The most common cancer in men is prostate cancer, however, it is not the tumor that causes the most mortality. It is estimated that only around 5% of these tumors are initially diagnosed with metastatic disease.
The symptoms can be varied, but the most frequent is the alteration and/or difficulty to urinate. In the initial stages of the disease, it does not cause any alteration perceptible by the patient, however, in cases of locally advanced or metastatic disease, symptoms such as blood in the urine (infiltration of the bladder), inflammation of the legs or the scrotum area (lymphatic drainage difficulty), or bone pain due to metastases.
Is screening necessary?
Although there is much controversy among specialists in establishing screening programs for men between 50 and 70 years of age, scientific societies agree that it is not necessary to apply a screening policy to men over 70 years of age. There are different tests to detect prostate cancer early, but the most relevant are the digital rectal examination and PSA determination. It is very important that a person who wants to carry out early diagnosis tests is informed of the possibility of overtreatment. In some cases, it is possible to diagnose and carry out treatment for a tumor that will not affect their prognosis for life but that could cause a health problem.
The importance of the multidisciplinary committee
Before any positive diagnosis, before making a therapeutic decision, it is necessary that each case be presented to a multidisciplinary committee. An individualized evaluation and a multidisciplinary vision are the focus of the Tumor Committees. These committees have the mission of bringing together all the professionals who participate in the diagnostic and therapeutic process with the sole objective of approaching and agreeing on the most appropriate prostate cancer treatment decision for each patient and optimizing patient monitoring during all stages of their disease.
Treatment options for curative purposes are surgery (radical prostatectomy), either open, laparoscopic, or robotic, and radiation therapy. The experience of specialists, surgeons and radio oncologists is key in each case.
On the other hand, depending on which cases, doctors may recommend active surveillance instead of prostate cancer treatment. Active surveillance may be the alternative for prostate cancer that does not cause symptoms, is expected to grow very slowly, and is confined to a small area of the prostate.
Aftermath, do they affect sex life?
Prostate cancer treatments can cause side effects and sequelae. Both radiation therapy and surgery can affect the sexual life of patients causing impotence. This is due to the involvement of the nerves and vessels involved in the erection, causing impotence called coeundi and making intercourse impossible. But the involvement is different if it is caused by surgery or radiation therapy. In surgery, impotence appears immediately after the intervention and may improve over time, while in radiotherapy treatment the evolution is the other way around. Initially, there does not seem to be any deterioration, but this may appear over the years; fibrosis caused by radiotherapy causes a progressive deterioration of the vessels and nerves responsible for erection.