2024-11-04 11:00:00
Unspecific symptoms
« Prostate cancer most often develops without symptoms for several years », explains Professor Romain Mathieu, urologist at Rennes University Hospital (Ille-et-Vilaine), member of the cancerology committee of the French Urology Association (AFU). “ Urinary symptoms may appear when the disease progresses locally. However, in older men, they are often due to a benign prostate adenoma. Our role, as urologists, is to be able to distinguish between this disease and possible cancer. »
What about screening?
« There is no recommended systematic screening », specifies our specialist. “ However, from the age of 50, we can discuss with men the benefit of carrying out a PSA test (blood marker) via a blood test and/or a rectal exam to identify a possible abnormality in the consistency of the prostate. . These examinations help guide a diagnosis of prostate cancer.. »
What medical care ?
The choice of treatment strategy will be adapted according to the severity of the tumor. “ For low-risk cancers, offering active surveillance has become the usual management. We monitor the progression of the disease with regular examinations (PSA, MRI, biopsies) and we only intervene“in the event of progress,” indicates Professor Mathieu. “ For more aggressive localized forms, surgery (prostatectomy), radiotherapy or alternative treatments such as ultrasound can be offered. In cases of more advanced cancer, hormonal therapies, most often combined with radiotherapy, are considered. »
In certain cases, metastases can develop distantly, particularly in the bones. “ Metastatic forms account for approximately 10% of prostate cancer diagnoses. They can be revealed by a PSA level, most often very high, or bone pain. Over the past fifteen years, major advances have been made, notably with new hormonal therapies, chemotherapy but also more targeted therapies, which make it possible to improve survival but above all the quality of life of patients. », Specifies Professor Romain Mathieu.
Boost supportive care
Mortality linked to prostate cancer is decreasing steadily, this is partly explained by improvements in treatments, particularly for advanced cancers. “ So much so that we can consider metastatic prostate cancer as a chronic disease », underlines Professor Mathieu. “ This is why it is important to support patients with supportive care, including adapted physical activity, which helps reduce the side effects of treatments and improves quality of life. Financial support is needed to encourage the prescription of appropriate physical activity. Just as it would be useful to offer nutritional and psychological support to our patients. »
S’informer
On the fr site, developed by Pfizer and the French-speaking Association for Supportive Oncology Care (AFSOS), you will be able to find the oncology support care closest to you. And this using an interactive map which allows you to identify the associations offering these care offers.
Source: INCa website. Prostate cancer – visited 4/10/24 – AFSOS website – Adapted physical activity and cancer » – visited 4/10/24 – AFU – French Committee Guidelines 2022-2024 prostate cancer – HAS 2023 report . Rectal high-intensity focused ultrasound (HIFU) destruction of localized prostate adenocarcinoma – The prostate cancer landscape in Europe. M.Marhold & all. Cancer Letters 526 (2022) 304–310
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**Interview with Professor Romain Mathieu on Prostate Cancer Screening and Treatment**
*Date: November 4, 2024*
**Interviewer:** Good morning, Professor Mathieu. Thank you for joining us today to discuss prostate cancer screening and treatment options.
**Professor Mathieu:** Good morning, and thank you for having me.
**Interviewer:** Prostate cancer often develops without symptoms for a long time. Can you explain how men can be proactive in detecting it?
**Professor Mathieu:** Absolutely. While prostate cancer is typically asymptomatic in its early stages, it becomes crucial for men, particularly those over 50, to discuss potential screening with their doctors. The primary tool for screening is the PSA test, which measures prostate-specific antigen levels in the blood. This test can indicate abnormalities in prostate health.
**Interviewer:** You mentioned that there’s no recommended systematic screening for prostate cancer. Why is that?
**Professor Mathieu:** Screening for prostate cancer is not universally recommended because the benefits do not necessarily outweigh the risks for all men. While the PSA test can help in early detection, it can also lead to false positives, unnecessary anxiety, and even invasive procedures. Therefore, it is essential for men to have an informed discussion with their healthcare provider about their individual risk factors before proceeding with testing.
**Interviewer:** Once diagnosed, how is the severity of prostate cancer assessed, and what are the typical treatment strategies?
**Professor Mathieu:** Treatment strategies vary widely based on the stage and aggressiveness of the cancer. For low-risk cases, we often recommend active surveillance, which involves monitoring the cancer through regular PSA tests, MRIs, and biopsies. If the cancer shows signs of progression, then intervention is considered. For more aggressive localized cancers, we may opt for surgical removal of the prostate, radiotherapy, or other treatments like ultrasound therapy. In advanced cases with distant metastases, more comprehensive treatments, including hormonal therapy combined with radiotherapy, may be necessary.
**Interviewer:** Are there specific challenges when it comes to managing advanced prostate cancer?
**Professor Mathieu:** Yes, advanced prostate cancer can be particularly challenging as it may lead to complications such as bone metastases, which can cause significant pain and other issues. In these cases, treatment is aimed not only at prolonging life but also at improving the quality of life through pain management and supportive care.
**Interviewer:** In closing, what message do you want to convey to men regarding prostate cancer and screening?
**Professor Mathieu:** My main message is the importance of awareness and communication. Men should understand the risks and symptoms associated with prostate cancer and engage their healthcare providers in discussions about the benefits and drawbacks of screening. Early detection or appropriate management can significantly impact outcomes, so proactive health management is key.
**Interviewer:** Thank you, Professor Mathieu, for sharing your insights on this important topic.
**Professor Mathieu:** Thank you for having me.
