Men must lose the shame and, at least over 50, take regularly a PSA analysis and consult a urologist, for the sooner disease or a prostatic tumour are detected the easier treatment will be, achieving cure in most cases and maintaining optimal quality of life without incontinence or sexual dysfunction. These were the main messages marking the session hold at Hospital da Luz Lisboa on November 9, gathering actor Ricardo Pereira and TV host Nuno Eiró in a conversation with urologists Kris Maes , João Pina and Tito Leitão . “Health is also a men’s issue” was the motto of this talk hold in the context of Movember, an international movement that happens every year in November, raising awareness to care in men’s health. José Luís Passos Coelho , director of Hospital da Luz Lisboa Oncology Centre, has welcomed all those present, including a few patients followed there. Then, along over one hour, Nuno Eiró and Ricardo Pereira asked about the essentials to know on the prevention, diagnosis and treatment of prostate cancer, the most common in men. Interviewers and specialists were unanimous admitting that men do not talk enough about their health, “they have shame or even fear” to see a doctor, and initiatives like this contribute to change minds and explain why prevention is so important. Ricardo Pereira and Nuno Eiró have asked, for instance, what screenings consist of, from what age it they should be taken, what is PSA, how is prostate cancer diagnosed, what treatments are there available and what are the effects on sexual function. And when cancer is early diagnosed, if it is possible to live a full life. And if benign prostatic hyperplasia (BPH) is the first step to develop cancer. Screening reduces mortality in 40% “Men should start taking screening from 50 on. When there are close relatives with cancer, then it should be taken at 40-45 years. If screening is done in due time, men can feel safe”, explained Tito Leitão. The PSA blood analysis (acronym for Prostate-Specific Antigen) “is the best tumoral marker that we have, and the most sensitive one” , but having high PSA “does not definitely mean it is prostate cancer, further exams are required”, corroborated Kris Maes and João Pina. “This is a type of cancer that can be cured when localized, small in size, and early detected. Early diagnosis is always better, we can even say it is already a cure. Then, we have to access the tumour’s aggressivity to decide on treatment, that is today highly advanced”, clarified Kris Maes, stressing that Hospital da Luz and Portugal are in the forefront in this area. “And it is not true that a man with prostate cancer will necessarily develop erectile dysfunction or incontinence”. The urologists listed a few symptoms of the disease: higher frequency and urgency urinating, or weak and slow urine flow. “Sometimes men spend years and years suffering with these symptoms and without seeking help. But if they do seek, with today’s therapies we can solve it”, underlined Tito Leitão, further clarifying the difference between cancer and BPH (benign prostatic hyperplasia, the enlargement of prostate as a consequence of ageing which has nothing to do with cancer): “About 90% men end by developing BPH. Prostate has a more internal zone where BPH takes place; the peripheral zone is where cancer develops”. Age, the type of cancer and location, and the global physical condition of the individual influence the choice of the most adequate treatment, as explained João Pina: “If the tumour has already spread, with metastases, treatment is required (namely radiotherapy). It all depends on the tumour’s status. But there is another situation: the individual takes exams and the cancer is so little aggressive that we decide that the best is to let it be and monitor. The truth is that, if detected early, we are witnessing a change in a disease that was nearly chronic and marked with high mortality.” Final messages and testimonies “Do not fear coming to a consultation with a urologist and taking the screening. And do not fear being diagnosed with prostate cancer. Nowadays, we can often ensure a cure, with good quality of life associated, even in advanced disease. The essential is to take the screening early. Obviously, not everyone will develop prostate cancer, and if so, they will be conveniently followed”, stated João Pina. “Prostate cancer screening saves lives. It reduces mortality in 40%. No one disputes that screening in breast cancer must be done, so men, take this screening”, urged Tito Leitão, revealing a few numbers: “Only a few years ago we were having 50% incontinence rate; today, with robotic surgery, we can obtain rates under 5%. Therefore, most men can be cured and maintain excellent quality of life”. “Men definitely have to talk with each other about these issues. It is fundamental to see a doctor, consult a urologist”, stressed Kris Maes. In the end, there was still time to hear the testimony of two patients followed at Hospital da Luz Lisboa – and both stories showed how important it was to assume a vigilant and preventive attitude. “I have started taking the screenings as early as 45, including manual rectal examination. Fear of doing it is ridiculous. This is an exam for our good, for having more time for those we love. I am very grateful and I have saved myself because I took the diagnosis early enough”, reported Edson , recalling that his father died of cancer. Paulo, aged 57, was operated four months ago and recalls: “When Dr Kris told me ‘we will fix this’, I focused on that. I do everything I am asked to and I am very happy. And I told everything to my friends – by the way, they all went to the doctor to ask for PSA assessment”. Also Nuno Eiró shared that he was diagnosed with BPH thanks to screenings he has been taking from early, since having relatives with cancer: “My motivation was not finding the disease, rather knowing that I would do everything in my power to treat it if it was there. It works as a relief of conscience and there is no ‘boogieman’ involved. If we get a quick diagnosis, we ensure an easier treatment and maintain quality of life”. “That is it: the more we, men, share these issues, the better. When we share with accurate information, we help others to do what is right. Take care of yourselves. Always”, urged Ricardo Pereira.
