2024-07-14 00:16:26
Between 2020 and 2040, cases will increase from 1.4 million to 2.9 million annually worldwide. However, success in early diagnosis and early and advanced treatments will also improve.
Every year around 34,000 new cases of prostate cancer are diagnosed in Spain, according to data from the Spanish Society of Medical Oncology (SEOM). It is the most common tumor in men and the third leading cause of death from cancer in this population group, with an estimated one in four men suffering from prostate cancer at some point in their lives. Therefore, it is very important to promote prevention and the need for annual checkups starting at age 50.
According to Luis A. San José Manso, head of the Section of Urology Service at La Princesa University Hospital in Madrid, worldwide, prostate cancer is the second most common neoplasm diagnosed in men, with up to 1.5 million new diagnoses per year. In Spain, it is the most frequent diagnosis in men in 2023, as in 2022, with 29,000 new cases, followed by those of the colon and rectum (26,357), lung (22,266) and urinary bladder (17,731).
“As we know, in recent decades, the absolute number of diseases diagnosed in our country has increased due to population growth, age, exposure to risk factors – tobacco, alcohol, pollution, obesity and sedentary life, among others-, and how it happened. in skin, breast, and uterine cancers, due to an increase in early detection.”
In fact, data from a published study The lancet warns of an imminent increase in cases of prostate cancer worldwide. The findings project that in the next 15 years the cases of this disease will double. According to the estimates of the aforementioned work, between 2020 and 2040, cases of prostate cancer will increase from 1.4 million to 2.9 million per year worldwide. The data show that this disease continues to be a major Public Health challenge that must include measures that improve research, prevention and education with the aim of reducing its impact.
THE INSIDE, THE OUTSIDE AND THE GENTLE MEN
Aging, as shown by San José Manso on the occasion of an updated session on this tumor held at the La Princesa University Hospital, is one of the main risk factors for its development, according to physical studies- The body has shown, “its prevalence is around 60% in people over 80 years old.”
However, experts also warn that many external and environmental factors have been proposed as being associated with the risk of developing prostate cancer or that are important in its progression, as it occurs in many types of cancer. For example, “the presence of metabolic syndrome or high blood pressure is associated with an increased risk.” Likewise, hypercholesterolemia and obesity are risk factors in this sense,” points out José Ángel Gómez Pascual, head of Urology at Quirónsalud Málaga Hospital.
Prostate cancer can also have a hereditary factor; This is why it is very important if there is a history in the family to start the diagnosis from the age of 45. “Controls should start at the age of 40-45 if you have a first relative who has suffered from prostate cancer or if you have a positive BRCA2 gene, because it is known that both conditions are related to an increased risk of “now there are certain cancers. , such as prostate cancer.”
According to data from the National Institute of Statistics (INE), the incidence and mortality from prostate cancer has increased in recent years, making it a public health problem. “Thankfully, improvements in early detection and treatments have improved the prognosis for many patients,” said François Peinado, head of the Urology Service at the Olympia Medical Center and Ruber Juan Bravo Hospital in Madrid. .
Advances in early detection methods and current treatments have led to greater control of this disease in which, without a doubt, early diagnosis is essential to improve the prognosis.
In Spain, prostate cancer is often detected by measuring a specific antigen in the blood (PSA) and digital rectal examination (DRE),” said Peinado, who indicated that “the practice of testing with PSA has been. a controversial subject, but it is often used to detect cancer in its early stages, when treatment can be most effective.”
EARLY READING WITH ALL TOOLS
Gómez Pascual explained that the normal urological diagnosis is completed with a clinical consultation with PSA analysis, prostate examination, uroflowmetry and prostate ultrasound or multiparametric MRI of the saliva, which shows more accurately if there is any type of lesion on the prostate. suspected and which replaces the biopsy on a random basis.
“Prostate cancer is usually diagnosed in the early stages thanks to a PSA test. You should not wait to have symptoms, because this type of tumor usually shows symptoms in advanced stages, causing symptoms of lower urinary tract symptoms, such as reduced pressure when urinating, intermittency during of urine, flow when finished, urgency or urge to go to the bathroom,” said this urologist.
Fusion biopsy, through the use of combined magnetic resonance imaging and transrectal ultrasound, has been one of the most important advances when it comes to biopsying, and therefore analyzing, the exact tissue in which cancer cells are located.
Carlos Núñez Mora, head of Urological surgery at MD Anderson Cancer Center Madrid, indicates that this system combines magnetic resonance software and previously taken ultrasound images of the patient’s prostate. “This results in a three-dimensional map of suspicious areas that helps us perform a guided biopsy. It is especially important when we have to find, for example, a small lesion, just 4 mm, in a 60 cm3 prostate, cases in which the procedure becomes very complicated.”
Another advantage of the hybrid system is that it avoids the so-called saturation biopsies, a procedure that was used before when they did not have this type of technology. “Years ago, to avoid wrong diagnoses, more than 40 biopsies could be done on the same patient if necessary. In this way, they ensure that the margin of error is very small. Currently, between 3 and 4 samples are taken from the suspicious area and then a mapping of 6 or 10 shots is done. “Therefore, the test is less lethal for the patient.”
Gómez Pascual added that the fusion biopsy is a key diagnostic tool of recent times, “by allowing the detection level of prostate cancer to be corrected over 95%, without blindness, without false negatives… Of all the available diagnostic tools, biopsies fusion is the one that provides the most important information, so that it allows 30% more aggressive cancers to be diagnosed, which would be noticed by a classic biopsy.”
Also, and according to Núñez Mora, the device has an advantage in relation to automatic treatments. “In the event that the patient is a candidate for therapy of this type (low-risk prostate cancer), doctors have mixed images of the lesion stored in the system. With the same combination, the team can start a more targeted therapy given that it has identified the lesion to treat and the exact location where it is.”
In this sense, this urologist points out that the automatic treatment of prostate cancer is a highly selective and less lethal treatment, with better results in selected cases and with less side effects in terms of Preserving urinary incontinence and sexual energy.. R. Serrano/S. Moreno (DM)
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