.

Always try to talk to your urologist, he or she is the right person to guide you.

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