Prostate cancer: keys to prevention and early detection that can save lives

The impact of prostate cancer is profound: in addition to a high diagnosis rate, one in 44 men dies from this disease. The biggest obstacle in the fight against this condition is the false belief that it will manifest with immediate pain or discomfort. In reality, a prostate tumor develops silently in its early phases, and when clinical symptoms finally appear, the condition may already be in an advanced stage. For the Hispanic community in the United States, overcoming reluctance toward routine medical checkups is a crucial step in caring for men's health.

Medical trajectories vary substantially depending on how timely the diagnosis is. For example, a routine checkup for hypertension in an asymptomatic patient can reveal elevated levels of prostate-specific antigen (PSA) and an abnormality during a digital rectal exam, allowing a small, localized nodule to be removed before it spreads. In other cases, subtle symptoms such as difficulty initiating urination or a weakened urine stream lead to the discovery of low-risk tumors that only require active surveillance. However, when clear signs like blood in the urine or lower back and pelvic pain are ignored, the cancer is often diagnosed at advanced stages that immediately require combined therapies such as radiation therapy and hormone treatment.

From an anatomical perspective, the prostate is a gland roughly the size of a walnut at age 20, located just below the bladder and surrounding the urethra, whose function is to produce seminal fluid. Cancer originates when alterations occur in the genetic material of its cells, causing them to multiply faster and survive longer than normal. As the tumor grows inside or around the gland, it compresses the urethra and disrupts urinary flow. For this reason, specialists must perform a differential diagnosis, as difficulty urinating can also be caused by an infection, inflammation, or benign prostatic hyperplasia, which is a non-cancerous enlargement very common starting at age 50.

Various risk factors increase the likelihood of developing this condition. Age is the primary variable, with a significant increase in risk starting at age 50. A first-degree family history—such as a father, brother, or son with the disease—elevates the risk and requires initiating medical evaluations at earlier ages, between 40 and 45 or according to urological assessment. Likewise, the presence of breast or ovarian cancer in first-degree female relatives (mother, sister, or daughter) is linked to genetic factors that increase predisposition in men. Additionally, Black men have a higher risk of suffering from this cancer and of it being more aggressive. Overweight, a sedentary lifestyle, and a poor diet also exert a negative influence.

For early detection, standard medical guidelines suggest that starting at age 50, men undergo two primary evaluations: a blood test to measure prostate-specific antigen (PSA) and a digital rectal exam to feel the size and texture of the gland. An elevated PSA level alone does not confirm cancer, as it can also result from infections or inflammation. In the case of any abnormal result, additional tests are ordered, such as a suprapubic ultrasound or a transrectal ultrasound—where a probe is inserted through the rectum to closely observe the prostate—followed by a biopsy to analyze the cells under a microscope. In more complex cases, MRIs, CT scans, and bone scans are requested to check if the tumor has spread to the lymph nodes or bones.

Treatment options vary and depend on the aggressiveness of the tumor, the presence of symptoms, the extent of the disease, the patient's age, and their general health status. One alternative is active surveillance, used when the cancer is low-risk, highly localized, or when the patient is elderly with other health conditions; in these cases, periodic PSA tests, digital rectal exams, and biopsies are performed to monitor progression without subjecting the patient to unnecessary invasive treatments.

When direct intervention is required, the surgery known as radical prostatectomy removes the prostate, surrounding tissue, and nearby lymph nodes. This is performed via robot-assisted laparoscopy through small abdominal incisions, or via an open incision in the lower abdomen. Other therapeutic alternatives include radiation therapy—which can be external via equipment that rotates around the patient, or internal (brachytherapy) by placing small radioactive seeds in the prostate—cryotherapy or application of heat to the tumor, hormone deprivation therapy, chemotherapy, immunotherapy, and targeted therapies.

This information is general in nature and does not replace professional advice. Always consult official sources and a specialist regarding your specific case.