One in seven men in the world have prostate cancer, according to Puerto Rican urologist Dr. William Román. However, it can be prevented and this depends on breaking the taboo on diagnosis and treatments.
“Having cancer is not a death sentence and the fear that we see in patients is unfounded,” says Dr. Héctor Antonio Vélez. Photo: Magazine of Medicine and Public Health.
The prostate is a gland in the male reproductive system, located between the bladder and the urethra. According to the American Cancer Society, the prostate cancer It occurs when cells in the body begin to grow out of control.
Prostate cancer in Puerto Rico
According to data from the Central Cancer Registry of Puerto Rico, this type of cancer is the most diagnosed in men with a representative rate of 40%, with an associated mortality of 18%.
A few days ago the Preventive Meeting was presented: Early detection of prostate cancercarried out by the Journal of Medicine and Public Health, where we had the opportunity to listen to different experts such as Dr. Héctor Antonio Vélez, Oncologist Hematologist, who spoke of the emotional impact on patients with this cancer.
Emotional impact of the diagnosis of prostate cancer
“In medical training, when I studied, the first time I saw a patient cry at the announcement of his diagnosis, it was a 75-year-old gentleman with prostate cancer… yes, it has a huge impact on the person”, comments Dr. Vélez.
Many times, men are more careless and relaxed in terms of health, which is why diseases are discovered in most cases when they are in advanced stages. Faced with this fact, Dr. Vélez suggests that the first line of defense is always important and consists of observation and attention.
“Having cancer is not a death sentence and the fear that we see in patients is unfounded. On the contrary, if you think or get scared, you go to your doctor’s office first so that a proper evaluation can be done,” said Vélez.
However, Vélez also makes the caveat regarding the purpose of treating cancer through the best possible means: “It is a disease that the mission is to cure, but if we cannot cure it, our most important mission is to lead a more normal life free of symptoms. for as long as possible. the experience is that the patients of prostate cancereven if they are metastatic, they live for many years”, he says.
Living with prostate cancer
“A patient with prostate cancer and well cared for, he has a normal life, to the extent that his condition allows. A person who has metastatic disease of prostate cancer and some in early stages need testosterone regulation therapies”, the expert clarified.
digital rectal examination
The prostate cancer is surrounded by myths and fears, in addition to the tumor. This means that patients are evasive in their routine check-ups such as digital rectal examination, where the urologist inserts one or two of his fingers to auscultate the prostate through the anus, in search of abnormalities. However, the situation is worse when the patient is told about the treatments that an extirpation or a so-called chemical “castration” would imply.
cancer stages
When we talk about the stages or stages of cancer, we refer to four moments. Doctor Vélez explains that in stage 1: “it is a tumor that is born in that organ, in a small size”.
In stage 2: “it’s that same tumor that has had the opportunity to get bigger, that’s the classic one.”
On the other hand, stage 3: “in almost all different cancers, it is a tumor that has a nodule, that breaks that border where it was born and moves through our cleaning system”
Finally in stage 4 or metastatic: “this is a tumor that is invading another organ, which is not a nodule.”
In the latter, Vélez affirms that the cancer, without medical attention, has spread to other organs of the body, even in the bones, which represents a reduction in the possibilities of cure: “a person with stage 4 must have the disease for the rest of his life,” he said.
Treatment hormonal
“The prostate is a gland, and it reacts to testosterone levels in the body, and malignant prostate cells when exposed to testosterone tend to grow and develop. When you starve malignant cells, they tend to go to sleep or die; Well then, the main therapy is hormonal therapy, not necessarily chemotherapy,” Vélez explained.
Castration is not the word
It cannot properly be called that, but indirectly it is the word that best identifies him, “I learned that it is a very harsh word for men”, says Dr. Vélez and adds: “it is to remove the testicle, or turn off the testicle. If a surgeon comes, he does it with the removal; but it can be done chemically… There are drugs that lower testosterone levels (almost undetectable), and for that reason, patients with prostate cancereven though they have metastatic disease, they do not feel the development of the disease”, he affirms.
Now, this generates many imaginaries, one of them is that if testosterone is what differentiates us from women, we will end up being more feminine, but: “testosterone is the hormone that differentiates us from women… libido is turned off and the structure changes, but this does not affect the identity”, he emphasized.
Prevention and action
However, it is best to attend the rectal exam controls and take advantage of the opportunity to discuss with the urologist any abnormalities or symptoms that may occur.
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