World swimming champion Petar Stoychev is this year's ambassador of the "Open to Men" information campaign for prostate cancer. Its goal is the early detection of the disease, and the motto is: "Checking is the highest form of masculinity." Faces of the fight against prostate cancer are also the actors Viktor Kalev, Mikhail Billalov and Yulian Vergov.
Free preventive examinations will be carried out from November 24 to 28 after prior registration at the beginning of the month in: Sofia - MC "Doverie" (0888 35 05 71) and DCC 6 (0888 25 75 56); Varna - MC "Nova" (052 57 06 70); Plovdiv - Polk. Sava Mutkurov" 30 (0898 661153) and Pleven - MC "Uromed" (064830930).
Mr. Stoychev, why did you join the fight against prostate cancer?
- I support the cause because I believe that it would save the lives of many Bulgarians. I also support the campaign because my grandfather, who I am named after, died of prostate cancer. I feel very sorry for him. Lack of information on the subject and ignorance of the symptoms is the reason why people do not recognize the problem. To me, responsible behavior is a manifestation of masculinity. Being a man means taking care of our he alth, going to a urologist for preventive examinations once a year, instead of neglecting ourselves. In this way, we will not leave this world prematurely, we will continue to take care of our family, the people we love.
I call on all Bulgarian men to show this responsibility towards their he alth. And at the end of November, in support of the "Open to Men" campaign, I will participate in a football match, to which I invite other athletes as well as journalists. I want us to show that we men can also come together and help many of our friends to be among us, as women have shown in the fight against breast cancer.
Prof. Dr. Alexander Hinev:
Prostate carcinoma is diagnosed in 2000 Bulgarians every year
The prevention of prostate cancer and its treatment were explained to the readers of "Doctor" by some of the biggest specialists in this field in Bulgaria. Prof. Dr. Alexander Hinev is professor of urology and oncology, secretary of the Bulgarian Urological Society and national urology consultant. He is the head of the Urology Clinic at the University Hospital "St. Marina" in Varna.
Prof. Hinev, how significant is the problem of prostate cancer for Bulgaria?
- Prostate cancer is the most common disease among all malignant diseases of men in developed countries - occupies 15%. In Bulgaria, the incidence is 9.2%, prostate cancer is second in frequency after lung cancer. About 2,000 new cases of prostate cancer are diagnosed in Bulgaria every year. The bad thing is that the death rate in Bulgaria and Romania continues to grow, unlike all other European countries, where since 1995this indicator began to decrease. One of the reasons is that the disease is detected too late. Few Bulgarians visit a urologist for a preventive examination. Our role as doctors and information campaigns like "Open for Men" is to turn this mortality curve downwards. There are enough opportunities for this to be done in our country. We have obtained data from the National Cancer Registry that the disease is found much more often in large cities. It is most common in Varna - 34.5 per 100,000 population. In Sofia, cancer is detected in 28 men per 100,000. For comparison, in Razgrad, the frequency of the disease is 10 per 100,000.
Is prostate cancer difficult to diagnose?
- Prostate cancer diagnosis is not difficult. There are three main diagnostic methods. A few years ago, prostate-specific antigen testing was introduced - a blood test that can be used to make an early diagnosis of prostate cancer. It is especially applied to men with family burdens.9% of men have a direct relative with prostate cancer. Their risk of getting sick is three times greater than that of other men. With two such relatives, the risk for the man jumps 12 times.
Diagnosis can also be made with a standard urological examination, because prostate cancer develops in the peripheral zone of the gland and makes its detection accessible by palpation. Ultrasound examination is also very important, although in our country it is not accepted as a mandatory preventive examination. This I think needs to change.
In addition to these three tests, there has been a lot of talk lately about the value of MRI and its combination with ultrasound. It makes it possible to do targeted biopsies, which really improves diagnostics a lot.
What are the symptoms of prostate cancer?
- Prostate cancer is one of the most mysterious tumors in men. It is a very insidious disease that manifests itself through 6-7 foci in the gland and not always the largest foci is the most aggressive and most malignant. In 30% of newly diagnosed cases, the cancer does not manifest itself clinically and thus can remain for years without progressing. But there are also cases when the disease develops quickly and inevitably leads to death. Distractions affect lymph nodes and bones.
In most cases, the disease is asymptomatic, in others it manifests itself with non-specific symptoms of the urinary tract and overlaps with symptoms of bladder diseases and benign prostatic hyperplasia (the enlargement of the prostate with age, which affects every man).
Rarely in clinical practice, the disease manifests first with metastases. And since they are in the bones, the complaints are like sciatica, lumbago, pathological fractures. But then we register the cancer at a very late stage.
What is the recommended age at which any man should see a urologist?
- Men aged 45 and over who have a family member who died of prostate cancer or who are suffering from it, should go for an examination once a year. Otherwise, as life expectancy increases, so does the frequency of disease. Prostate-specific antigen has been introduced as a test for men over 50 years of age. The earlier the cancer is diagnosed, the greater the possibilities for treatment and preserving the patient's quality of life.
Prof. Dr. Asen Dudov:
With 1 injection every three months the disease can be controlled
Prof. Dr. Asen Dudov is the chairman of the Bulgarian Oncology Society, a chemotherapist at Tsaritsa Joanna Hospital - ISUL. The great specialist explained what modern prostate cancer treatment is.
Prof. Dudov, what are the options for prostate cancer treatment?
- If it is proven that a man has prostate cancer that is limited in it and does not grow in the surrounding structures, then a radical surgery is undertaken - removal of the prostate gland. The important thing is that such a patient does not have other serious co-morbidities. The operation itself must be masterfully performed in order to preserve the nerves responsible for the bladder, for the sphincter of the rectum, so that the patient can then have a normal life. The situation becomes more complicated when the prostate cancer has entered the surrounding organs - the bladder and rectum, or there are metastases in the lymph nodes. Then the operative method is not suitable and radiation treatment is undertaken - with a radiation dose the tumor is destroyed. The same approach is taken when, after surgery in the prostate bed, a repeated thrust of the disease develops, called a relapse. It is even more difficult when the patient has suffered from the disease for many years and it manifests itself with pain in a limb, in the ribs, sometimes in the most unexpected places in the skeleton.
Why is the disease not detected in time?
- Usually, the man was treated for various diseases of the musculoskeletal system, until finally a doctor guessed that this persistent and persistent pain was a manifestation of bone metastases. A scintigraphy of the skeleton should then be performed to look for other abnormalities. In this case, the therapy is with systemic drug treatment. It is used both before surgery and before radiation treatment when the prostate-specific antigen in the patient's blood is higher. This is known as hormone therapy, but it is more correct to call it endocrine therapy. It works extremely well because this cancer is hormone sensitive. One of the modern medicinal products acts on the pituitary gland and suppresses the formation of the male sex hormone - testosterone. With one injection every three months, control of the disease is achieved. If there are metastases in the skeleton and in internal organs, their reverse development occurs and pain decreases.
