Movember, Gentlemen, take good care of your prostates!

In November the prevention against cancer does not lose momentum. Pink October gives way to Movember and raises awareness about male cancers.

With nearly 54,000 new cases and 9,000 deaths each year in France, prostate cancer is the most common cancer in men.

One man out of 8 will develop prostate cancer before the age of 75. While the number of new cases increases by an average of 4.8% per year, mortality rates are stable over time. (source urofrance)

Today, thanks to early detection, nearly 9 out of 10 patients are diagnosed with a localized form of cancer that can be treated.

Although Ozalys has been designed for women affected by breast cancer, it is not ” reserved ” for them uniquely. I would like to support this month of awareness of male cancer by bringing you, gentlemen, some information on this subject.

Understanding Prostate Cancer

What is the prostate?

The prostate is a male genital gland, located in the small pelvis, just below the bladder and in front of the rectum. It is the shape and size of a chestnut and weighs 20 to 25 grams. The older a man gets, the bigger his prostate becomes.

Its development and functioning begins at puberty, dependent on male sex hormones (the most important of these hormones is testosterone, mainly produced by the testicles).

The main role of the prostate gland is to produce prostatic fluid. This fluid, which represents one third of the volume of sperm, plays a role in the survival, maturation and motility of sperm produced by the testicles.

Symptoms that should raise concern

Prostate cancer is usually asymptomatic in the early stages of the disease. Signs and symptoms often appear as the tumour grows and causes changes in urinary habits.

A number of symptoms can be warning signs:

–Urinary symptoms: frequency of urination, urgent need to urinate, difficulty starting to urinate, weak, slow or interrupted stream of urine, inability to completely empty the bladder, burning sensation, incontinence and blood in the urine.

– erectile dysfunction, blood in the semen, painful ejaculation

– pain or stiffness in bones the hip, back, or chest bones, weakness or numbness in the legs or feet

– loss of bowel control

Be aware, other medical conditions can cause the same symptoms as prostate cancer, therefore, gentlemen, it is important to consult your doctor to understand the origin of your problems.

The tests to be performed

For early detection of prostate cancer, the French Association of Urology  recommends an annual digital rectal exam and a PSA test in all men over 50 years of age.

In people at risk (family history, men of Afro-Caribbean origin), screening can be started from the age of 40.

The prostate specific antigen (PSA) blood test is used to determine the level of prostate specific antigen (a molecule produced by the prostate gland).

If the PSA level in the blood is too high, it suggests that the prostate cells are behaving abnormally. The cause can be a prostate tumor, but also an infection or benign prostate enlargement. (prostate that has grown in size)

Your doctor will use the results of the blood test, as well as your age and family history, to estimate your risk of developing cancer. If the risk is high, you will be offered a biopsy of your prostate tissue to confirm whether it is a tumor.

Prostate cancer treatments

Gleason’s score and Amico’s classification

Prostate tumors are classified according to the stage of the tumor and the degree of aggressiveness of the tumor cells. The stage of the tumor represents its level of progression and its possible spread to the lymph nodes or other organs.

The other element of classification is the Gleason score, which gives information on the aggressiveness of the cells and the speed of development of the tumor. Tumors with a higher score (8-9-10) are more aggressive and more difficult to treat.

The Gleason score, associated with the clinical stage and the PSA level, will allow to define a D’Amico classification and to distinguish between low, intermediate and high risk tumors. It is based on these elements that the oncologist will define a therapeutic strategy.

The role of hormones

As with breast cancer, the vast majority of prostate cancers are hormone-sensitive, i.e. the growth of the tumor is stimulated by androgens (male sex hormones). Testosterone, produced by the testes, is the most important androgen.

The different treatments

After the diagnosis of cancer, appropriate care is proposed. However, when there are no troublesome symptoms, the patient is otherwise healthy and the tumor has been identified as small, localized and low-risk, the medical team may defer treatment until signs appear or change.

Active surveillance involves the physician monitoring the tumor and its growth according to a strict schedule of visits. At each visit, several tests are performed to check, among other things, the level of prostate specific antigen (PSA) in the blood. The goal is to switch to other treatment options if signs of disease progression appear.

Several treatment options exist depending on the form and stage of prostate cancer progression:

-HIFU (High Intensity Focused Ultrasound) treatment consists of destroying the tumor by destroying the diseased cells with focused ultrasound. A probe is introduced into the patient’s rectum under anesthesia, which allows both visualization of the prostate and generation of the focused ultrasound.

– Prostatectomy is the standard surgical treatment for prostate cancer that is not or only slightly enlarged. It removes the prostate and seminal vesicles. (glands connected to the prostate that produce a liquid used to nourish sperm).

– Radiotherapy may also be indicated to control and/or eradicate cancer cells.

– Hormonal therapy consists of administering to the patient drugs that block the action of testosterone in order to inhibit the development of the tumor (and possibly metastasis). It can be administered orally or by subcutaneous injections.

More rarely, the production of androgens can be stopped by surgical removal of both testicles.

In the case of hormone-resistant metastatic cancer, treatment with chemotherapy and/or radiotherapy may be considered if there is pain or to relieve the symptoms of the disease.

Adverse effects

a psychological and social impact

A cancer diagnosis has an impact on your life and that of your loved ones. It can cause feelings of anxiety, uncertainty, fear or even depression. Its treatment can cause undesirable effects and affect your work, your social life and your intimate relationships.

During this difficult period, it is important not to feel alone, to share your fears and hopes, to feel informed, aware, accompanied and listened to.

To find support, I invite you to get in touch with your medical team, who will be able to direct you towards local associations or professionals who can accompany you. You can also contact the CERHOM and ANAMACAP associations, dedicated to prostate cancer.

Sexual disorders

Cancer treatment can also affect your sexuality.

After a radical prostatectomy, the erector nerves (located along the sides of the prostate gland) that drive the nerve message to achieve an erection, are often damaged during surgery and lead to erectile dysfunction.

Your surgeon will be able to refer you to erectile function rehabilitation, which consists of provoking erections on a regular basis through micro-injections at the base of the penis.

This treatment is 100% covered by the health insurance in case of prostatectomy, while remember, the vaginal laser intended to treat vaginal atrophy following a female cancer is not.

When, for various reasons, intracavernous injection is not suitable, there are alternatives: a small suppository containing a prostaglandin-based gel can be inserted into the urethra; a vacuum pump called cacuum can be used to achieve an erection.

Just like estrogen-free vaginal ova, which help to minimize dryness, these two alternative methods are not covered by Health Insurance.

Beyond the physiological aspect, hormone therapy can lead to a decrease in libido. A feeling of depression and fatigue can also have a negative effect on your sex life.

urinary incontinence

When the prostate is removed, all the nerves around it and the sphincter below it are injured. From an anatomical point of view, the disappearance of the prostate bundle makes the urinary sphincter the only actor of continence, which can lead to incontinence problems.

Each person is unique and incontinence is very different from one patient to another in terms of intensity, perception and impact.

Whether permanent or intermittent, bladder weakness is a factor to consider.

Different solutions can be proposed to you: Pelvi-perineal rehabilitation, penile sheaths, wearing protection, injectable agents, and pressure balloons on the urethra, artificial sphincter, and sub urethral bandages.

There is a whole range of techniques, there is not one better than the others, the objective is finally to find a tailor-made solution for each one of you.

TO CONCLUDE

Prostate cancer, like breast cancer, is (overwhelmingly) hormone-sensitive and requires hormone therapy, with its share of side effects.

However, we can observe, these side effects, particularly in terms of sexuality, are not covered by the health care system. Why is erectile function rehabilitation covered by health insurance, while the vaginal laser to treat vaginal atrophy is not?

Is a woman’s sexuality and pleasure less important than a man’s?

Having been heard in the Senate by the Cancer Task Force in June 2019, I continue to advocate for the widespread use and management of women’s treatments.

Thought of for women affected by breast cancer, but not reserved for…Ozalys is a committed brand that accompanies without distinction, women and men to better live with the side effects of cancer treatments.

Because life is precious, because you are precious.