The growth also due to early diagnosis: visit to the urologist and PSA test lead to healings. Looking for DNA mutations allows you to guide prevention and choose the most effective therapies
The number of young men who are diagnosed with prostate cancer before the age of 50 has been growing for years. Although the disease, in the vast majority of cases, affects men over 65, statistics indicate in Italy an increase in cases of 3.4% per year in the under 50s. If the reasons remain partly to be clarified, it is also necessary to evaluate the role of prevention, for which by undergoing checks some men discover the neoplasm “in advance” which must be analyzed with great attention: in young age, in fact, prostate cancer is often completely asymptomatic and not very aggressive, but there is a share of cases in which the disease appears biologically different and progresses more rapidly. As emerges from the national congress of the Italian Society of Oncological Urology (SIUrO), however, doctors have two increasingly important weapons at their disposal: precision uro-oncology and multidisciplinarity. Personalized treatments for each individual case and shared patient management by a group of different medical specialists can help counter the growing incidence of what remains, with 36 thousand new cases discovered every year in our country, the most common male cancer.
Visit to the urologist and PSA test
Numbers in hand, one in eight men could get prostate cancer in the course of their own, but thanks to advances made with prevention, early diagnosis and new therapies, more than 80% of patients are alive 10 years after diagnosis . «Prostate cancer is on the rise also because, compared to the more recent past, it is more sought after among the entire population – explains Alberto Lapini, SIUrO national president -. The PSA test is easy to perform because it takes place through a normal blood sample (which measures prostate specific antigen). It is recommended from the age of 50, but men who are familiar should start between the ages of 40 and 45. To a patient with prostatic symptoms, the urologist can propose to perform the PSA explaining what are the advantages and limits of the method – continues Lapini, head of the Prostate Cancer Unit at the Careggi hospital in Florence – and what may need to be done if this examination resulted not within normal limits because high Psa values do not necessarily mean that there is a tumor, but rather indicate that something is wrong with the prostate ». Visiting the urologist once a year, starting at the age of 50 (or 40 if you have several cases of cancer in the family) is a simple and very effective way to stay healthy and find out in time, when they are older. easy to care for, any problems.
The decisive role of genetics (for healthy and sick)
It is always good to talk to the family doctor or urologist who can better assess what is best to do, especially in those who are most at risk of prostate cancer: “That is men who first degree relatives (father and brothers) with the disease (especially if manifested at the age of under 55), or those who have family members with a hereditary tumor of the breast and / or ovary (due to the BRCA genes) – explains Lapini -. Men with a first-degree relative who has this disease have an up to 3 times higher risk of developing it. For those who have more than one family member affected, the risk increases by even 5 times. With genetic investigations it is possible to carry out timely therapeutic interventions capable of increasing the chances of recovery ». Recent statistics indicate that about 10-15% of prostate cancer cases are hereditary and a non-negligible percentage (between 20 and 30%) has a mutation of the BRCA1 / 2 or ATM genes that is often associated with a potentially disease less responsive to the most commonly used drugs. For this it could be useful, in patients in which it is indicated (young and familiar), to perform the test that verifies the existence of the genetic alteration before starting medical therapy. The genetic test serves in fact to “characterize the molecular profile” of the tumor of the individual patient and to discover if there are any targets that can be hit more effectively by certain drugs than by others.
Precision medicine, the new drugs
Today the expectation of people with prostate cancer is getting longer and the valid therapeutic solutions are different: surgery, radiotherapy, brachytherapy or active surveillance in the early stages, to which are added numerous types of different drugs as the neoplasm progresses. “Prostate cancer is emblematic of the need to resort to precision uro-oncology – underlines Giario Conti, SIUrO national secretary -. We must be able to give an increasingly appropriate classification of our patients and to do this we can use new tools at our disposal. Research is perfecting genetic tests and other diagnostic technologies capable of perfecting the selection of therapies: today we know that studying DNA is crucial both for prevention and for choosing the most suitable treatments for the individual patient. Mutations of the BRCA1 and BRCA2 genes will be increasingly sought, even in genitourinary tumors, to discover the usefulness or otherwise of using a new class of drugs, PARP inhibitors, already approved in Italy and successfully used for cancer of breast and ovary: soon there will also be the possibility of using them also against advanced, metastatic or castration-resistant prostate cancer. On the other hand, targeted therapies have for several years been included in all national and international guidelines for the treatment of renal carcinoma. The use of tests and other examinations is therefore increasingly relevant in our daily clinical practice ».
We need a group of experts to treat patients well
«Closely linked to precision uro-oncology is the multidisciplinarity that represents the cardinal principle on which our Scientific Society is based – says Renzo Colombo, SIUrO vice president -. Therapeutic strategies must be decided and agreed upon by a team in which there is a coordinated work of several medical professionals. Prostate cancer (but also others in the urological area such as kidney, bladder, testicle or penis cancers) is a very complex disease that requires integrated strategies to give more personalized responses to our patients. In fact, important clinical innovations are on the way that are allowing a more dynamic and in-depth knowledge of these diseases. The multidisciplinary approach facilitates the patient, making the various specialists (urologist, radiotherapist, oncologist, sexologist, pathologist, to name a few) rotate around him and allows us to optimize the use of resources, favor diagnostic and therapeutic appropriateness. observational, make available treatments more accessible and improve the quality of life and compliance of patients with therapies and follow-up “. Especially for prostate cancer in the early stages, when diagnosis is early and the cancer is localized, without metastasis, there is no “best cure” that is valid for everyone: “The choice is up to the patients, who are called to decide which is the best alternative by evaluating the probable undesirable consequences – concludes Colombo, coordinator of the Uro-Oncological Area at the Hospital San Raffaele of Milan -. Also in this perspective (and the early diagnoses of non-aggressive carcinomas are growing) the role of the multidisciplinary team is crucial ».
October 1, 2021 (change October 1, 2021 | 18:09)
© Time.News