The urologist said which men have a higher risk of prostate cancer

– I am probably not wrong when I say that prostate cancer is the most common cancer disease in men. How does Lithuania look in the context of other countries?

– In Lithuania, every year 2 to 3 thousand diseases are diagnosed. Recently this number has been decreasing and this is probably related to the fact that since 2006 we have an early prostate diagnosis program in Lithuania. In its first year, the number of detected cases has increased significantly, to more than 3,000, and has recently reached around 2,200 cases per year. The incidence is similar in neighboring countries.

– In November, men encourage each other not to shave their beards and thus pay attention to this disease. Will there be an increase in the number of men registering in November?

– This year, of course, no. We all probably understand why. But this is not the first year that this campaign has been run and we feel a greater interest in men in December and January. Men find out about this opportunity to check, go to family doctors, and before it reaches us, a month passes.

– Prostate cancer usually affects men over 50 years of age. But have you heard that the disease is rejuvenating?

– With better diagnoses, more knowledge about the inheritance of the disease and all the other related things, the disease is also found in younger men. The youngest man to be treated was 38 years old. But this is not news, since prostate cancer in men begins to develop in the third, fourth, fifty. It takes 10 years for the disease to be diagnosed. As the diagnosis improves, the disease can be detected at an earlier age. Men who have prostate cancer among their close relatives should worry first. A PSA test is recommended for all men over the age of 40. If the risk of disease is high, the test should be done well before the preventive diagnosis.

– Let’s talk about what causes this oncological disease and how is it different from other oncological diseases?

– Oncological factors are similar to other diseases. The incidence of prostate cancer is higher in the west than in the east. It has been linked to eating habits, sedentary lifestyles, excessive consumption of meat, especially red meat, environmental pollution, genetics, as well as cancers in the family where the mother has ovarian cancer.

– How many men participate in the program for the early diagnosis of prostate cancer?

– The data is constantly changing and the numbers for this program in Lithuania are not bad enough, much better than cervical examination for women. About 60 percent. men ages 50 to 70 have had a PSA test at least once.

– How is this study carried out?

– If we talk about a screening test performed by family doctors, it is the simplest blood test. If it exceeds the normal range, the person is referred to a urologist, an ultrasound is performed, the prostate is palpated through the rectum, and an MRI is performed as indicated. If lesions are found, a prostate biopsy is performed. It can be done through the rectum or through the perineal skin with analgesia.

– Many doctors say that men tend to go to the doctor only when something bad is already happening. What are the primary symptoms you should go to?

– According to several studies, interviews with men have shown that one of the reasons why men turn to urologists is the fear that it is an oncological disorder. The second cause is urinary incontinence. Early prostate cancer has no specific symptoms. There may be a weak stream of urine when urinating, frequent night urination, feeling of incomplete urination, spasmodic currents. Men should be tested even without symptoms, as they occur when it is too late, when the disease spreads from the prostate to surrounding tissues, to the pelvic wall, or spreads to the bones. Men feel pain in the back, shoulders, legs and arms.

– Doctor, maybe you can reassure men now: what other disorders can plague you if you experience these listed symptoms? After all, isn’t it necessarily an oncological disease?

– Yes, if we talk about the same PSA test, it is completely nonspecific for any disease, only prostate tissue. With disease of the prostate tissue, it begins to grow. It may be the same enlarged prostate, a very large prostate. The more prostate tissue, the more PSA enters the bloodstream. Another cause is inflammation of the glands, acute or chronic prostatitis. Perineal injuries can occur if, for example, a man rides a bicycle frequently. Having sex the night before the test can also distort the PSA rate.

– What happens next when prostate cancer is diagnosed?

– Usually, when we make a diagnosis and there is a first conversation call, the patient only hears one word “cancer”. Everything else fades away and the patient begins to lock in, rejecting the information provided. And, in the long run, they begin to accept the diagnosis, they begin to look for options and treatment alternatives. It is recommended that the patient engage in such a conversation not alone, but with a partner or child. We often schedule a second interview in a week or two so we can answer questions.

– What are the chances of survival and for how long after hearing said diagnosis?

– We usually detect stage II prostate cancer. It is not uncommon for 7, 10 or even 12 years to elapse between the moment we diagnose the disease and the appearance of tumor foci in other organs. Currently, with these treatment alternatives, even after the disease has progressed to metastasis, survival is about 5 years. In the case of early prostate cancer, the treatment applied is to ensure that the life expectancy of the patient is not reduced in any way as a consequence of the disease. After radical prostatectomy or radiation treatment, in fact, most patients recover and those who relapse receive other treatment.

– In which cases is aggressive prostate cancer detected and is it true that it can develop even in a few months?

– We usually have between 10% and 20% of aggressive prostate cancer cases. For cancer that is aggressive and metastatic, we are currently detecting much less than simply introducing a prevention program. It is very rare for a patient to die of illness within a couple of months. Yes, if the cancer is very aggressive, it can occur in half a year or in a year and a half. It is not a disease such as, for example, acute leukemia, cancer of the stomach, pancreas, lung, when a person’s disease can sometimes “eat” in half a year or less.

– In which cases is prostate cancer not treated but simply monitored?

– There are several tactics, one of which is active monitoring and the other is waiting. Active surveillance only applies when we believe we have diagnosed clinically insignificant prostate cancer. Without treatment in these patients, the 15-year survival rate for prostate cancer is 95% to 98%. Regular PSA tests, repeat radiological examinations, and sometimes follow-up biopsies are done to assess whether the disease is not progressing and if worse cells are developing. Active treatment has side effects that eventually affect a man’s quality of life. So if possible, try to delay treatment. If we talk about a waiting tactic, it is applied when a radical treatment is no longer planned, because its phenomena can lead to an alteration in the quality of life. A man with a life expectancy of less than 10 years due to possible comorbidities or old age is simply subjected to a waiting tactic until metastasis occurs and treatment is started.

– Is it possible to prevent this disease in your lifestyle?

– It will probably not be completely avoided. But the lifestyle is 50 percent. our health in general. Nutrition and physical activity are factors that, when regulated, can delay the disease or, in some cases, improve the results of cancer treatment. I believe that by living a healthy life we ​​can delay disease or prevent it completely.

– What other diseases would you like to warn men about to check?

– The oncological disease in young men is testicular cancer, so I encourage men, if you have felt any formation in the scrotum that did not exist before, do not wait and see a doctor. Perhaps initially to the GP, but it is important not to delay because every day is important.

– Doctor, in short, what symptoms should a man have immediately and go to the doctor?

– If there is blood in the urine, when urinating it hurts, it is difficult to do, when urinating you feel that you have something left, pain in the lower back, painful carving, similar to an attack, which extends to the lower abdomen If you have a fever, do not delay, you should see a doctor.