More than one in five cancers diagnosed in men are prostate cancer, significantly more than lung and bowel (colorectal) cancer. On average there are 54,000 new cases per year among men in their seventies. Despite the problem of overdiagnosis, since 2005 there has been a fall in the incidence of prostate cancer and associated mortality (fewer than 8,876 deaths per year). Thanks to screening and improved treatment, the 5-year survival rate is now 84%, and 70% at 10 years.
In most cases, there is no family history of prostate cancer. However, there may be a genetic predisposition to the disease, particularly in men of African and Caribbean descent. Just like breast cancer, prostate cancer is considered a “hormone-dependent” cancer. Environmental factors also increase the risk of developing the disease. Chronic infections and toxin poisoning can disrupt the body’s hormone system (heavy metals, bisphenols and pesticides).
Anyone who experiences urinary symptoms (poor bladder control, difficulty or inability to urinate, burning or pain when urinating, blood in the urine or sperm) or erectile dysfunction should consult their doctor as soon as possible. Preventive screening is fully covered by health insurance for people over 50.
The PSA test is a blood test that measures the amount of prostate specific antigen in the blood. In nine out of ten cases, it can detect the presence of a tumor. However, there are some activities men should avoid before having a PSA test (or wait a few days before having the test following) :
- Sexual activity
- A digital rectal examination
- Vigorous exercise such as cycling
This may raise the PSA level and cause unnecessary worry. Other conditions can also raise the level of PSA in the blood. These include benign prostatic hypertrophy (an enlarged prostate, also known as adenoma), and prostatitis (a urinary tract infection)
Abnormalities can also be detected by a digital rectal examination, if they are palpable. Depending on the results, a biopsy will be performed. The tissue samples are then examined to detect the presence or absence of cancer cells.
Half of all prostate cancers detected will develop very slowly (frequently over more than 15 years) and do not require treatment; however, there is no way to tell which cancers will become aggressive and need to be treated. For this reason, one option is simply to monitor patients with early-stage prostate cancer.
More advanced forms of the disease are treated using standard therapies: surgery, radiotherapy, brachytherapy, hormone therapy and chemotherapy. Alongside these treatments, regular exercise improves both the quality and length of patients’ lives, according to a recent study conducted by researchers in Ireland and Australia. This is all the more important since these treatments often have side effects that can affect patients’ daily lives: urinary incontinence, impotence and intestinal problems.
French National Cancer Institute, Prostate cancer screening
French National Cancer Institute, Prostate cancer
Institut Curie, Prostate cancer risk factors
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