Enough prostate for every wise man

Enough prostate for every wise man

What men need to know to avoid cancer

 

Every third case of cancer in men is either lung cancer or prostate cancer. But if everything is more or less clear with the lungs - smoking is to blame, then how to protect a man’s “second heart” from cancer?

 

The older a man is, the higher the risk of developing prostate cancer; among those 60 years of age and older, this type of cancer is already in first place. In Russia, 38 thousand men die from it every year. What are the reasons for the increase in incidence? After all, if we know the reasons, we will be able to defend ourselves.

 

- There are several reasons. Firstly, the aging population. Cancer occurs mainly in older men. The second reason for the alarming statistics is actually a good thing: we have become more active in identifying early forms of this type of cancer, since we have in our arsenal such a marker as prostate specific antigen - it is determined by a blood test. A normal PSA level in men indicates the absence of abnormalities, and exceeding established standards - they depend on age - may indicate the presence of a pathological process, including oncology. And in such cases, the man must undergo additional tests.

 

Previously, when this marker was not yet known, men consulted a doctor when symptoms of the disease appeared. As a result, the diagnosis was made at a later stage of the disease.

 

The third point is that we see not only an increase in morbidity associated with more thorough and early diagnosis, but also a true increase. Indeed, prostate cancer is becoming more common today. There is no one reason that would lead to the development of cancer. But there are risk factors: old age, heredity, Negroid race, overweight, sedentary lifestyle, unbalanced diet - fatty foods, diet high in calcium.

 

What symptoms may indicate that a person has prostate cancer? When does a man need to immediately run to a urologist?

 

- Any disturbances in urination should alert you - frequent, difficult, painful, blood in the ejaculate, in the urine. But, of course, similar symptoms occur in other diseases. There are no specific signs that specifically indicate cancer. Therefore, trouble is not a reason for panic, but for a thorough examination.

 

This type of cancer is not the most severe, it develops slowly, and is not difficult to diagnose. With prostate cancer, it’s no secret, people today can live 10 years or more.

 

Today, approximately every fifth man in the world is likely to develop prostate cancer. But only every 30th person dies from it. This suggests that in most men the disease occurs in a latent form and does not lead to death. In addition, effective treatment methods have emerged. This difference between morbidity and mortality is not typical for all cancers, namely prostate cancer.

 

What can a man do to prevent illness? Should he, for example, monitor his PSA level?

 

- Here you need to understand: the PSA marker is not specific for prostate cancer. It increases not only with malignant formation, but also with benign hyperplasia (prostate adenoma), with inflammatory diseases, with mechanical effects on the prostate gland - massage, instrumental studies. Therefore, interpreting the result is a very difficult thing. You can’t judge anything by one analysis; dynamics are important to decide what to do with the patient - take a biopsy or leave him under observation, etc. But this does not mean that this test should be done by everyone precisely for the purpose of “catching” cancer. In Europe and America, large-scale studies have been conducted on the feasibility of screening for prostate cancer based on PSA. Since this type of cancer develops very slowly, there is no need to conduct such studies “just in case” for young patients who do not have any abnormalities or complaints. The result will not be comparable to the costs. Another thing is early diagnosis, which is carried out if the patient has any symptoms. Here a PSA test is mandatory, and the doctor, of course, will prescribe it.

 

We welcome so-called “risk-adapted” early diagnosis. If a man knows that his closest relatives have had cancer, he should be wary of his health. This is a compelling reason to do a PSA test. Moreover, we are talking not only about cases of cancer in the male line, but also in the female line too. In men, it is prostate cancer - in the father, brother, and in women, breast cancer - in the mother, sister. The fact is that there are hereditary diseases associated with a mutation of a certain gene, and the presence of this mutation greatly increases the risk of malignancy.

 

Any specific recommendations?

 

Men, especially those at risk, should have their first PSA test at 40-45 years of age. The indicator should normally be less than one. If it is greater than one, then it must be repeated annually. If everything is in order, the next time it can be repeated after 8 years.

For men 60 years old, the approach is the same, but the norms are different. For them, PSA should be less than 2. If it is more, then you need to repeat the test annually and watch the dynamics. If the result is less than 2, the next control is carried out at 68 years of age.

 

If the PSA test is abnormal, does this mean that the patient should be examined for possible cancer?

 

- First of all, the analysis needs to be repeated, and if it is still elevated, the examination should be expanded to decide whether a biopsy is necessary. Additional tests such as PHI (Prostate Health Index) and prostate MRI (Magnetic Resonance Imaging) may be performed.

 

Should all patients, if the diagnosis is confirmed, begin treatment immediately?

 

- For non-aggressive forms of prostate cancer that develop slowly, we use a type of treatment approach called active surveillance. That is, the patient does not receive any treatment, but is regularly examined. If there are signs that the tumor is becoming aggressive and starting to grow, then we carry out treatment. This tactic is mainly used for elderly patients. If a 70-75 year old man is diagnosed with a non-aggressive early form of prostate cancer, the likelihood that he will require treatment is no more than 50 percent. He is more likely to die from other causes - cardiovascular diseases, for example.

 

Cancer causes fear, close to horror, although we are told that today cancer can be treated much better. But we see that people are still dying from it. What do we have in terms of treatment options for prostate cancer?

 

- Treatment options are the same all over the world; here they are absolutely the same as in other countries. If we are talking about the initial stages, then this is treatment aimed at curing. As a rule, surgical and radiation methods are used, if necessary, a combination of them: surgery plus radiation therapy. The surgery can be performed openly, laparoscopically, or using robotic systems. There are also many different techniques in radiation therapy, and new ones are constantly being developed. There is interstitial radiation therapy, brachytherapy, external conformal radiation therapy, and not so long ago they began to use proton therapy, etc. The essence is the same. There is radiation therapy and there is surgery. These are the two main methods of treating prostate cancer.

 

If we talk about more advanced stages of cancer, up to the fourth stage, then great advances in treatment have been achieved here too. Today, patients even with widespread metastases live on average five years, and of course, it is extremely important to maintain the quality of life for such patients. In addition to conventional hormonal therapy, which has been used since the 60-70s, second-, third- and fourth-line drugs have appeared. Treatment is usually started based on the stage, symptoms, age of the patient, tolerability of treatment, and side effects that occur. All this together makes it possible for an experienced oncologist to decide which drug is preferable at the first stage of treatment, which at the second, etc. Ideally, patients receive all existing drugs, because each adds something to increase life expectancy.

 

Can you reduce your risk of cancer with food?

 

- There are many studies on this topic. There are well-known and proven facts: for example, smoked and fried food is evil. Meat, fish, eggs, potatoes, cooked in hot oil or with “smoke” contain substances that provoke the disease. Not so long ago, scientists discovered that milk is not at all as harmless a product as we used to think. Scientists at the US National Cancer Institute were the first to identify a pattern: women who consume a lot of dairy products are more likely to develop breast cancer. More recent studies have confirmed that excess dairy (more than 4 servings per day) increases the risk of breast and ovarian cancer in women and prostate cancer in men. Scientists explained: milk contains a lot of saturated fatty acids, estrogens, and an insulin-like growth factor, which provoke tumor processes. The risk of prostate cancer in men is also associated with excess calcium in food, and its main source is dairy products. On the other hand, calcium protects against colorectal cancer. So oncologists do not urge men to completely give up milk, but not to overdo it with the amount and give preference to fermented milk products.

 

What food can protect against cancer?

 

Antioxidants, which are abundant in fresh vegetables and fruits, are powerful oncoprotectors. Lycopene has been well studied - there is a lot of it in tomatoes. A “protector” such as indole-3-carbinol is also very necessary - all types of cabbage are rich in it, especially dark green broccoli. The long-named flavonoid epigallocatechin-3-gallate, which is abundant in green tea, is the most active of the four tea catechins. Its anti-cancer effectiveness is 100 times higher than that of vitamin C and 25 times higher than that of vitamin E. In countries where green tea is drunk every day, prostate cancer is rare.

 

For questions, you can contact us by phone +(998 78) 140-03-03, +(998 78) 140-01-60 and at the address Tashkent, Uchtepa district, 12th quarter, st. M. Shaikhzoda. Telegram channel: https://t.me/urologic_uz