Prostate cancer is a disease in which malignant (cancerous) cells form in the tissues of the prostate. The prostate is a gland of the male reproductive system whose function is to make a fluid that is part of semen. The prostate is located below the bladder and surrounds part of the urethra. It is about the size of a walnut.
The incidence of prostate cancer diagnosis varies greatly between different geographical areas, and this may be related to ethnic factors, aging of the population, as the incidence is mainly age-dependent, and the routine use of PSA for prostate cancer screening.
Family and ethnic background are associated with a higher incidence of prostate cancer, suggesting a genetic predisposition to the disease. Hereditary prostate cancer is associated with an earlier disease onset of six to seven years, but disease aggressiveness and clinical course do not appear to differ.
Depending on whether or not the tumor is located within the prostate and the presence of metastases, prostate cancer can be classified into different stages. This classification is important because, depending on the evolution of the tumor, different treatments can be applied:
Prostate cancer and some of its treatments may be associated with various complications:
At the age of 50 it is advisable to have a PSA, a blood test to measure the Prostate Specific Antigen that helps to detect possible abnormalities in the prostate. If you have a family history of breast or prostate cancer, it is recommended to start screening at around 45 years of age due to the increased risk associated with prostate cancer.
It is sufficient to perform PSA and a digital rectal examination -especially if the PSA is higher than 2.5-. On some occasions ultrasound, flowmetry or even genetic tests can be performed to study different aspects of the prostate.
It is normal to be frightened, but we have many options for a cure. Localized prostate cancer refers to cancer that is confined to the prostate gland only, with no evidence of spread to other parts of the body. This stage offers several treatment options with a high likelihood of cure. Depending on the characteristics of the tumor, we can consider focal treatment, prostatectomy or radiotherapy. It is important to carefully weigh the pros and cons of each of the treatments and to carry out a personalized therapy. Most men with early diagnosis and adequate treatment can expect a complete cure.
The most common are erectile dysfunction and urinary incontinence. It is especially important for the surgeon to be very experienced in order to respect the nerves that give erection, since this has been related to better erection and better continence. The appearance and duration of these sequelae depend on factors such as the type of surgery performed, the technique used and the individual characteristics of each patient. It is essential to follow medical indications and attend follow-up consultations to ensure optimal recovery.
Salvage lymph node dissection in patients with prostate cancer treated with radical prostatectomy or radiotherapy and positive choline positron emission tomography (PET/CT) scan