Prostate cancer - why screening matters so much
The prostate is a gland whose name comes from its anatomical position, as in men it “stands before” the urinary bladder. Prostate cancer is the most common cancer in men and, statistically, the second leading cause of death today after lung cancer.
Anatomically, the prostate is divided into three zones: the transition zone, the central zone and the peripheral zone.
At least in its early stages, prostate cancer does NOT cause symptoms, so it is easy to see why prevention matters so much here.
Precisely because, statistically speaking, one in seven men will develop prostate cancer at some point in his life, all men aged 50 and over should see their urologist once a year for a check-up.
Where there is a family history of the disease, the first visit to the urologist is recommended at an even younger age, as there is a statistically confirmed higher likelihood of the disease in men with a first-degree relative who has had it.
Other predisposing factors, besides age and heredity, are ethnicity (a higher incidence of the disease in Black men) and dietary habits (a diet rich in fibre has been found to be beneficial, reducing the likelihood of developing this cancer).
So what weapons does the urologist have to diagnose prostate cancer at an early stage and to treat it?
Pride of place goes to the digital rectal examination of the prostate (DRE), an examination that all patients dread and feel uncomfortable with. It was, is and always will be the basic examination of the prostate, as it gives the urologist information about the size and consistency of the prostate, and on that basis any further investigation of the patient is decided.
A second major weapon at our disposal is the level of PSA in the blood.
Here it is worth mentioning that PSA is not a cancer marker. Quite often a patient arrives at the urologist terrified, carrying laboratory results in which a PSA test, done as part of a general check-up, has come back raised, convinced that he has cancer.
The level of prostate-specific antigen is enormously important to the urologist, but what interests us most is how the level changes over time, not the value itself.
It is always weighed together with the digital rectal examination and other diagnostic tests, so that we reach a safe conclusion. There are conditions that raise the PSA level, such as inflammation of the prostate (prostatitis) or enlargement of the prostate (hyperplasia), without this necessarily meaning anything bad.
The third weapon is transrectal ultrasound. You could think of it as an evolution of the digital rectal examination, as it gives us a direct picture of the size and consistency of the prostate. It is usually combined with taking a biopsy, which is the final step in the differential diagnosis of this disease.
What I would like you to take away from this article is that, as with every condition, and with prostate cancer more than most, the best treatment is prevention.
Prostate cancer diagnosed at an early stage has a very high chance of cure, and men today should become aware of this and have their annual check-up, so as not to be caught by surprise.
For more information, please do not hesitate to contact your urologist and, if you are over 50, to visit him for a screening check-up.