Prostate cancer, recognizing it is not always easy

Prostate cancer is the most frequent cancer among men over 50 years of age. In 2013 there were 36,<> new diagnoses, but in reality, recognizing its presence is not always an easy task.

Lack of evidence

The first difficulty lies in the fact that only in the most advanced stages prostate cancer manifests itself with clear symptoms, such as problems urinating, presence of blood in semen or urine, pain in the lower back, hips or thighs, discomfort in the lower abdomen, bone pain and erectile dysfunction.

Often, however, the earliest stages of development are asymptomatic. This makes it more difficult to make early diagnosis desirable if you want to increase the chances of successful treatments.

For this reason, some experts believe that it is important, after the age of 50, that even healthy men undergo the so-called screening for prostate cancer, of which the PSA test is an integral part.

Ambiguous results

PSA (prostate-specific antigen) is a molecule naturally produced by the prostate. In the presence of a tumor in this gland its concentrations in the blood may increase compared to the values considered normal, less than 4.0 ng / ml.

However, this does not mean that PSA levels above 4.0 ng/ml necessarily indicate the presence of cancer. In fact, other prostate problems, such as prostatitis or enlargement, but also urinary tract infections, can lead to an increase in PSA in the blood. But the problems do not end there.

It happens, in fact, that some aggressive forms of prostate cancer are not associated with PSA values higher than 4.0 ng / ml. Not only that, some drugs can interfere with the PSA test, leading to lower values than the real ones.

For this reason, the PSA test should always be combined with digital rectal exploration. Only by combining the results of these two analyzes will the doctor be able to decide whether it is appropriate to deepen the examinations.

More in-depth testing

Subsequent tests may include an ultrasound and biopsy, which typically provides definitive confirmation or denial of the presence of cancer.

However, even biopsies can give suspicious results. These are the cases in which the cells of the prostate do not look healthy, but do not even have the appearance of cancer cells: prostatic intraepithelial neoplasia, atypical acinar proliferation and proliferative inflammatory atrophy.

These conditions are not necessarily associated with prostate cancer and sometimes, especially low-grade intraepithelial neoplasms, are treated as if the tumor were absent; Other times it will be necessary to undergo new biopsies.

What is clear is that the diagnosis of prostate cancer cannot be based on a simple blood test.