It is estimated that one in nine men will be diagnosed with prostate cancer in his lifetime. For this reason, years ago there was a need to promote prevention and periodic male health check-ups throughout the month of November, worldwide.
Men generally do not acknowledge that they have a health problem and may not feel comfortable asking for help. The Movember initiative came to raise awareness at the family level, since 2003: men over 40 should visit the urologist at least once a year. If you have a male relative over 40 years of age, a reminder is made with a tone of support and empathy.
Dr. Andrea Guevara, urologist, supports that education should be directed to the patient and his family. “Today, the life expectancy of the Costa Rican is 85 years and not 70, as 30 years ago. Costa Ricans are retiring today, but they continue to keep their jobs, their companies. They even remarry and have children after age 50; exercise more; they have more social life; they take better care of themselves nutritionally and have stopped smoking. That is, they are still very active. The annual visit will be essential to ensure that good health that they are looking for today in order to continue maintaining a good quality of life ”.
Guevara explains that in this consultation, risk factors that the patient may have to develop prostate cancer are looked for. “If the patient is under 50 years of age and does not have a family history of prostate, breast, pancreas or ovarian cancer, and his prostate examination is within normal and low risk values, it is very possible that he should return to the consultation every two years, or when your doctor determines. But, if the urologist observes any data that suggests monitoring him more closely, a more continuous visit will be recommended. From 50-53 years of age, an annual routine visit to the doctor is already recommended ”, warns the urological health specialist.
Prostate cancer ranks, worldwide, between the second and third leading causes of cancer incidence in men over 50 years of age, after skin and colon cancer. And although in recent decades, the diagnosis has improved, it also continues to occupy the first mortality rates.
This means that, despite the fact that each day we diagnose prostate cancer in earlier stages, death from this disease is still high and it is precisely what we seek to avoid.
— Dr. Andrea Guevara
What is the visit to the urologist?
For the specialist, the first big step and the most economical. It is a visit that can save your life. Is this going to be assessed whether or not the patient has difficulty urinating or other discomforts that, although not specific to prostate cancer, may indicate other urological problems that should be treated?
“A physical examination is performed, which consists of a general medical examination including the prostate. The prostate is a gland that is between the bladder and the penis, and its only function is to produce semen. Urine passes through it, and it is shaped like a small lemon. When the digital rectal examination is performed, the prostate is examined through the rectum and what the doctor will look for, when palpating it, is that it feels soft, like the palm of the hand. The test takes about 10 seconds if everything is normal. It’s uncomfortable, but it shouldn’t be painful, ”he warns.
The specialist will look for a malignant mass on digital rectal examination, whether in a large or small prostate, with or without urination problems.
Prostate antigen tests also help diagnose this disease. It is performed in any clinical laboratory and must be evaluated by the doctor, not by the laboratory or by the patient, says the doctor, according to Guevara.
It is a test that gives a fairly adequate guide to assess the state of the prostate, since it is a substance produced by prostate cells, which increases to higher values when inflammatory, infection or malignant processes occur.
Dr. Karen Ulate, a microbiologist at Labin Laboratories, explains that it is an easy test to take as it is performed by collecting a blood sample that does not require fasting. However, there are some recommendations to do it:
– Do not have sexual intercourse, or have carried out vigorous physical activity at least 48 hours before
– Not having had a digital rectal exam at least 1 week before, or a prostate biopsy at least 6 weeks before, as these things could influence the results
“It is said that the recommended age to start this test is 40 years, however, it can be performed if there is suspicion of prostate malignancies. Undoubtedly, the risk increases after 40 years of age, but this does not mean that cases cannot appear before this age ”, he specifies.
Ulate recalls that there are two prostate antigen tests: total) and free. With both, the health of the prostate is evaluated, and their results can guide the doctor to make a clinical decision, so having both tests could be of utmost importance in many clinical pictures.
“Although these tests are very important, the results should be complemented with a visit to the urologist and with the digital rectal examination, this on the recommendation of the Costa Rican Association of Urological Surgery”, reaffirms Dr. Ulate.
“It is worth mentioning that out of every ten patients who come to the office with a ‘normal’ blood test, three have prostate cancer on physical examination. Therefore, the visit to the doctor is not only to examine the patient’s prostate. There is also an important part of education. This saves him many inconveniences in the future, because prostate cancer diagnosed in time saves lives ”, concludes Dr. Andrea Guevara.