What is prostate cancer?
Prostate cancer is a condition that affects the prostate gland, part of the male reproductive system, located just below the bladder. This small, apple-shaped gland plays an essential role in the production of semen, the thick fluid that contains sperm and is released during sexual activity.
In Brazil, prostate cancer is the second most common type of cancer among men, second only to non-melanoma skin cancer. Statistics from the Instituto Nacional do Câncer (INCA) estimate about 71,000 new cases diagnosed in 2023.
Symptoms of prostate cancer
Prostate cancer is known for its silent early stage, during which many patients do not show apparent symptoms. However, when signs do appear, they may include:
- Pain when urinating
- Frequent need to urinate during the day or night
- Presence of blood in the urine or semen
- Pain in the pelvic region, back, or hips
- Erectile dysfunction
- Pain during ejaculation
- In rare cases, bone pain
Diagnosis
To diagnose prostate cancer, the physician relies on clinical evaluation, which includes a digital rectal exam and measuring prostate-specific antigen (PSA) levels in the blood. Additionally, multiparametric magnetic resonance imaging (mpMRI) is a valuable tool in assessing any suspicious area in the prostate and can help avoid biopsies (removal of a tissue part for microscopic analysis).
The diagnosis is confirmed through a prostate biopsy. In this context, the transperineal biopsy, performed through the skin near the anus (perineal), has brought significant advances in reducing the risk of infection and sepsis.
The age to start screening varies, but generally begins around 40 or 50 years, especially for individuals with a family history of prostate cancer.
To assess the extent of prostate cancer and assist in choosing the appropriate treatment, especially in higher-risk tumors, advanced technologies such as PET PSMA are available. The exam uses a substance that binds to a molecule with an affinity for PSMA (prostate-specific membrane antigen) in cancer cells. This allows for the precise detection of metastases (cancer spread in the body) in other organs, aiding in determining the disease stage and therapy. Additionally, risk markers such as Oncotype, PCA3, and 4K score are increasingly used in risk assessment and decision-making regarding treatment.
These tests provide important information about the aggressiveness of cancer and help physicians choose the most appropriate approach for each patient.
Treatment of prostate cancer
The treatment of prostate cancer varies according to the disease stage and individual patient characteristics. When the cancer is localized, common treatment options include surgical removal (radical prostatectomy), radiation therapy, and, in some situations, active surveillance.
Hormone therapy is often used when the cancer spreads to other parts of the body (metastasis). Recent studies include the development of robotic surgery and new hormonal agents, chemotherapies, and interventions for treating bone metastases (types of cancer that affect the bones and originate from other parts of the body).
It is very important that the choice of treatment is personalized and decided after a detailed conversation with the physician, considering the risks and benefits.
Prevention
Preventing prostate cancer involves adopting healthy habits, such as:
- Maintaining a balanced diet rich in fruits, vegetables, legumes, grains, and whole cereals, with restricted fats, especially of animal origin
- Engaging in at least 30 minutes of daily physical activity
- Maintaining a healthy weight
- Avoiding alcohol consumption
- Avoiding the habit of smoking
- Undergoing routine exams and periodic medical consultations
Discuss prostate cancer with your physician, especially if you have risk factors, and remember that prevention and early diagnosis are the best strategies against this disease.
References
Câncer de próstata — Instituto Nacional de Câncer - INCA
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Erectile dysfunction: a condition that prevents a person from having or maintaining an erection long enough for sexual intercourse
Prostatitis: the prostate becomes inflamed or infected. It can arise suddenly and cause symptoms (acute prostatitis), or it can remain hidden and asymptomatic for a long time (chronic prostatitis)
Urinary tract infection: a medical condition caused by bacteria, viruses, fungi, or other microorganisms that enter the urinary system, multiply within it, and cause changes such as inflammation