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Prostate cancer is a very common disease that affects 25% of men over 50 years of age and 80% of those over 80 years of age.
Prostate cancer is a disease in which malignant (cancerous) cells form in the tissues of the prostate gland . The prostate is a gland in the male reproductive system whose function is to produce 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, which may be related to ethnic factors, the aging of the population, since this incidence depends mainly on age, and the routine use of PSA for screening for this type of tumor.
Family history and ethnicity are associated with a higher incidence of prostate cancer, suggesting a genetic predisposition to the disease. Hereditary prostate cancer is associated with an earlier onset of the disease six to seven years, but the aggressiveness of the disease and its clinical course do not appear to differ.
Prostate cancer usually doesn't cause symptoms. Most of the time it's diagnosed before it produces any effects. The symptoms a man with a prostate tumor typically experiences are secondary to benign prostatic hyperplasia (BPH), which often coexists with it.
In some cases, prostate cancer may present at advanced stages . In these instances, the tumor may cause local symptoms such as:
The causes of prostate cancer are unknown, but the main risk factor for developing it is age . There are some associations between racial factors (it is more common in Black men) and a higher rate of prostate cancer diagnosis. In addition, there appears to be a clear association between certain mutations, such as those found in the BRCA1 and BRCA2 genes, and the likelihood of developing prostate cancer.
On the other hand, there appear to be dietary factors , such as obesity, diabetes, alcohol consumption, excessive consumption of red meat, and diets with a high percentage of fatty, fried, dairy, and processed foods.
Tomatoes, lycopene, and soy appear to be protective. The relationship between some micronutrients (selenium and vitamin E) and the development of prostate cancer is debatable.
Prostate cancer often presents no symptoms in its early stages. For this reason, it is very important to see a urologist for early diagnosis of prostate cancer through the following tests:
If any abnormality is detected in the previous tests, further tests, such as the following, may be ordered to determine if you have prostate cancer:
When a biopsy confirms the presence of prostate cancer, the next step is to determine its level of aggressiveness (grade) . A higher grade indicates a more aggressive cancer with a greater likelihood of metastasizing or spreading rapidly. To determine tumor aggressiveness, techniques include:
Apart from these tests, nowadays there are also diagnostic tests that facilitate the detection of prostate cancer before symptoms appear: pro-PSA, 4kallikreins, PCA-3, MDX and others.
Once the diagnosis has been confirmed, if there is suspicion that the cancer may have spread beyond the prostate, imaging tests such as abdominal CT scans and bone scans may be recommended to rule out lymph node involvement, organ involvement, and bone metastasis.
In some cases, a prostate cancer with a good prognosis and no aggressive growth may not require immediate treatment and can simply be monitored. Active surveillance can be an option for cancer that causes no symptoms, is confined to a small area of the prostate, and is expected to grow very slowly. Treatment will only be initiated if the cancer's aggressiveness is detected and begins to pose a risk to the patient's life. However, closely monitoring these types of tumors does not mean 'doing nothing.' First, a complete prostate mapping is necessary, ensuring that no high-risk tumors are present, and the patient must understand the pros and cons of this strategy. Second, the monitoring of men in this situation is very thorough, using prostate MRIs and follow-up biopsies, in addition to highly specialized urologists in uro-oncology.
The main benefit is the absence of side effects. Among the disadvantages is the fact that patients have to undergo many tests, some of them invasive, such as prostate biopsies.
Some tumors with a good prognosis can be treated locally without the need to remove the entire prostate. The treatment used for this is focal therapy , which allows treatment of only the lesion while preserving the prostate, substantially improving the postoperative period and reducing treatment side effects.
It is a technique performed in an operating room, which destroys prostate tissue with cold or heat and can be applied in specific cases of single tumors:
In cases where the tumor is aggressive and conservative treatment is not possible , surgery is the most curative option. Surgical treatment, or prostate cancer surgery, involves the complete removal of the prostate gland and surrounding tissues, and in some cases, the removal of lymph nodes in the pelvic area. It is an option for treating cancer that is confined to the prostate. Sometimes, surgery is recommended in combination with other treatments for advanced prostate cancer.
It can be done through several approaches such as:
Currently, at ROC Clinic, we have both available robotic systems: da Vinci (from Intuitive Surgical) and Toumai (from MicroPort® MedBot™ ), making us the first center in Spain to incorporate the latter. Robotic technology translates the surgeon's movements, improving ergonomics and reducing tremor. Furthermore, it allows for a true three-dimensional view of the surgical field with high-quality images that guarantee clarity and precision of detail.
However, none of the aforementioned approaches has proven superior to the others in terms of cancer control and better preservation of the patient's urinary or sexual function. While it is true that both laparoscopic and robotic surgery have been shown to reduce bleeding and the patient's hospital stay.
These procedures last approximately 2 to 4 hours and are performed under general anesthesia.
Radiation therapy is the administration of ionizing radiation to treat cancer, as it uses high-powered energy to destroy cancer cells. Radiation therapy treatments can be given alone or in combination with surgery.
In the case of prostate cancer, there is a treatment called brachytherapy, indicated only for patients with low-risk tumors, which involves inserting radioactive seeds into the prostate gland. These seeds deliver a low dose of radiation over a prolonged period.
External beam radiation therapy can also be administered using machines. This is an option for treating cancer that is limited to the prostate and can help slow the growth of prostate tumors that spread to other areas of the body, such as the bones, and relieve symptoms, such as pain. In external beam radiation therapy, the patient lies on a table while a machine moves around their body, directing high-powered energy beams (X-rays or protons) at the prostate cancer.
Testosterone (the male sex hormone) is directly related to the progression of prostate cancer. Hormone therapy is used to reduce testosterone levels in the body or to block its effects on the prostate. Suppression of this hormone leads to tumor regression.
Hormone deprivation therapy is usually indicated in conjunction with radiotherapy or when the disease is widespread.
Every diagnosis is unique. Choosing the right treatment for prostate cancer depends on several factors that must be evaluated individually by a specialized medical team. There is no single option that works for all patients. Our specialists will comprehensively assess your case and explain the available options, benefits, and potential side effects.
We treat our patients at the ROC Chamberí clinic and in the HM Hospitals network of centers in Madrid: Sanchinarro, Montepríncipe, Madrid Río, Rivas, Puerta del Sur, Nuevo Belén, Policlínico HM Moraleja and Nuevo Norte.
Coming soon
We treat our patients at the ROC Chamberí clinic and in the HM Hospitals network of centers in Madrid: Sanchinarro, Montepríncipe, Madrid Río, Rivas, Puerta del Sur, Nuevo Belén, Policlínico HM Moraleja and Nuevo Norte.
Coming soon
We left very happy with the doctor-patient relationship
Our patients' trust reflects our commitment to providing excellent, personalized, and attentive urological care. Every experience motivates us to continue improving and offering the care and support each patient needs.
Excellent urological clinic due to the professionals who work there.
A highly professional clinic, with a very high scientific level and advanced technology. They helped me solve my urological problem.
I can only say one thing, the urology girls are the best you can find in this...
I want to express my gratitude to the Roc team, especially Dr. David Carracedo, for their professionalism, the...
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