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Douglas Ramírez, urologist, explains that This type of cancer is the most common in menbut not the first cause of death.
He points out that it is metaplasia or cellular changes that occur in prostate asinar cells and it happens for different reasons. One of the fundamental factors is age: above 40 years of age is where the main risk of developing the disease is. From there, the probability doubles.
“That is why, in the majority of patients, the diagnosis above 56 to 60 years of age,” says Ramírez in an interview with DIARIO LAS AMERICAS.
He states that, currently, each patient It is handled individually. This means that factors such as ethnicity come into consideration: African American patients They have an increased risk of eight times more likely to have more aggressive prostate cancer.
“Another factor is the background in the BRCA gene family, especially BRCA2, which is also involved in breast cancer, predisposing to extremely aggressive prostate cancer. Nowadays, in developed countries, genetic duplication is done in practically the majority of patients,” says Douglas Ramírez.
The urologist points out that, in recent years, the incidence of this type of cancer has been seen in patients aged 45 years, as long as the patient has a history: African-American race, history of a father and brother with prostate cancer, history of prostate cancer. breast or generically studied history where there is a predisposition to the disease.
Ramírez asserts that an important aspect is that the barrier of machismo has been crossed, especially in Latin America, where the patient went to the urologist only if they presented symptoms. At this point, the importance of Blue Men’s Health Month covering prostate cancer, testicular cancer and mental health care.
“By increasing the incidence of detection, we have increased the attention to prostate cancer in very early stages, which has allowed a about life in the patient,” he says.
He adds that, hence the importance of attending an annual medical appointment with the urologist: from the age of 40, as indicated by current medical guidelines.
Cancer detection
Urologist Douglas Ramírez explains that among the least invasive ways to detect this type of cancer is the prostate antigen test.
“The antigen is a glycoprotein that the prostate secretes naturally, it acts at the seminal level. But, in the presence of cancer, it becomes overstressed and rises in blood. This may be one of the initial tools that urologists have for detection,” he indicates.
Likewise, he points out that there are advanced imaging studies, but the digital rectal examination continues to be a tool for underdeveloped countries. “When something is palpated, that is when the patient already has the development of a malignant tumor,” says the doctor.
It indicates that specialized imaging studies are performed such as multiparametric magnetic resonance imaging (MRI) of the prostate, which will determine whether a biopsy is performed.
DOUGLAS RAMÍREZ.jpg
Dr. Douglas Ramírez highlights the importance of Blue Men’s Health Month, which covers prostate cancer care, testicular cancer, and mental health.
Courtesy Douglas Ramirez
According to the protocol, and depending on the findings, it is indicated whether the puncture biopsy should proceed, which is very precise, generates linear lines and less damage to the patient. He adds that traditional transrectal biopsies also provide important information.
If required, when there is part of a diagnosis or suspicion of malignancy, Positron Emission Tomography (PET) is performed. With this study, explains Dr. Ramírez, it is also seen if there is the presence of lymph nodes or metastases.
Disease prognosis
The urologist points out that, until a few years ago, prostate cancer was indicative of radical prostate surgery. In this sense, he expresses that it is a very demanding surgery that leaves many consequences for the patient, such as incontinence and erectile dysfunction.
“Over the years, there is less and less surgery for prostate cancer and more adjuvant treatments. Only highly localized cancers are those that may undergo surgical therapy, radical prostate surgeries that have nothing to do with the benign part, but that can leave important consequences with an impact on the quality of life. This is explained to the patient,” says the doctor.
In this context, he points out, focal therapies, including radiotherapies, can be given to the patient that have given good results without affecting their personal conditions and mental health.
This maintains urinary continence and erection: “It will allow us to ensure that the patient’s survival is quite long.”
A key element is that not all cancers behave the same way. “That is why it is important that the study is complemented by medical oncologists and radiation therapists. We have divided cancers into low risk, intermediate risk and high risk and that is why they are treated independently,” he highlights.
Hence low-risk prostate cancer is not treated. In this case, long-term monitoring is done. “We have seen that these patients are going to die from everything but that,” says Douglas Ramírez.
The urologist asserts that the lack of cure will depend on the type of cancer, if it is localized, and its type of cellular differentiation. He adds that, when we talk about healing, it is when a patient is operated on and there will be no residual disease left.
“And that’s why the cases are specific, there are few where it can be said that there was surgery and nothing was left. They have to be cases that stick in the initial phase, he claims.
The specialist emphasizes: “Cancer is not an indication that it is the end. On the contrary, the diagnosis of prostate cancer today is indicative of that you learn to live with a condition “It does not necessarily affect the quality of life, but it must be overcome, as happens with hypertension or diabetes.”
Dr. Ramírez also states that hormonal therapies are used, which are carried out exogenously with the use of medications.
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FUENTE: National Cancer Institute / WHO / Diario Las Américas
**Considering the various treatment options available, how can patients and their physicians work together to create a personalized treatment plan that aligns with individual needs and priorities?**
## Interview on Prostate Cancer with Dr. Douglas Ramirez
This interview focuses on prostate cancer, exploring its prevalence, diagnosis, treatment, and the importance of early detection. Dr. Douglas Ramirez, a leading Urologist, provides expert insights on this crucial topic.
**Section 1: Understanding Prostate Cancer**
* **Interviewer:** Dr. Ramirez, you mention that prostate cancer is the most common cancer in men, yet not the leading cause of death. Could you elaborate on this statistic and perhaps discuss the reasons behind the discrepancy?
* **Interviewer:** The article mentions several risk factors for prostate cancer, including age, race, and family history. What other factors might contribute to an individual’s susceptibility to this disease? Could lifestyle choices play a role?
**Section 2: Detection and Diagnosis**
* **Interviewer:** You highlight the importance of early detection. What are the most effective methods for detecting prostate cancer, and how have these methods evolved over time?
* **Interviewer:** The article discusses various diagnostic tools like PSA testing, digital rectal exams, imaging studies, and biopsies. Could you discuss the benefits and limitations of each method, and how they are used in conjunction to arrive at a diagnosis?
**Section 3: Treatment Approaches**
* **Interviewer:** The article emphasizes that treatment options are evolving, moving away from solely surgical interventions. Could you describe the range of modern treatments available for prostate cancer, highlighting the advantages and disadvantages of each approach?
* **Interviewer:** It’s encouraging to hear that some prostate cancers are not actively treated. Could you explain the rationale behind this “watchful waiting” approach and discuss when it might be considered the best option?
**Section 4: Living with Prostate Cancer**
* **Interviewer:** You state that cancer is not necessarily the end. What kind of support systems and resources are available for men diagnosed with prostate cancer, both physically and emotionally?
* **Interviewer:** How can men proactively engage in their own healthcare and advocate for themselves, especially when facing a diagnosis like prostate cancer?
**Section 5: Blue Men’s Health Month**
* **Interviewer:** The article highlights Blue Men’s Health Month. What is the significance of this month, and what message would you like to convey to men about their health during this time?
**Closing**
* **Interviewer:** Dr. Ramirez, thank you for sharing your expertise and valuable insights on this important topic. What final message would you like to leave our viewers with regarding prostate health and early detection?
This structure allows for a comprehensive and engaging interview that delves into various facets of prostate cancer, while encouraging discussion and providing valuable information to viewers.
