Prostate cancer is the most commonly diagnosed cancer among men. The risk factors here are age and genetics. But also the lifestyle: the risk of getting sick is increased by overweight, lack of exercise and smoking. How do I know if it’s prostate cancer? For MedTvoiLokony, Dr. hab. n. med. Roman Sosnowski.
- The symptoms of prostate cancer are easy to underestimate. And often men do just that
- This is a cardinal mistake because they deny themselves the chance to receive treatment at an early stage
- Prostate cancer detected early gives a very good chance of recovery
- Check your health. Just answer these questions
- More information can be found on the Onet homepage.
Urologist, member of the Polish and European Association of Urology.
Patients are seen at the UROS doctor’s office.
Karolina Świdrak, Medonet: European Society of Urology On September 15th, the European Day of Prostate Cancer was established. Currently, it is the most frequently diagnosed malignant neoplasm among men in Poland. What factors increase the risk of developing this disease in men?
Dr hab. n. med. Roman Sosnowski, urologist: Indeed, this problem is very clear both in Poland and in the world. The latest data collected in 2018 shows that when it comes to cancer incidence among men, prostate cancer was number one. We are talking about 1. 16 people diagnosed with this disease. At the same time, there were over 414 thousand deaths. Among all cancer deaths among men, this cancer ranked third. So we are dealing with a phenomenon that is also important in terms of epidemics.
As for the risk factors you are asking about, of course we urologists strongly encourage you to build health awareness based on information about what we can do for ourselves to reduce the risk of prostate cancer and to treat it if necessary. as effective as possible. One of such actions is a proper diet – we encourage you to avoid overweight and obesity at all costs. In addition, physical activity is important. We have the greatest influence on these factors. The triad ends with cigarette smoking, which also significantly increases the risk of prostate cancer. It all depends on us. Discontinuation or elimination of these factors may improve the effectiveness of treatment and increase the effectiveness of medical activities.
On the other hand, we also have risk factors that, unfortunately, are beyond our control. It’s mainly age. As a man grows older, his risk of developing prostate cancer automatically increases. It’s the same with race – African Americans are at higher risk. The third such factor is genetics, or family history of cancer. If a brother, father or uncle developed prostate cancer or other cancer at a relatively young age (before the age of 60), it is a sign that we may also have a special predisposition to it. We have no influence on these factors, but we should be aware of them.
The rest of the text is below the video.
You mentioned that age itself is a risk factor. What stage of life are we talking about?
Prostate cancer is a disease with the peak incidence in the seventh decade of life. But we start early diagnostics when the patient turns 50. If a diagnosis is made at this stage, then most often it is an early-stage disease. And that means the chance of a patient being cured is very, very high. Such proceedings lead to the minimization of possible side effects. Treatment of cancer at an early stage is less toxic and often does not require additional chronic therapies. Thus, for example, a 60-year-old patient with diagnosed and successfully treated prostate cancer will be able to live in good health for the next two or even three decades of life.
The situation is different with the development of a generalized disease. Then it is no longer possible to cure completely, but only to extend and improve the quality of life of the patient.
So the effectiveness of treatment in the case of prostate cancer depends on early diagnosis. And then there is a chance to completely cure the patient. What else does this effectiveness depend on?
In this case, chance does not equal chance. Hypothetically, we have a patient diagnosed with a so-called cancer. low risk. So it is a cancer that has no symptoms. It is only because the patient undergoes early diagnosis that we can detect him. In such a situation, the patient has a good chance not to suffer from cancer. We can propose him to postpone radical treatment, and instead introduce close monitoring. Thanks to careful observation of the situation. when the nature of the cancer changes, we will be able to safely apply effective radical treatment.
On the other hand, when a cancer with very high aggressiveness, high risk and local advancement is diagnosed, the treatment is likely to be multifaceted. Then, apart from direct treatment of the prostate gland (e.g. prostatectomy), we extend the procedure to remove lymph nodes, and in some cases, additional radiotherapy is indicated. These methods, although effective and providing a chance for a permanent cure, are not devoid of side effects, which, unfortunately, may lead to a reduction in the patient’s quality of life.
Today, the type of therapy is individually selected for a specific patient and his needs. Colloquially we say that this is a “tailor-made” treatment. This is the clue of modern prostate cancer treatment.
What is the prognosis of patients with prostate cancer? You mentioned that if a cancer is detected early there is a good chance of a cure. What about prostate cancer that will be detected later?
With low-risk cancer, without clinical symptoms, it is practically 100%. chances of recovery. When a locally advanced cancer is present, the effectiveness is lower, but the goal of treatment is still a complete cure. However, when a patient is diagnosed with a systemic disease, especially if it is an aggressive cancer, there is no chance of a complete cure. The applied therapy is then aimed at slowing down the disease and extending the patient’s life. We then strive to change the disease into a co-morbid, chronic disease. Unfortunately, also being aware that sooner or later there will be progression and exhaustion of available treatment methods for such a patient.
Please tell us what are the symptoms of prostate cancer? What should men pay special attention to?
Unfortunately, there are no symptoms clearly associated with prostate cancer. The most common symptoms are similar to those associated with a mildly enlarged prostate gland. The most common ones include problems with urination, day or night pollakiuria, and a narrow, intermittent stream of urine. Sometimes it is also blood in the urine. These are symptoms associated with the local development of the disease. When the disease is generalized, metastases will appear, and the symptoms associated with distant metastases will be dominant – mainly pain from the skeletal system, because this is where metastatic changes are most common. In addition, symptoms may include general weakness, loss of strength, weight loss, problems with passing stools or erectile dysfunction.
Unfortunately, these are not symptoms that are unequivocally associated with prostate cancer. Each of them can be associated with a different condition. We encourage men to observe themselves. If you get up twice at night to urinate, if you notice blood in your urine, if you have trouble starting to soak or if the flow of water is interrupted, see your urologist. Deepen your research. Similarly, if you have bone pains of unclear cause, have lost weight recently, are apathetic or have no strength – ask your doctor for help.
Exactly … Men of a certain age are convinced that such problems simply result from birth certificate. That it must be so.
The aging of a man causes problems in the urological aspect. This is an undeniable fact. But this does not mean that we should not look for an answer to the question why these symptoms appear and look for ways to counteract them, eliminate them, improving the quality of our life. Treatment should be tailored to the condition that needs to be diagnosed by a urologist first, and not to be taken for granted that it is simply due to age. I bust the myth that nothing can be done and that it must be so. But I do not disprove the fact that urological ailments appear in men with age. However, we should not leave them “on their own”, but look for the cause in order to be able to apply the appropriate therapy.
Now let’s talk about proper prevention. What does it look like in Poland and what should it look like?
On the one hand, the prevention of prostate cancer is about avoiding the risk factors that we have influence on, which I have already mentioned. On the other hand, controlling our organism, and in spite of the lack of obvious symptoms, no cancer has occurred. This is done through regular urological visits. Such a “check-up” should start after the age of 50, and in the case of men with a history of cancer in the family, a few years earlier. During the visit, the doctor examines the patient, recommends, inter alia, determining the concentration of PSA in the blood serum, which will significantly help us in the detection of prostate cancer. As PSA levels increase, the risk of prostate cancer increases, although additional specialized tests are required to make a definitive diagnosis. Currently, it is mainly an imaging test – multiparameter magnetic resonance imaging of the prostate, followed, if necessary, by a biopsy, i.e. histopathological diagnosis of prostate cancer.
You said that cigarette smoking is among the risk factors for developing prostate cancer. How does tobacco smoke increase this risk?
It should be remembered that smoking is a risk factor for many diseases, including those oncological. Among the urological ones, it concerns bladder cancer and prostate cancer. The mechanism is not clearly known, but it seems that burning tobacco provides carcinogens that contribute to the occurrence of certain disorders, which we call mutations. Most likely, cigarette smoke contributes to the phenomenon of hypoxia, which leads to a more aggressive form of cancer. The risk of inflammatory processes and hormonal disorders also increases. All this translates into an increased risk of disease occurrence, but also an increased percentage of prostate cancer-specific deaths as well as general deaths. Patients who smoke more often and die faster.
Does quitting smoking have a significant impact on the prognosis of a patient with prostate cancer?
These dependencies are investigated and, in fact, in the case of quitting smoking, the effectiveness of the implemented therapy is higher. However, it is best not to smoke at all. Then we know that we do not have this risk factor at all. Unfortunately, research shows that only 10 – 20 years after quitting tobacco, the body returns to such a state as if there was no smoking at all. Here you really need to think ahead. If I quit smoking today, I will lower my risk of dying from prostate cancer in 10 to 20 years. There is a long healing process ahead of me after the tar that I provided while smoking.
Unfortunately, it happens that a patient who hears an oncological diagnosis states that he can continue smoking, because he “will die anyway” …
And that is not the correct approach. Imagine a man has had his prostate removed due to cancer. He is a smoker and continues to smoke after surgery. His cancer is more likely to come back than if the patient was not a smoker. By quitting smoking, we support the therapeutic process not only by supporting oncological treatment, but also by caring for the general health of a man.
What about alternatives to cigarettes? In the scientific documentation for one of the alternative devices assessed by the Food and Drug Administration as a risk-modified tobacco product, there is information that tobacco heated in it emits 91 percent. lower concentrations of compounds considered carcinogenic to humans by the International Agency for Research on Cancer.
As urologists, we convey a clear message: do not smoke at all! Don’t start smoking. And if you smoke, try to stop it at all costs. There is no single best method to quit smoking. We know that smokers quit and smoke again many times. It’s an addiction that often leads to relapses. We must therefore use all available means. For one, a psychotherapist or pharmacology will be the most effective, for another, nicotine replacement therapy or forms such as a tobacco warmer or e-cigarette. In this case, they actually appear to have a less toxic effect than the tobacco pumpkin. But you have to remember that we do not have long-term studies on the safety of such devices, so it is always better to give up the addiction completely.
We are aware that in the case of tea lights or e-cigarettes we have less harmful substances, but remember that it is still nicotine, which is addictive. In turn, in e-cigarettes, apart from nicotine, there are also flavors and fragrances. We do not know if they are completely safe for us after heating. We cannot say that these alternatives are absolutely safe. We can only presume that these are devices that minimize the negative effects of smoking.
You mentioned at the beginning of our conversation that the statistics for prostate cancer are alarming. The incidence of the disease has increased over the years. Can we do something on a global scale to reverse this trend?
We have no influence on some things: our PESEL number or family history. But we can start researching, analyzing our family tree for oncological diseases. Then actions for modifiable factors: smoking cessation, reduction of side effects related to tobacco smoke. Watch and listen to your body, react to the symptoms it sends you.
We should also remember that we are subjected to environmental factors – pollution in the air or in the products we eat. These are also factors contributing to the development of cancer. Globally, we should therefore lead to proper nutrition, the production of healthy food, care for the environment and reduction of pollution.
But most of all, let’s take care of your backyard. About yourself. We will definitely be able to implement something positive in our lives. Remember that it is a disease that, if detected early, can be effectively treated and, in some cases, safely monitored. Let’s stop smoking or minimize its negative effects, which will not only increase the effectiveness of prostate cancer therapy, but also save us from other cancers.
Are you concerned about prostate cancer? Perform a genetic test available at Medonet Market.
Also read:
- Is it cancer already? These symptoms should be food for thought
- It develops quickly, it is easy to mistake it for something else. It’s an insidious tumor
- Lung cancer: Poland is a leader in the number of cases and the number of deaths. Why?