One of the biggest challenges of prostate cancer is precisely its ability to remain silent for years. In most cases, early tumors do not cause pain, discomfort or urinary changes, which reinforces the importance of discussing screening with a specialist.
Prostate cancer is one of the most common tumors among men and represents an important public health problem. When signs such as difficulty urinating, blood in the urine or bone pain appear, the disease may already be at an advanced stage. Fortunately, when identified early, the chances of treating and controlling the disease are usually significantly greater.
What is tracking?
Screening consists of carrying out tests on men without symptoms, with the aim of
identify signs of the disease before it manifests clinically.
Currently, the main test used is the PSA (Prostate Specific Antigen), carried out through a simple blood collection. Depending on the result and characteristics of each patient, the doctor may complement the evaluation with a physical examination of the prostate and other tests.
The aim is not to diagnose cancer in all men, but to identify those who are at higher risk and may benefit from further investigation.
Who Should Consider Tracking
The most recent recommendations from medical societies do not advocate indiscriminate testing of the entire male population. Instead, they guide an individualized strategy, based on risk factors and a conversation between doctor and patient.
In general, men over the age of 50 should talk to their urologist about the potential benefits and limitations of screening, individually evaluating the best strategy for each case.
Some groups deserve special attention and may benefit from earlier assessment,
including:
– Men with a family history of prostate cancer;
– Black men;
– Carriers of certain genetic changes associated with an increased risk of the disease.
In these cases, the evaluation can begin before the age of 50, according to medical advice.
Does high PSA mean cancer?
Not necessarily.
Although it is an extremely important tool, PSA is not a specific test for cancer. Benign changes in the prostate, inflammation and urinary infections can also cause an increase in levels.
Therefore, an altered result does not automatically mean the presence of a tumor. Same
However, some men with cancer may present values considered normal.
The correct interpretation must always be carried out by a specialist, taking into account age, family history, previous exams and other clinical characteristics.
Is rectal examination still important?
Despite still generating discomfort and prejudice in some people, the rectal examination continues to be an important tool in prostate assessment.
The exam allows the doctor to identify changes that cannot always be detected by PSA alone. When carried out in conjunction with clinical and laboratory assessment, it contributes to a more complete analysis of individual risk.
What happens if there is suspicion?
If the tests indicate a higher risk of cancer, the doctor may request additional tests.
What changes when there is suspicion
In recent years, multiparametric MRI of the prostate has started to play a fundamental role in the investigation of the disease, allowing a more precise assessment of suspicious areas and helping to decide whether a biopsy is necessary.
This evolution made it possible to reduce unnecessary procedures and increase diagnostic accuracy.
What are the benefits of early diagnosis?
The main benefit of screening is to identify potentially aggressive tumors before they spread to other organs.
Studies that support international guidelines demonstrate that screening strategies
risk-based approaches can reduce prostate cancer mortality and reduce the occurrence of
metastatic disease, as long as they are carried out appropriately and individually.
Are there any disadvantages?
Yes. Not all prostate cancers exhibit aggressive behavior.
Some tumors grow so slowly that they may never cause problems throughout the patient’s life.
patient. Therefore, carrying out tests without criteria can lead to diagnoses and treatments
unnecessary.
This is precisely why current guidelines advocate the so-called shared decision: the patient must understand both the benefits and limitations of screening before deciding to perform it.
When to see a urologist?
If you are aged 50 or over, have family members who have had prostate cancer, belong to higher risk groups or simply want to better understand your health, it is worth talking to a
urologist.
Screening is not the same for all men. The best strategy is one built on an individual basis, considering age, family history, general health and life expectancy.
Although prostate cancer remains an important challenge for men’s health, advances in screening and diagnosis make it possible to identify many cases at an early stage. Talking to a urologist and understanding your individual risk are fundamental steps towards making an informed, evidence-based decision.
Dr. Rafael Benjamin Rosa da Silva – CRM-SP 218.713 | RQE 133.808
General Surgeon
