– I would like our men to take care of their health just like they take care of their own cars. Nobody needs to remind them about periodic reviews. So why don’t they remember their own health screening? With dr hab. med. Piotr Jarzemski, we are talking about prostate cancer.
Medoent.pl: Doctor, how serious is the risk of prostate cancer?
Dr hab. med. Piotr Jarzemski: Still underappreciated – at the moment, prostate cancer has overtaken lung cancer and has moved to the first place among malignant neoplasms diagnosed in men. It can be said that almost 1/5 of all diagnosed cancers in men are prostate cancer. So it is a very serious problem for today and the future. Especially since we are an aging society and the incidence of prostate cancer increases with age. Importantly, prostate cancer is not a sentence – its diagnosis at an early stage gives a survival chance for 98,8%. men.
According to statistics, 15 percent of prostate cancer cases in our country are only detected in stage IV – why is this happening?
The problem is that early stage prostate cancer does not cause any discomfort. When the first symptoms appear, such as difficulty urinating or bone pain, we usually recognize an advanced tumor. The Polish man is a macho type who avoids doctors. He comes to the office and says: Doctor, I have never been to a doctor, which I treat as a reason to be proud.
- It does not give any symptoms for a long time. What are the first symptoms of prostate cancer?
For many, a real man is one who never actually uses help. This procedure is not wise, because then the first meeting with the doctor may turn out to be one of the last. We must start prostate cancer diagnosis before the first symptoms of the disease appear. Then we have a chance to recover completely. Hence, prevention is so important. We must do everything to increase the percentage of cancers detected at an early stage in Poland.
In other European Union countries, the number of deaths from prostate cancer is falling – why Poland is falling to the “gray end” again?
When it comes to the level of urology in Poland, we do not differ from the European average. Our branches are equipped with equipment that meets Western standards, and urologists are well trained. Anyone who wants to become a urologist in Poland must pass the European exam and obtain the FEBU (Fellow of the European Board of Urology) certificate.
So we have all the advantages to treat patients at the highest world level, but there is one condition, the patient must reach us. The problem is that, unfortunately, patients still come to the urologist too late, hence in Poland higher diagnosis of third or fourth stage neoplasms than in other countries, which translates into worse treatment outcomes.
So it can be said that the health awareness of our neighbors is higher?
Yes, but it is also partially enforced by the insurer. Let’s not forget that preventive examinations are somehow included in the scope of insurance in many countries. It just pays off. Prevention, and thus early diagnosis, recovery and return to work are always cheaper than chronic treatment of a patient in the advanced stage of the disease.
Who is at risk of developing prostate cancer?
All men with a family history of prostate cancer. The greater the number of cases in the family, the greater the likelihood that a man will develop prostate cancer. In addition, hereditary cancer may appear earlier in a more malignant form in each subsequent family member.
- “I thought that at my age it must be like that.” Half a million Poles have this problem
And other factors: diet, smoking, drinking alcohol?
We are still not sure why the prostate cancer incidence is highest in developed countries. We know that the African American population is most at risk of developing prostate cancer, while African people are less likely to suffer from prostate cancer. A similar relationship applies to the Japanese – in Japan, prostate cancer cases are less common, but Japanese immigrants living in the United States suffer from the same disease as Americans. So, most likely, lifestyle matters.
For example, tumors of the lung, kidney, bladder and prostate have been shown to be tobacco-dependent. We know that. Does lack of exercise, a sedentary lifestyle, and a Western processed-food diet have a similar effect? It’s hard to say, but there is definitely something to it.
Is it true that men with high testosterone levels are at risk?
Not. However, we know that prostate cancer is testosterone dependent, but it has not been proven that the relationship is so simple. In fact, young men have the highest testosterone levels, and they don’t have prostate cancer.
You said that prostate cancer does not hurt – what should we be concerned about then?
First of all, urination disorders – if a man notices that he is urinating differently than in the past, for example much more often, also at night, the urine stream has become thinner or he has difficulty emptying the bladder, these are warning signs.
These symptoms are also characteristic of benign prostatic hyperplasia that affects most men – how to distinguish one from the other?
Indeed, the symptoms are the same and we cannot tell them apart. Therefore, you should go to a urologist who can tell the difference.
- Famous men who have had prostate cancer
When should we do the first prostate examination?
At the age of 45, with men who have a family burden, i.e. a member of their family who had had male prostate cancer or female breast cancer, they should be regularly tested for early-stage prostate cancer from the age of 40. age.
What does the diagnosis look like?
We start with the PSA test – PSA (Prostate Specific Antigen) is the only organ-specific antigen known in humans, produced exclusively by the cells of the prostate glandular epithelium. Increased PSA levels are indicative of prostate disorders that may be due to the developing cancer. But an increase in PSA levels is not the same as a diagnosis of cancer.
PSA may also rise in the case of mild prostate enlargement, inflammation or even irritation, e.g. after cycling. Therefore, further diagnosis is necessary. The PSA test is performed from the patient’s blood, it is a simple, cheap test that is offered by virtually every laboratory in Poland. The next stage is a urological consultation: PSA interpretation and finger examination through the anus.
- Every XNUMX-year-old should have this cancer screening done
Rectal Examination As Scary As It Sounds?
I will not lie: this is not a pleasant test for the patient or the urologist, but it must be performed. Especially since about 10 percent. Prostate tumors develop without elevated PSA levels. A finger examination through the anus allows us to assess not only the size of the gland, but its structure and consistency. If the consistency of the prostate is changed, and the PSA level is elevated, cancer is very likely to be suspected. The next step in confirming the cancer is a prostate biopsy. That is, ultrasound before the rectum, during which we take samples. Only after receiving the result of the histopathological examination we know whether what we suspected in the prostate is cancer or not.
During the pandemic, many Poles give up preventive examinations, is it a good idea to postpone a visit to a urologist for the next year?
I think it is fatal – failure to diagnose can have enormous consequences. You can die of prostate cancer. I agree that it is more difficult to access doctors in a pandemic, but it is not that we cannot do a PSA test. Laboratories are open, hospitals are open, and urology clinics are open. We conduct diagnostics and treatment all the time.
Can we reduce the risk of developing prostate cancer?
Let me put it this way – doctors all over the world are looking for predictors of prostate cancer. So far, to no avail. We should definitely take care of our health – we don’t have to run marathons, but let’s walk. We do not eat fast food every day and we absolutely do not smoke cigarettes.
What would you like to say to Polish men at the end?
Gentlemen, take care of your health! I wish our men would take care of themselves as they would take care of their own cars. Nobody needs to remind them about periodic car inspections. At least once a year, we check the condition of the engine, brakes and shock absorbers, so that the car does not fail when we need it most. It is the same with our body, which requires periodic inspection not because something is wrong with it, but so that it does not let us down at the least expected moment. Every man over 45 should visit a urologist regularly once a year. Not only to heal, but also to prevent the effects of an extremely common and dangerous disease, diagnosed too late.
Read also:
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- If a father, brother or grandfather has been ill, the risk increases up to ten times
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