The prostate is a gland that sits below the bladder (the hollow organ where urine is stored) and in front of the rectum (the final part of the intestines). The prostate produces some of the fluid that makes up semen, along with the seminal vesicles, which lie behind the prostate. The urethra, which is the tube that carries urine and semen out of the body through the penis, passes through the centre of the prostate.
Prostate cancer occurs when cells in the prostate begin to grow out of control, leading to the development of a tumour. Some prostate cancers grow and spread quickly, but most grow slowly. The patient may not even notice that they have prostate cancer in the early stages of the disease. These tumours generally progress slowly and symptoms usually appear later on in the process.
Prostate cancer is the second most common type of cancer in men, accounting for 11.7% of all male tumours.
It is age-related, as 75% of cases occur in men over 65 years of age.
Having a family history doubles the risk of developing prostate cancer, especially when two or more direct first-degree relatives (father or brothers) are affected by the disease.
Bad lifestyle habits such as a poor diet, a sedentary lifestyle and obesity may also influence the potential development of prostate cancer.
Smoking is another risk factor that may favour the development of this type of cancer, as it increases hormone secretion, which causes the tumour to grow.
Prostate cancer is the second most common cancer in men
It is age-related: 75% of cases occur in men over 65 years of age.
More than 34,000 cases of prostate cancer are diagnosed in Spain every year
Prostate cancer, like many other the malignant tumours, may not be noticed by the patient in the initial stages of the disease. These tumours generally evolve slowly, and symptoms usually appear in more advanced stages of the process.
In many cases, the diagnosis is made during a routine medical check-up when the patient has no symptoms.
In other cases, it manifests with symptoms related to urination. It can either affect urinary frequency and urgency, or there may be pain and stinging when urinating.
Post-void dribbling or urinary retention may also occur in cases where the tumour has obstructed the urethra.
The IVO runs an Early Opportunistic Diagnosis programme for prostate cancer targeted at men between 50 and 75 years of age (or from 40 years of age for men with a family history of prostate cancer), with a life expectancy of more than 10 years.
The test consists of a simple examination, such as a digital rectal examination and a conventional blood test to detect PSA levels.
In its early stage, when it produces no symptoms, prostate cancer can be cured, hence the importance of early diagnosis.
Advances in imaging techniques and early detection programmes for prostate cancer now make it possible to diagnose the disease at an early stage.
The first, initial test is a simple examination known as a digital rectal examination. This is an examination of the lower rectum that the specialist performs on the patient to examine the prostate area.
Prostate-specific antigen, or PSA, is a protein produced by normal cells as well as malignant cells in the prostate gland. The PSA test measures the concentration of PSA in a man's blood. It is obtained by a conventional blood test. If the PSA is over 3ng/ml, a urinalysis and culture will be performed. After ruling out a urinary tract infection, a second PSA test is performed, and if it is over 3ng/ml again, a multiparametric MRI is carried out.
If the blood test shows PSA levels greater than 3ng/ml, a multiparametric MRI is performed. This is a radiological test that provides information about the shape of the prostate from all angles, and also about the surrounding and neighbouring organs and the way they function together.
Based on the results of the above procedures, the Uro-radiology Committee discusses the appropriateness of performing a transrectal or transperineal prostate biopsy using software that can fuse MRI and ultrasound imaging results, or a mapping biopsy.
Its treatment will always depend on how extensive or advanced the disease is. Depending on each specific case, different treatment options are available, such as surgery, external radiotherapy or brachytherapy, and hormone-blocking treatments.
Surgery is the standard treatment for patients with a tumour located in the prostate. Surgery can either be performed openly or laparascopically.
New techniques for the selective detection of pathological nodes have now been incorporated to optimise the indication and extent of the lymphadenectomy that usually accompanies radical prostatectomies.
Iodine-125 seed brachytherapy, a therapeutic practice also used at the IVO in appropriately selected patients, is proving to be an innovative treatment with excellent results and minimal discomfort for the patient.
This practice, together with other techniques such as focal therapy and cryotherapy, put the IVO at the forefront of urological treatments.
Surgery for prostate cancer patients is performed by the IVO's general surgery service.
The Service's team of professionals accompanies cancer patients throughout the whole disease process.
A clinical trial is a research study carried out on people with the aim of learning more about how the body reacts to certain treatments. These trials generally seek to find drugs that are more effective than the current best therapeutic option for patients, or that have similar efficacy but a better toxicity profile.
Bearing in mind that almost all currently available treatments are the result of clinical research, the importance of clinical trials is obvious.
The IVO has a clinical trials unit for all types of tumours and participates in phase 1-3 studies as well as other types of studies.
Whether you receive the news of an initial diagnosis of cancer or a relapse, coping with cancer can be emotionally overwhelming. Each person has their own way of coping with a prostate cancer diagnosis, but there are some recommendations that can help you through this process: