Interview with the doctor for “Adesmeftos”
Prostate cancer is the most common type of cancer among men in Cyprus. According to the Global Cancer Observatory, approximately 22–30% of new cancer diagnoses in men are prostate cancer cases. The incidence of prostate cancer in Cyprus is estimated at approximately 136 cases per 100,000 men.
Unfortunately, routine screening for prostate cancer is not implemented nationwide as part of a national screening programme in Cyprus. As a result, a number of cases may go undiagnosed, particularly at an early stage.
Based on my own clinical experience, I can say with certainty that prostate cancer is part of my daily medical practice. Every day, I assess 2–3 new patients with a suspected diagnosis of prostate cancer. The encouraging aspect, however, is that the vast majority of these cases are diagnosed at an early stage. When prostate cancer is detected early and the appropriate treatment is provided, complete cure can be achieved in most cases, which is always our primary objective.
1. What are the most common types of cancer in men?
The prevalence of different types of cancer in men varies significantly depending on age. Among young men aged 14–35, testicular cancer is the most common. Although relatively rare overall, it is the most frequently diagnosed cancer in this age group. It is followed by lymphoma and thyroid cancer.
At older ages, particularly after the age of 50, the picture changes. Prostate cancer becomes the most common cancer among adult men, and its incidence progressively increases with age. Other common cancers in men include lung cancer, colorectal cancer and bladder cancer, all of which are associated to varying degrees with environmental and lifestyle factors.
The current month is dedicated to raising awareness of cancers affecting men and is often — perhaps incorrectly — associated exclusively with prostate cancer. It is equally important, however, to raise awareness of other common cancers affecting men, including bladder cancer and testicular cancer.
The reason greater emphasis is ultimately placed on prostate cancer is that it is extremely common, its incidence increases progressively with age, and for us as urologists it represents an everyday reality in clinical practice.
2. What are the main symptoms?
Testicular cancer mainly affects younger men, and its symptoms are usually relatively easy to identify. A hard, painless swelling or a palpable lump in the testicle should always be assessed promptly by a doctor.
With regard to prostate cancer, in its early stages it usually causes no symptoms at all, which is why preventive screening is so important.
When symptoms do occur, they are usually related to urinary function and may include difficulty or inability to urinate, frequent urination — particularly at night — and a weak or interrupted urinary stream.
At more advanced stages, symptoms may include blood in the urine or semen, bone pain when metastases are present, and unexplained weight loss or fatigue.
3. At what age is regular preventive screening recommended?
Preventive screening for prostate cancer is generally recommended from the age of 50 for men at average risk.
However, for men considered to be at higher risk, screening should begin earlier, at around the age of 45, particularly for men with a strong family history of prostate cancer, such as a father or brother who has been diagnosed with the disease.
Screening includes a PSA blood test and, where necessary, a digital rectal examination. The frequency of follow-up testing depends on PSA levels and each individual’s overall risk profile.
4. How important are prevention and routine examinations?
Prevention and regular screening play a crucial role in prostate cancer, particularly because the disease generally causes no symptoms during its early stages.
Through routine examinations — primarily the PSA blood test — prostate cancer can be detected at a very early stage, when it is highly treatable. Early diagnosis offers higher cure rates, the possibility of less invasive treatments, better quality of life and reduced mortality.
Simply put, “prevention is the most powerful weapon a man has against prostate cancer.”
5. Are there risk factors we can control, such as diet or lifestyle?
Although prostate cancer is strongly influenced by age and hereditary factors — which cannot be changed — there are several lifestyle factors that can be improved in order to reduce overall risk.
A diet that limits red and processed meat, while increasing the consumption of fruit, vegetables and foods rich in antioxidants, together with the adoption of a Mediterranean-style diet, has been associated with a lower risk of developing aggressive forms of cancer.
Obesity is also associated with an increased likelihood of more aggressive prostate cancer. Regular physical activity improves hormonal metabolism and may help reduce the risk of both developing and progressing disease.
Smoking does not appear to increase the risk of developing prostate cancer to the same extent, but it is associated with a poorer prognosis and a higher likelihood of metastasis. It is, however, the leading risk factor for bladder cancer.
Overall, a healthy lifestyle does not eliminate the risk of prostate cancer, but it can contribute to reducing the likelihood of aggressive disease while also improving a man’s overall health and well-being.
