ask the main questions about prostate cancer

November is the month of awareness of prostate cancer, which affects about 65 thousand Brazilians per year and is responsible for 13.6 deaths for every 100 thousand men, according to data from the Inca (National Cancer Institute).

Although the incidence and mortality rates are high, according to experts, the numbers are not what most afflicts Brazilians, but rather the fear of becoming sexually impotent, which does not happen in all cases.

In addition to the fear of losing an erection, there are doubts about the real causes for the development of prostate cancer, about how to make the diagnosis and the types of treatment. Below, we clarify the main questions about the disease.

Ask questions about prostate cancer

Prostate cancer is more common in which age group?

Prostate cancer is more common in the elderly. It is estimated that six out of ten cases recorded worldwide occur in men aged 65 and over. However, men of all ages should be aware of personal risk factors and talk to their doctors for tests to allow early detection of the disease.

How to detect prostate cancer early?

Going to the urologist regularly is the way to early detection. The medical recommendation is to have PSA exams and digital rectal examination from 50 years of age. For people with close relatives who have had the disease at a younger age, tests may start a little earlier.

What are the symptoms of prostate cancer?

Prostate cancer usually arises as a silent and painless disease. In addition, symptoms can often be confused or attributed to other diseases. The signs are often detected for the first time during routine examinations.

The most common symptoms include frequent urination, difficulty in starting or stopping urination, weak or interrupted flow of urine, pain or burning, difficulty in having an erection, painful ejaculation, blood in the urine or semen, frequent pain and stiffness in lower back, hips or thighs. If you experience any of these symptoms, see your doctor for diagnosis and treatment, if necessary.

Does the enlarged prostate gland indicate prostate cancer?

Prostate enlargement and prostate cancer are different things. Signs and symptoms of an enlarged gland include difficulty emptying the bladder completely, frequent need to urinate at night and urinary incontinence. Prostate enlargement happens to most men as they get older and this condition does not increase the risk of prostate cancer.

Does replacing testosterone cause cancer?

Male hormones stimulate the growth of tumors, so there is this fear. However, experts point out that, to date, there is not enough evidence to say that testosterone replacement increases the risk of prostate cancer.

Is prostate cancer transmissible?

Prostate cancer, like any other type of cancer, develops from the disordered proliferation of our cells, caused by mutations in the genetic code. It is therefore not transmitted from one person to another, as it is not infectious or contagious.

What are the tests that detect prostate cancer?

PSA tests measure prostate-specific antigen levels in the prostate, not cancer. PSA is produced by the prostate in response to a number of changes that may be present, including an infection or inflammation (prostatitis), an enlarged prostate (benign prostatic hyperplasia) or possibly cancer.

PSA is the first step in the diagnostic process for cancer. It is useful for detecting the disease in the early stages, when it is possible to be treated. Experts believe that the PSA test saves the lives of approximately 1 in 39 men taking the test.

But he does not dispense with digital rectal examination. The PSA test is more effective when it is done concomitantly with digital rectal examination and when taking into account the assessment of the patient’s risk factors.

What are the treatment options for prostate cancer?

The best treatment for each case depends on the stage of the disease (stage it is in), the age and the general health of the patient. In general, surgery, radiotherapy and hormone therapy are usually the most common options.

Does all prostate cancer need treatment?

Not all types of prostate cancer require immediate treatment. The treatment of prostate cancer depends on the age, the stage of the tumor, the amount of cancer cells present in the biopsy tissue, the signs and symptoms presented and the patient’s general health. Men diagnosed with prostate cancer should talk to their doctor about the need for treatment.

Some require active treatment, which may include surgery or radiation therapy, and others may do what is called active surveillance. Active surveillance is when the doctor monitors the patient and the evolution of the disease over time, intervening when necessary. Before starting any treatment, talk to your doctor about the risks and benefits so that you can make a quality decision about what is best for you.

Is the progression of prostate cancer fast or slow?

There are different types of prostate cancer, some very slow-growing and others more aggressive. Once the diagnosis of prostate cancer has been confirmed by the pathologist, the doctor is able to characterize the tumor’s aggressive potential and indicate the best treatment based on several factors, including the patient’s age and general health status. Patients need to understand the complexity of the disease and make decisions regarding their treatment together with their doctor.

Does prostate cancer treatment end sexual function?

In some treatments for prostate cancer, such as surgery, the nerves that surround the prostate and control penile erection can be damaged. However, the extent of this lesion depends on a number of factors, such as the location and size of the tumor and the type of treatment performed.

In numbers, about half of men with good sexual performance before treatment for prostate cancer will still perform well after treatment for the disease. Other men will experience moderate to severe impotence, but most have only a small loss of sexual function, which often returns to normal within a few months to a year after treatment. However, age can be a complicating factor and, as men age, they already have some impairment of sexual function.

Does prostate cancer treatment result in urinary incontinence?

Not all patients have this sequel. One in five men treated for prostate cancer have urinary incontinence as a consequence of treatment, and younger patients generally progress better. Techniques such as rehabilitation with pelvic floor physiotherapy using electrostimulation are adopted.

How to prevent prostate cancer?

Regular physical activity, maintaining a healthy weight, decreasing or avoiding alcohol and not smoking are important recommendations to minimize the risk of the disease. A diet low in animal fats and rich in fruits, vegetables, grains and whole grains can decrease the risk of cancer, as well as that of other chronic diseases.

In addition, studies have already pointed out the benefits of lycopene, present, for example, in tomato sauce, in preventing this and other types of cancer.

Source: Gustavo Guimarães, director of IUCR (Institute of Urology, Oncology and Robotic Surgery) and general coordinator of the Oncological Surgical Departments of the BP – A Beneficência Portuguesa de São Paulo group; Rodolfo Santana, quality supervisor urologist at CEJAM (Center for Studies and Research Dr. João Amorim); and Brazilian Society of Urology.