There are many options available today, but it is essential to be treated in centers that we have a group of different experts (urologist, radiotherapist, oncologist) able to choose the best treatment and identify who is most at risk.
One in eight men in Italy come to terms with a diagnosis of prostate cancer that, with 36 thousand new cases diagnosed every year in Italythe most common type of cancer in men after the age of 50. Thanks to early diagnosis and increasingly effective therapies, today over 90% of patients manage to recover or live with the disease for decades. Many new options are also available today for those patients, about 7 thousand more every year in Italy, who have metastatic neoplasia, as illustrated by the specialists of the Italian Society of Oncological Urology (SIUrO) gathered in these days in Florence for their national congress.
Relying on a center with several experts in a team
What is important for a patient with metastatic prostate cancer to know? That it is essential to be treated by a multidisciplinary team, in which several experts work in close collaboration with each other – he replies Sergio Bracarda, president SIUrO -. A speech that applies to all men who have to face prostate cancer, at any stage. We have made a lot of progress because we have many effective therapies available: surgery, radiotherapy, many drugs old (but still valid) and new ones and, for those with an early stage and not very aggressive neoplasm, there is also active surveillance. A vast offer also entails a complex panorama and having to make various choices, which also take into account the desires of man, his quality of life. In short, it is necessary to evaluate numerous parameters and if the different experts confront each other, it is easier to reach the most suitable solution for each individual case. Several studies, moreover, have scientifically demonstrated this: the collaboration between the various experts (urologist, radiotherapist, oncologist, psychologist, sexologist, rehabilitator and others) within the team allows make more correct therapeutic choices to the benefit of the patient, both for the quantity of his life and for the quality of his days.
Symptoms that indicate an advancing tumor
No less important to pay attention to some symptoms: chronic fatigue, pain (especially to the bones), weakness, urinary disorders, difficulty sleeping or doing normal daily activities, such as walking or climbing stairs. These are the alarm bells that should put you on alert because they could indicate that the disease is getting worse. Talk immediately with the oncologist, urologist or fundamental radiotherapist, so that you can immediately start the most effective therapy in the individual case with two purposes – clarifies Alberto Lapini, which ends during the congress the SIUrO presidency and director of the Prostate Cancer Unit at the Careggi hospital in Florence -: block the evolution of cancer (and the onset or evolution of metastases) and keep one good quality of life, without pain or other ailments, with advantages also on the extension of survival.
Genetic mutations and risks in the family
Being treated in centers with extensive experience is also decisive in light of the new knowledge on the causes of the disease: it is now certain, in fact, that a share of prostate cancers is due to the mutation of the BRCA genes (and in particular of BRCA 2), which in this case they tend to be particularly aggressive and to metastasize. Thanks to the possibility of searching for the mutation on biopsy tissue or blood sampling, the multidisciplinary team that assists the patient can select the best therapy to propose to the patient. The BRCA test should be proposed to all patients with metastatic prostate cancer to evaluate the possibility of using, when indicated, an individualized therapy (there are targeted drugs, the so-called PARP-inhibitors, able to slow down the growth of the tumor) – adds Lapini -. We then know that mutated BRCA genes are linked to cancers of the ovary, breast and pancreas, for which it is very important to carry out, when indicated, a real genetic counseling also in other members of the family unit. Recent statistics indicate that about 10-15% of hereditary prostate cancer cases and a non-negligible percentage (between 20 and 30%) have a mutation of the BRCA1 / 2 or ATM genes that is often associated with a potentially less disease responsive to the most commonly used drugs.
Drugs
The treatment of metastatic prostate cancer includes – says Bracarda, director of the Department of Oncology and Medical and Translational Oncology of the Santa Maria di Terni Hospital -. The choice of therapy depends on the characteristics of the patient and the disease. First of all you have to distinguish between those who are metastatic since diagnosiswhich therefore has a more aggressive neoplasm, and those patients who, on the other hand, arrive at the most advanced stages over time. A time that lasts several years and can be extended in both cases. The standard of care for men with metastatic prostate cancer has been there for decades hormone therapy: the testosterone produced by the male testes, in fact, stimulates the growth of the tumor and hormone therapy tries to counteract this action by slowing down or blocking the synthesis of testosterone (androgen deprivation). For patients who progress in the course of first-line hormone therapy , the so-called “resistant” to castration, there is now a wide range of therapeutic options: chemotherapy drugs, a radiopharmaceutical and next-generation hormonal drugs. It is thus possible, in many cases, to prevent bone metastases, to extend (even by several years) the survival of patients, who can lead an almost normal life.
radiotherapy
Radiotherapy can also prove very useful against metastases which, thanks to increasingly sophisticated machinery and imaging, hits the target better and has fewer and fewer side effects. Prostate cancer in its early stages can also be cured and cured only with radiation treatment – he concludes Rolando D’Angelillo, Professor of Radiotherapy at the University of Rome Tor Vergata -. increasingly effective and precise radiation also comes to the aid of metastatic patients, for ablative purposes for example for bone lesions. Or in combination with some drugs, or to delay the use of other drugs: this is also why collaboration between the various experts is essential.
October 7, 2022 (change October 7, 2022 | 18:55)
© Time.News