Blue November: Check out answers to 10 common prostate questions

The campaign Blue november which begins this Tuesday (1st), promotes awareness of comprehensive care for men’s health.

Although it is mainly associated with the prevention of prostate cancer, the action aims to highlight the importance of adopting healthy habits to reduce the risks of diseases as a whole.

Experts warn that the male habit of seeking medical attention only in the face of some symptom, such as pain or discomfort, contributes to the late diagnosis of health problems such as cancer, hypertension and high cholesterol, for example.

Incidence of prostate cancer

In Brazil, the prostate cancer it is the second most common among men, only behind non-melanoma skin cancer, according to the National Cancer Institute (Inca). In absolute values ​​and considering both sexes, it is the second most common type. The incidence rate is higher in developed countries compared to developing countries.

According to Inca, part of the tumors can grow quickly, spreading to other organs and leading to death. However, most develop slowly and do not show signs or threaten health.

Early diagnosis reduces the risk of complications. To confirm the disease, it is necessary to perform a biopsy, a procedure in which small pieces of the prostate are removed for laboratory analysis. Biopsy is indicated if any changes are found in the preventive exams (read below ).

Age, family history of cancer, overweight and obesity are among the factors that can increase the risk of prostate cancer.

The risk increases with advancing age. In Brazil, every ten men diagnosed with prostate cancer, nine are over 55 years old. Men whose father or brother had prostate cancer before age 60 are also more susceptible. Recent studies show a higher risk of the disease in men with high body weight.

See 10 answers to the most common prostate questions

1. What is the prostate?

THE prostate It is a gland present in men, located in front of the rectum, below the bladder, surrounding the upper part of the urethra, which is the channel through which urine passes.

she has like function to produce a liquid that makes up part of the semen , which nourishes and protects sperm. However, it is not responsible for erection or orgasm.

2. Is prostate enlargement serious?

Prostate enlargement can happen naturally during a man’s aging process. The framework, technically called Benign prostatic hyperplasia may not pose a health risk.

“Simple prostate enlargement is not serious, almost half of men over 50 have an enlarged prostate. As long as the person urinates well and does not have a tumor, this increase can simply be monitored”, explains urologist Flávio Trigo from Hospital Sírio-Libanês and professor at the Faculty of Medicine of the University of São Paulo (USP).

3. Can an enlarged prostate turn into cancer?

Hyperplasia does not turn into cancer, but the two situations can happen simultaneously in the prostate, experts warn.

“Prostate enlargement does not turn into cancer. The chance of a man with an enlarged prostate having prostate cancer is the same as that of a man with a normal-sized prostate, but it does exist, so he should have periodic examinations. What prostate enlargement can cause in about half of patients are symptoms such as urinating with a weak stream, going to the bathroom frequently, waking up at night to urinate or having to run to the bathroom,” says Trigo.

According to the specialist, patients with pronounced symptoms should be treated with drugs or surgery, with the so-called prostate scraping.

4. Does prostate cancer cause any symptoms?

In its initial phase, Prostate cancer has a silent evolution according to the National Cancer Institute (Inca).

Many patients do not have any symptoms or, when they do, are similar to those of benign prostate growth, such as difficulty urinating, needing to urinate more often during the day or night.

In the advanced stage, it can cause bone pain, urinary symptoms or, when more severe, generalized infection or kidney failure.

5. What is PSA? Is enlargement a sign of prostate cancer?

PSA (Prostate Specific Antigen) is a protein produced by the prostate tissue, which can be detected in a blood test.

“Because it is a prostate-specific marker, its elevation increases the suspicion for prostate cancer. It is very common for the patient to question what the limit of this PSA is. In fact, it has no limits, unlike when we measure blood sugar, cholesterol or triglycerides, which have pre-defined limits, PSA does not work that way”, says urologist Fernando Leão, robotic surgeon at Hospital Israelita Albert Einstein of São Paulo and Goiania.

Experts say that the increase in PSA does not necessarily mean the presence of prostate cancer. Therefore, the exam indicators must be related by the doctor to other patient data, such as age, prostate size and results of previous exams, for example.

“As the prostate, in humans, increases benignly over the years, PSA also tends to increase. Likewise, PSA increases with the progression of prostate cancer. Thus, if PSA is increasing, the urologist can define whether the PSA change is due to a benign or malignant cause”, says urologist Túlio Meyer Graziottin. “The interpretation of PSA is a complex activity and must be done by a specialist in the subject: the urologist. As an example, a low PSA does not exempt a patient from having prostate cancer and a high PSA does not indicate that they have prostate cancer.”

6 – Is the digital rectal exam still necessary?

Yea, timely diagnosis of prostate cancer are performed from perceptible changes from the touch by the doctor.

“O touch exam which is the digital study of the prostate, known as digital rectal examination , is an extremely important test that must be performed in the male prostate evaluation. Investigations should be carried out in men over 50 years of age, except for those who have a family history of cancer, especially prostate cancer, in a father, brother or uncle, who have had the disease”, says Leão.

According to the doctor, for these patients the orientation is to start preventive exams from 40 to 45 years of age, with annual periodicity.

“Although there is a perception that this simple test is essential for the identification of prostate cancer in the initial phase, the touch still comes up against misinformation and the culture of two-thirds of Brazilian men, who do not undergo the test. The procedure should be viewed in the same way as a mouth, nose or ear exam. Touch does not interfere with anyone’s masculinity, on the contrary, it is a sign that the man is worried about himself and his family members”, says urologist Lucas Nogueira.

7. How is prostate cancer treated?

O prostate cancer treatment can be done from different approaches. The most appropriate treatment should be indicated by the medical team after an individualized evaluation, considering the characteristics of the tumor, the stage it is in, the patient’s age and general health status.

Patients who have localized disease, which has only reached the prostate and has not spread to other organs, may undergo surgery, radiotherapy and only vigilant observation, which consists of monitoring the clinical picture.

For locally advanced disease, radiation therapy or surgery in combination with hormonal treatment has been used. In more severe cases, when the tumor has spread to other parts of the body, the so-called metastasis, the most indicated treatment is hormone therapy, according to Inca.

8 – After surgery to treat prostate cancer, is there any other treatment necessary?

Post-surgical management depends on the evolution of the patient after the procedure.

PSA tests can show whether the surgery was enough to eliminate the cancer or whether additional treatments will be needed, such as medication or radiation therapy, for example.

9. Is there a risk of sexual impotence?

With the evolution of technology, more and more men treated for prostate cancer are maintaining a normal sex life.

The rates of sexual impotence have been falling to values ​​below 10%, says doctor José Anacleto, head of the Urology Service at the Federal Hospital of Lagoa (HFL), in Rio de Janeiro.

“Prostate cancer can cause sexual impotence, but it is not a common condition. Impotence is multifactorial and the risk of a man with prostate cancer developing it needs to be analyzed individually, on a case-by-case basis. It may be associated with tumor growth. When the cancer passes the limits of the capsule, it infiltrates the nerves, which pass around the prostate, responsible for erection, erection problems can arise”, explains Anacleto.

The psychological factor also ends up being important and very common in men with prostate cancer, who have reduced libido and sexual desire, says the specialist.

10. Is prostate cancer curable?

Yup. Early detection of cancer is a strategy used to find a tumor at an early stage and thus provide a greater chance of successful treatment, according to Inca.

Early detection can be done through investigation with clinical, laboratory, endoscope or radiological exams, of people with signs and symptoms suggestive of the disease (early diagnosis), or of people without signs or symptoms (screening), but belonging to groups with greater chance of having the disease.

“Once making the early diagnosis and the most appropriate treatment for the case, the man can have cure rates above 98%”, says Anacleto.