It could be said that prostate cancer is the equivalent in men of breast cancer in women (due to its prevalence, survival, cure rate and even its link with sexuality). However, The visibility given to one and the other has nothing to do with each other. Rather, they are at the antipodes.
Thus, while in the case of breast cancer there are many prevention and awareness campaigns about its diagnosis, the importance of having periodic check-ups or even social activities of all kinds, in prostate cancer there is still a long way to go. And, although comparisons are odious, and it is true that progress has been made in this sense, this example highlights how the stigma related to this male cancer remains a problem.
To confront this taboo and normalize a tumor, which is the third most diagnosed among men In our country, the round table “Mutual support and tools for patients and families” took place within the framework of the II Prostate Cancer Forum, organized by ROC Clinic and A TU SALUD last Wednesday at the headquarters of LA RAZÓN.
In her Carlos Manuel Nieto, who underwent prostate cancer surgery not even six months ago, wanted to share his experience To, in his own words, “dedramatize, you have to take it seriously and have respect, surely not all cases are positive, but what I want with this is to dedramatize prostate cancer,” he said.
“I have normalized it, I have given it visibility in my environment and I never considered hiding it”
In his case, it was a periodic work review that alerted him when it detected high levels of PSA in his analysis in 2022. After months of follow-up and uncertainty, he was diagnosed with a 5mm highly encapsulated carcinoma. So, at 53 years old and asymptomatic, he decided with his doctor to do active surveillance.
After having surgery on December 18, and after a very good postoperative period “there is no bleeding in the drainage and I have not taken a single paracetamol since I had the operation,” he went home and ten days later they removed the tube “and I had a “Normal New Year’s Eve.” Everything remains in order until she starts work on January 9 and after 25 days she even starts running.
Carlos says that what he has experienced in recent years has been for him “like a Netflix series.” That’s why, talks about the “aftermath chapter”, one of the most feared in these cases both due to the possibility of urinary problems and erectile dysfunction. However, in his case, once again, everything went well: “2-3 hours after removing the catheter I had the urge to go to the bathroom and I was able to control it perfectly.” As for sexual function, there are no problems either, although, he points out, “I don’t have the same quality as before the operation, but I can finish without problems.”
“Because of how we have been educated, men usually find it more difficult to go to a psychologist”
Carlos’s case is an example of success, not only because of the good results obtained to date, but because of the naturalness and generosity with which he shares his story. Something that, although it is becoming more frequent, is not normal. He himself acknowledges that he has “normalized it and in no case have I considered hiding it.”
But it doesn’t always happen that way. Attest to it Lara Fernández, psycho-oncologist of the Spanish Group of Cancer Patients (Gepac): “It is difficult to manage emotions such as fear, anger or even guilt,” he explains. «It is also normal that it is difficult to manage uncertainty. Or the concern about the diagnosis and treatment, or the impact that this will have on the quality of life and how it will also affect the people around us.
This is because “because of the stigma of this pathology, it is usually more difficult to take the step, because of how we have been educated, because men are strong and do not ask for help,” he laments. For this reason, they try to ensure that, once they do so, “they find themselves in a space of trust where they can transmit all that,” he continues. «We are here to help patients and their families. Public health is very good, but it has its shortcomings and we, the associations, are here to fill that gap to the best of our ability. Because that is another added problem: in the SNS there are not as many psychologists or psycho-oncologists as would be necessary: ”We find many waiting lists and the follow-up is done very far apart in time.” In any case, they try to make sure that “anxiety limits them as little as possible and to accompany them throughout the entire process, as long as they want it that way.” For them They have the specific “Gepac with you prostate cancer” Program in this regard.
“Supply and demand go hand in hand: if patients do not ask for these services, there is no supply”
And the approach to cancer of this tumor goes far beyond therapeutic treatment, surgery or radiotherapy, something that many patients are unaware of. This is where, in most cases, patient associations come into play, in which not only are men informed of the possibility of accessing these services, but they are also often the only ones that offer them. . Such is the case of the Spanish Association Against Cancer (AECC), which has a Physiotherapy service for these patients. “In the association we are betting on physiotherapy to address pelvic floor problems,” explains Virginia Prieto, coordinator of this area of the AECC..
Something necessary given the high percentage of sexual and urinary dysfunctions that occur in these cases and that considerably reduce the quality of life and well-being. But, as in the case of psychology, “we found a certain barrier for patients to ask for help. And not only that, but when it is offered to them they do not take the witness,” says the expert. «We want to align ourselves to create strategies together because if these treatments do not arrive, it makes no sense to continue researching in this area. “Supply and demand go hand in hand and if patients do not demand them, there is no supply,” says Prieto. Furthermore, she continues, There is a gender gap, in this case against men: «Physios are trained to treat women’s pelvic floor and we see that female models are extrapolated to men and that is not appropriate because physiology is different. “That’s why we want research to also reach man.”
“We are committed to population screening. We continue to say that we want to be the fourth in Spain”
For its part, Santiago Gómez, first vice president of the National Prostate Cancer Association (Ancap), drew attention to the number of cases diagnosed around 33,700 last year according to the AECC. For this reason, he said “we are committed to population screening. We keep saying that we want to be the fourth cancer screening in Spain. The European Society of Urology also supports screening. The WHO warns of a 38% increase in the mortality rate of this tumor. Furthermore, we understand that it does not represent an extra cost.
Despite these figures, his message is one of hope because, as he concluded, «Although it is the most prevalent, it has a high life expectancy: 80% of tumors are diagnosed in the local phase and these have 100% five-year survival. Let’s collaborate to make prostate cancer chronic.”