Prof. Flogging: We are unable to delay the onset of prostate cancer

Prostate cancer is the cause of deaths of almost 100. men annually in Europe. We cannot prevent or delay the onset of this cancer. “But we can prevent the adverse effects that come with aggressive and” crippling “treatments. The condition is early diagnosis of the disease – says urologist Prof. Piotr Chłosta.

1. Most men will develop prostate cancer at some point in their lives
2. Prostate cancer is the most commonly diagnosed cancer in Europe, currently over 2 million people live with it on our continent
3. We are not able to delay the appearance of this cancer – says prof. Piotr Chłosta, president of the Polish Society of Urology.
4. Coronavirus can only kill, but cancer will certainly kill – says the urologist in the first part of the interview
5. You can find more such stories on the TvoiLokony home page

Adrian Dąbek, MedTvoiLokony: It is said that at a certain age, prostate cancer may affect up to 100% of patients. men. Why does the nature of us men experience so much in this topic?

Prof. Piotr Chłosta: The occurrence of this neoplasm is closely related to age. It will occur in almost every man. But beware, not every man has to leave because of this. The one who is diagnosed with it early and the one diagnosed at a very old age will not go away, but the oncological potential of the disease is not significant. In other words, it is not very extensive and not very malignant.

If, on the other hand, prostate cancer is diagnosed at a young age, a man whose so-called life expectancy may be greater than 30-40 years, therefore, failure to treat a person may result in further development of the disease and the risk of its development of a systemic, or metastatic, nature.

Is it possible to somehow delay the time of the appearance of this cancer?

We cannot do that. I would even add that the risk of prostate cancer in relatives in a straight line, i.e. if it occurred in the father, grandfather or father’s brother, the risk of this cancer is 11 times higher than in the population where there is no such relationship. We cannot prevent the occurrence of prostate cancer. But we can prevent the negative effects that come with aggressive and “crippling” treatments or the inability to heal, and then the only thing left is to try to prolong life and try to improve its quality.

And here we come back to the first question, i.e. if I take care, I will win, if I visit a urologist often, then even if I am at risk of prostate cancer, its early detection, i.e. limited to the organ and with a low degree of malignancy, allows apply minimally invasive treatments. That is, for example, surgical removal of the prostate by laparoscopy or robot-assisted laparoscopy, or use alternative methods, such as external field irradiation or internal, interstitial irradiation, without the risk of losing any element that reduces the quality of life.

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Then I will ask the question on the other hand. Is there anything that is conducive to the earlier development of this cancer?

An interesting epidemiological finding is that prostate cancer is one of the leading places in the United States, with African Americans being the most vulnerable ethnic group. On the other hand, in the Far East countries, prostate cancer is only 10th in terms of incidence. Perhaps some dietary components based on the consumption of large amounts of soybeans or tomatoes containing lycopene have an influence. Environmental or genetic or biological determinants may give rise to the assumption that there is less risk in certain parts of society, but there is no evidence for this.

Prostate hypertrophy and prostate cancer. Is there a relationship here?

Let’s start with the fact that we are not talking about hypertrophy. We say growth. Hypertrophy only means an increase in cell volume. In the case of the prostate gland, we use the term “enlargement”, which means an increase in the volume and number of glandular cells, which occurs in every man over 30, resulting in a mild enlargement of the gland. At the same time, since the enlargement, i.e. the increase in the volume of the prostate gland, occurs in all directions, it causes the narrowing of the passage of the urethra, which runs through the prostate gland in the immediate vicinity and thus may cause difficulties in urination.

1. Prostate cancer is not a sentence

These are two independent things – benign prostatic hyperplasia, popularly known as hypertrophy, and the presence of prostate cancer. It is possible to have an enlarged prostate with benign hyperplasia combined with difficulties in urinating (although enlargement of the prostate does not necessarily mean difficulty in urinating) and regardless of the presence of a tumor in the prostate.

When are the first signs that you need to consult a urologist?

In each of those with a family history of prostate cancer, i.e. in the grandfather-father, father-son relationship, these men, regardless of the risk of ailments, should visit a urologist once a year and undergo basic examinations, i.e. a physical examination, examination using the ultrasound method and determination of the concentration of PSA, i.e. the specific prostate antigen in the serum. This antigen is not a tumor marker but a prostate marker. And not always its increased value in relation to the laboratory standard means that there is a risk of cancer, but on the other hand, its value not exceeding the laboratory standard does not necessarily mean that there is no cancer in the prostate.

Another thing is that ailments from the urinary system consisting in increased frequency of urination, the need to get up at night, weakening of the urine stream, urgent urgency, the feeling of urine retention in the bladder or, finally, confirmation of this delay on the basis of ultrasound examination, are symptoms prompting you to visit at the urologist. On the basis of consultations and analysis of examinations, the urologist decides whether it can be treated conservatively or whether more invasive methods of treatment are necessary. You may also need to consider having a prostate biopsy at this visit. The aim of the biopsy is to determine what type of histology, microscopic type or hyperplasia we are dealing with, and whether to exclude, or look for, or confirm the presence of a neoplasm.

A man feels these symptoms and, encouraged by an advertisement, buys supplements in a pharmacy instead of consulting a doctor.

There is no evidence that dietary supplements are effective in alleviating symptoms and preventing possible prostate hyperplasia or preventing the presence of prostate cancer. On the contrary, if these preparations can have a placebo effect, i.e. the feeling that they help, and it does not have to be, they may mask the need to consult a urologist and thus cause the diagnosis of the disease at a more advanced stage and thus prevent treatment. Let me put it this way – there is no evidence that these measures are harmful, but there is also fundamental evidence that they do not help.

1. What are the first symptoms of prostate cancer?

These are drugs, usually of plant origin. There is no research, and there will never be a research that compares drugs that work effectively with herbal drugs. Because the manufacturers of these drugs are not interested in such research. They are more based on the subjective impressions of certain groups of respondents, such as “it helped me”. There is no objective research on this topic and there will not be.

In summary, prostate cancer is common, but at the same time one that you can live with for a long time in a relatively good condition.

Yes of course. At part of society. But just because it’s growing slowly doesn’t mean it can’t kill. He is able to kill. If it is not diagnosed at very high grade and if aggressive treatment is not given, prostate cancer can shorten life. It is the cause of deaths of almost 100. men annually in Europe.

We must bear in mind that its oncological potential is confirmed not only by the degree of malignancy, because there are less and more malignant tumors, but also by the degree of advancement and the ability to metastasize, both to the lymph nodes and to the skeletal system. The earlier we recognize the disease, the greater the chance we have to eliminate it completely, with the intention of delaying its progression, if there is a risk of relapse. But there is indeed a group of patients for whom it may be of less clinical importance. But in order to unequivocally settle it, we need to know about this cancer and know its harmful potential.

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