Prostate cancer is the most common cancer in men over 60 years. It is possible to detect prostate cancer early in its evolution. Strictly speaking, we can not prevent the onset of prostate cancer, but it can detect when its size is still very small by regular review. This is the same approach as for women who are advised screening for breast cancer or cervical cancer.

Cancer cells are often present in the prostate, but they do not grow: they say they remain latent. This is so microscopic cancers without danger. Between 50 and 59 years, 1 in 3 men to a microscopic cancer as is the case for 4 in 10 men between 70 and 79 and the proportion is 7 out of 10 men after 79 years. Sometimes, about once every hundred, these tiny cancers evolve very slowly and become true cancers. It is therefore important that you regularly review time to recognize these true cancers.

1. How to detect prostate cancer?

To detect cancer at its appearance, from the age of 50, he must go every year to the doctor for a review of DRE. The doctor inserts his index finger cot covered with Vaseline impregnated into the anus and feeling the prostate with this finger, aided by the other hand placed on his stomach. The medical research with his finger if he receives a hard zone, ie an area of suspected prostate cancer. If this review raises a doubt, take a sample from the area in question is a biopsy. It is then analyzed under a microscope by a laboratory of pathology (the medical specialty that examines body tissue).

But the DRE is insufficient to diagnose all cancers. To see if there in prostate cancer cells that the doctor’s finger could not perceive, it is necessary to make another examination. It is a blood test, which allows to dose a substance called prostate specific antigen, or PSA.

Responsible for 10,000 deaths annually, prostate cancer is the leading male cancer in France. Yet, faced with this problem, the utility of mass screening remains controversial. Beneficial for some, useless and dangerous to others … Published in late March 2009, two major studies (one American and one European) would enable a clearer picture.

There are in France more than 40 000 new cases of prostate cancer annually. Thus the first human cancer, to lung cancer. Like breast cancer for women, a man about 9 present a clinical form of the disease during his lifetime. This disease is responsible for 10,000 deaths per year in France.

1. Obstacles to screening for prostate

Based on the adage that more cancer is detected early, the better it is processed, the screening of prostate cancer has rapidly been a topic of public health. But such screening is hampered by several obstacles as sociological than scientific.

On the one hand, men are less accustomed to submit to screening, unlike women who are willingly submitting to thanks from a young age (smear, palpation, mammography …). As pointed out a study of the French Association of Urology, though women have learned to manage their sexual health, men are still reluctant to talk about it. A word more difficult to clear they have no interlocutor, unlike women who listen to the gynecologist.

But it is the very usefulness of screening and its tools at the heart of a controversy redundant.

2. Screening worthwhile?

A mass screening should be based on a simple, economical, non-hazardous and should lead to a reduction in mortality from the disease focus. For prostate cancer, the test in question is the PSA, a prostate protein whose rate increases in blood cancer cases. Problem: this test features a higher risk but can not make a diagnosis. For this, a biopsy is necessary. But this invasive test can then detect prostate cancers are indolent and which may have remained devoid of symptoms …

In July 2007, two specialists Catherine Hill and Professor Gerard Dubois felt that mass screening would lead to over-diagnosis and therefore treatment unnecessary and not without side effects. According to their calculations, a screening of the 7 million men aged 50 to 75 years would lead to 336 000 positive tests (12%), to discover 70 000 cancers, of which approximately 30% of cases that would never become symptomatic.Following treatment, 33 000 men (45%) had problems of impotence, incontinence or proctitis. Results that have earned them the wrath of the French Association of Urology who recalled that one such screening could identify certain cancers very active and very dangerous but which are 95% curable if detected early.

Today, the BAS recommends testing (and remember this message on the occasion of a national day dedicated to the prostate), while InCA and HAS do not recommend it for lack of evidence of a decrease mortality related to screening.

2. Screening for prostate cancer: the controversy continues …

Only large-scale studies showing the influence of screening on mortality could settle this debate redundant. And late March, the two studies (American and European) were finally published in The New England Journal of Medicine!

The study conducted in eight European countries (including France) was initiated in 1990 and covers more than 160 000 men aged 55 to 69 years. Half have been screened, the other not. Preliminary results as at 31 December 2006 reveal a decrease in deaths from prostate cancer by 20% in the screened cohort. Twice as many cancers were diagnosed among screened men. The authors estimate that 1408 men should be screened for PSA, 48 cancers were detected and in the end death is avoided. Moreover, the benefit of screening appears only in the age group 55-69 years.

End of controversy? Not really, since the U.S. study (conducted on 76 000 men) do not show benefit on mortality …

While the “controversy refuses to die” (as stated by Michael Barry in an editorial in the same journal), the High Authority for Health (HAS), Institute of Cancer (INCA) and the French Association of Urology should consider these results to develop joint recommendations shortly.

Dangerous! Scandalous! Masturbation has long been considered the mother of all vices. But now a study that could finally kill off this myth. Frequent solitary practices would prevent prostate cancer, responsible for 10,000 deaths each year.

“You’ll go deaf!”, “Gonna make you idiot!” … Such threats have long contributed to the bad reputation of masturbation. But while the harmlessness of masturbation is now demonstrated, that a new study assigned the same beneficial effects. Practiced frequently, it could prevent the most common cancer in men.

1. Hand games …

The prostate is involved in sperm production (production of seminal fluid, mixed with the sperm) before it does pass into the urethra during ejaculation. Besides its role in reproduction, this small gland is the subject of much attention since they are responsible for more than 40 000 new cancers and 10,000 deaths each year. Faced with this situation, various scientists were interested in the relationship between this disease and sexual behavior. The most recent study is the most amazing!

Between 1994 and 1998, a team of researchers from the Centre for Cancer Epidemiology Melbourne (Australia) asked 1,079 men with prostate cancer diagnosed before age 70 complete a questionnaire about their sexual habits. Their responses were then compared with 1259 healthy men of similar age.

The team concludes that the more men ejaculate between 20 and 40 years, the less risk of developing prostate cancer. And prevention does not expect the number of years, since the protective effect can best be seen for young men. Men who ejaculated more than five times per week during the twenty years would reduce by one third their risk of developing prostate cancer during their lifetime!

2. Prefer solitary game of checkers?

But these results may thus undermine few certainties. In this study, no association with the number of sexual partners has been highlighted. However, several studies had reported such an influence. In June 2001 a U.S. study had even unearthed a directly proportional relationship. The greatest seducers more than 30 partners) were more often affected by aggressive forms of cancer. The authors were then referred to the possible responsibility of one or more sexually transmitted infections. The increasing incidence of cancer in patients who reported a history of gonorrhea or syphilis credence to this track. To learn more about this study, read our article “incorrigible seducer, attention to your prostate!”.

In the weekly New Scientist, Australian authors believe their results are not inconsistent with the hypothesis that infectious, quite the contrary. The difference between the two studies based on sexual activity considered. The U.S. investigation retains the amount of sex, while Australian researchers are taking into account the number of ejaculations, with or without a partner. Solo sex does not entail the same risk as infectious, as confirmed by one of the authors Graham Giles: “If we could have isolated the ejaculations associated with sexual intercourse, we could certainly have found a protective effect even more important” .

3. Prevention at hand

But what assumptions can certify the protective power of solitary practices? According to the authors, this activity would limit the accumulation of seminal fluid. Certain compounds of this fluid component of semen (potassium, zinc, fructose, citric acid and of 3-methylcholanthrene for smokers) may have carcinogenic properties in case of stagnation in the channels of the prostate. This assumption is based reasoning and quite simple, the flow in these “pipes” is important, unless the substances they contain can cling to and damage the cells that constitute it. Alternatively, ejaculation might induce a more complete maturation of prostate cells, making them less likely to become cancerous. But for now, then it is mere speculation.

And if tomorrow, a good diet and exercise were not the only lifestyle and dietary advice provided by your doctor? Do not worry gentlemen, before your doctor does not encourage you masturbate regularly, the results of this study should be confirmed.

However, this practice is harmless, nothing prevents you from taking now your health …

Nutritionists will tell you the secrets of good health are often in our plate. The higher proportion of men affected by prostate cancer in Western countries identified food “at risk”. Doctissimo reviews the latest studies on the subject.

By the early 1990s, several epidemiological studies have highlighted the influence of some bad habits. A diet containing too much fat and could increase the risk of prostate cancer. In the dock, animal fats are the most harmful.

1. Food: prefer fish to meat

Men who do not eat fish are two to three times more risk of prostate cancer than those who consumed moderate or large quantities. That is the surprising conclusion of a Swedish study published in the prestigious medical journal The Lancet. The hello would it the sea? Particularly fatty fish (mackerel, sardines, salmon, tuna …).

The survey covered 6,272 Swedish followed for 30 years. During this period, 466 prostate cancers were diagnosed.

Having reviewed the dietary habits and lifestyle of patients, it appears that even moderate consumption of fatty fish (two to three times per week) would have protective properties vis-à-vis this type of cancer . The origin of this phenomenon, we suspected the long-chain fatty acids, with anti-inflammatory and anti-tumor. But the low number of cancers identified in this study does not however provide a definitive conclusion.

2. The carrots are cooked!

They had also suspected a protective effect associated with the consumption of beta-carotene (found in green vegetables, carrots) and lycopene (a carotenoid mainly contained in tomatoes, watermelons, grapes and crustaceans). But by studying 317 cases of prostate cancer, researchers from New Zealand claim the lack of effect of the first and weak protection associated with the lycopene in tomato-based foods.

Last link between prostate cancer and diet, a U.S. study concluded that flaxseed may slow the progression of prostate cancer. Besides their beneficial fatty acids Omega 3 family, these foods would be able to reduce testosterone levels in the blood. This male hormone is believed to accelerate the progression of prostate cancer. However, this study covered only 25 volunteers and other studies will confirm this action. Another question, what are the possible influences on the development of sexual characteristics and libido in these patients? Stay tuned …

Finally, a recent study suggests that a diet rich in calcium increases the risk of prostate cancer. But this last link is still very controversial …

After lung cancer, prostate cancer is most common in humans. It affects 40,000 people each year in France. According to a U.S. study, men who had multiple sexual partners have a higher risk of being affected.

The links between sexuality and gynecological cancers are well established. Thus, the multiplication of partners increases the risk of cancer of the cervix. In this case, this relationship is from infection by certain HPV that are spread through sexual intercourse and lead to the development of precancerous lesions on the cervix.

In contrast, no association between sexual life and pelvic cancers in humans had previously been highlighted. A recent study *, the number of sexual partners is not without influence on the risk of prostate cancer.

1. 40 000 new cases each year

Prostate cancer is the most common cancer in men over 50 years. It is possible to detect very early in its evolution. Through regular review, testing is possible when the tumor size is still very small. This is the same approach as for women who are advised screening for breast cancer or cervical cancer.

Recommended annually after age 50 years, this screening is based on digital rectal examination and PSA assay, a marker of the activity of the prostate. Its increase in the blood indicates an abnormal behavior of the prostate and can lead to a biopsy to confirm or refute the diagnosis. Today, progress in treatment can successfully treat many of these cancers.

2. Risk little studied

For obvious anatomical reasons, the male organs are less susceptible to infection than the woman’s uterus. Thus, the relationship between sexually transmitted diseases and certain cancers have not been studied extensively.

Researchers have identified all prostate cancers diagnosed between 1993 and 1996 among men aged 40 to 64 years County, Washington. They then asked these people about their sex lives, and then compared their answers with those collected from healthy men, age-matched. In total, 753 patients with prostate cancer and 703 healthy men participated in the survey.

3. How many partners?

After statistical analysis, the authors found that the risk of prostate cancer was directly proportional to the number of sexual partners during life. At the extreme practices, having had more than 30 partners was associated with the presence of more aggressive forms. In addition, cancer risk was slightly higher among men who had in the past gonococcal infections. However, the frequency of intercourse did not appear to have any influence.

4. Difficult to establish a link

Still preliminary, these results need to be confirmed, the responses gathered in such surveys are often unreliable. Until now, investigations attempting to establish a correlation between prostate cancer and sexually transmitted diseases have yielded conflicting results.

Some seemed to suggest an association between cancer and infection with gonorrhea or HPV, but these findings were not confirmed by other studies. Finding a causal factor is further complicated by the fact that infection may simply show unsafe sex.

Family history, diet … Today, experts agree on the influence of certain factors, including the principal remains undoubtedly age. Doctissimo reviews the principal accused.

With more than 40 000 new cases per year, prostate cancer is the most common cancer of men in France. Discover the main risk factors identified.

1. Age

Age is undoubtedly the main risk factor. Over three quarters of prostate cancers are diagnosed in men over 65.

2. Family factors

Men with first-degree relatives (father or brothers) who had prostate cancer are more likely to be affected themselves. The studies describe a multiplication of 2 to 5 times the risk compared to a man without family history. Currently, several teams are working to find the genes responsible for prostate tumors. Since 1996 and the identification of the HPC1 gene by Swedish and American teams, research has progressed and one by one the susceptibility genes are identified.

3. Ethnic factors

Studies of the U.S. population show that the incidence of prostate cancer is higher among men of color. Nevertheless, Africans and Japanese have not immigrated to the United States have a lower risk of prostate cancer. The explanation may lie in changing eating habits (food rich in fat), smoking or exposure to certain environmental pollutants (cadmium, etc.)..

4. Food

A diet containing too much fat could increase the risk of prostate cancer. Animal fats are the most dangerous.

Recent research suggested that a diet rich in calcium and low in fructose increases the risk of prostate cancer. This link is still very controversial.

5. History of vasectomy

There is no consensus regarding the risk of a vasectomy. Nevertheless, the studies finding that this criterion as more significant point that this is done at a young age, his influence is more important.

6. The sex hormone levels

High levels of male hormones called androgens may increase the risk of prostate cancer in some men. This factor is now referred to as possible, not certain.

7. Physical activity, body weight and physical inactivity

Most epidemiological studies have observed an increased risk of prostate cancer in individuals with body mass index too high. A sedentary lifestyle, lack of exercise and obesity are well accepted as possibly having an influence on the occurrence of this disease.

8. Other risk factors

Alcohol, a long suspected, did not appear to influence this type of cancer. Similarly, no study to date seems to confirm any effect of stress. More strange, sun exposure may play a protective role. By interviewing more than 200 male survivors of prostate cancer, it appears that men who have suffered the highest exposures to UV are affected by the disease later on average 5 years later.

62 000 new cases of prostate cancer are diagnosed each year, but the third of cancers are indolent said, who do not progress or very little. Faced with these tumors, careful monitoring can prevent or delay surgery. Specially dedicated to the men in this case, a new center opens at Tenon Hospital.

Operational for several days at the Hospital Tenon, the Center for diagnosis and monitoring of prostate cancer should allow patients to live more calmly cancer “indolent”, which warrants close surveillance but no immediate treatment “invasive.”For these patients, treatment options must be weighed against the risk of cancer progression, but also potential side effects of surgery, may irreversibly alter the quality of life …

1. A unique center for men at high risk of prostate cancer

The clinic of the Hospital Tenon is an integrated platform for identifying men at high risk of prostate cancer and customize their treatment. It allows to combine two advantages: early detection (to keep all his chances when the patient free of metastases) and the economics of an intervention to possible side effects. This center is for men:

• In whom we discover a cancer called “low grade” for which treatment options can range from simple monitoring to a light treatment, minimally invasive or heavier;
• Who have elevated PSA (more than normal), yet biopsies (the review that says the diagnosis) negative;
• Including a member of the family had young prostate cancer (or breast cancer because of the potential crossover with this cancer hormone), which warrant more frequent monitoring.

Registration is done on written request of the referring physician, in consultation with the patient course. But as pointed out by Professor Oliver Cussenot, urologist, oncologist responsible for the Centre, “The problem of cancer in general and that of the prostate in particular is less than the screening, the consequences of this testing …”.

2. Better monitoring for better care

“A Tenon (as in Lyon and Toulouse where such structures already in operation), patients referred by his doctor therefore has a platform for specialists: oncologists, andrologists, psychologists, etc.. Decisions are thus taken collectively, according to the medical profile and wishes of this man suffering from cancer at low evolutionary potential or high-risk family or individual prostate cancer “says Professor Cussenot.

With the imaging techniques most recent blood and urine markers, biopsies and minimally invasive treatments, monitoring is individualized. Regularly updated according to the latest, he expects the pace and modalities of monitoring, and possible alternative treatments.

Finally the day came to an intervention and possible side effects, this support facilitates early postoperative management of urinary and / or sexual abuse. ”These problems depend on the sexual status before surgery, age, factors of” comorbid “(such a smoking or diabetes) and motivation of the couple,” says Professor François Haab, chief of urology Hospital Tenon.

According to a U.S. study, a drug could reduce the risk of developing cancer of the prostate. What could be the applications of this discovery against the first cancer male? Doctissimo an update.

Prostate cancer affects 40 000 French people each year, the first male cancer before the cancer poumon1. Plus it is detected early, the better it is processed. Treatment options include simple monitoring, hormone therapy, recently targeted therapies, radiotherapy or surgery. But despite the progress, both therapeutic and screening, cervical cancer still causes 10,000 deaths per year. Given these figures, the idea of being able to prevent the onset of the cancer made its way past several years. A new study seems to confirm the validity of this thesis.

1. Former drug effective in prevention?

Certain sex hormones (androgens) could play a role in the development of this type of cancer. Several hormonal therapies work by blocking them. The idea would be to see if this therapeutic action may also be effective in prevention.

In the prestigious New England Journal of Medicine, an American team has evaluated dutasteride. The drug, marketed under the name Avodart ® by GlaxoSmithKline, is already used in the treatment of prostate adenoma. It inhibits the conversion of testosterone to dihydrotestosterone, an androgen particularly active in the prostate. A total of 6729 men aged 50-75 years at risk for prostate cancer (PSA – a marker of cancer – high but no cancer, proven by a biopsy performed within 6 months preceding the start of the study ) were divided into two groups. The first received 0.5 mg of dutasteride, the other half a placebo (inactive pill). According to the principle of double-blind, neither the doctor nor the patient knew whether they received drug or placebo.

After 4 years of follow up, 659 of the dutasteride group had developed cancer of the prostate (19.9%), against 858 in the placebo group (25.1%). Result: the drug reduced the number by 23% the risk of cancer, and 31.4% for the familial forms. Side effects are summarized in reductions of libido (3.3% against 1.6% in the placebo group), for erectile dysfunction (9% against 5.7%). Cependantn the risk of heart attacks is more important in the dutasteride group (0.7% against 0.4%), although statistically this difference was not significant.

2. An attractive hypothesis for the moment but unenforceable

In an editorial accompanying the publication of this study, Prof. Patrick Walsh of the James Buchanan Brady Urological Institute tempers the enthusiasm of researchers.He recalls the results of the study Prostate Cancer Prevention Trial (PCPT), which was tested on over 18,000 men over 55 years finasteride, another inhibitor of the conversion of testosterone into dihydrotestosterone. After 7 years of follow-up, scientists had found a reduced risk of prostate cancer by 24.8%. But it emerged later that the number of biopsies between the two groups was not equivalent, and after correction, no significant difference was observed between the two groups. A disappointment confirmed by a Finnish team. In the study of dutasteride, the risk of potentially fatal tumor is not reduced …

According to Professor Patrick Walsh, “neither finasteride nor dutasteride not prevent prostate cancer but just temporarily reduce tumors that have little risk of being fatal, and they do not reduce the risk of positive biopsy at patients who have an elevated PSA (PSA that must be corrected if the patient takes the treatments) or abnormal DRE. Similar criticisms were advanced in 2003 by Professor Peter Scardino, who believed that the only relevant criterion in terms of preventing cancer is overall survival.Indeed, for cancers of the prostate, the risk of death within 15 years after diagnosis is between 4 and 30% depending on age and severity of the tumor. Thus, it dies more often with prostate cancer, that due to a prostate cancer … Prof. Patrick Walsh advance one final argument: “According to him, the use of these drugs in prevention could be risky. Because PSA levels are suppressed, men may feel undue security, and if a cancer prostate grows, the diagnosis may be delayed until the advanced stages, which would then be more difficult to treat.

Conclusion: If the hypothesis of a prevention of prostate cancer is scientifically appealing, today these compounds (finasteride and dutasteride) does not appear to be agents of chemoprevention very relevant. The issue of support for prostate cancer is now well detected and then find out whether it is useful to treat it.

Prostatitis is an inflammation of the prostate that affects young men. This inflammation is the cause of 2 million visits each year in France. Causes various forms, learn about the disorder mainly male.

Representing 9% of consultations in urology and 1% of visits to the GP, prostatitis are far from uncommon.

1. Inflammation of the prostate

Unlike other prostate disease, prostatitis frequently affect young men. Presumably this characteristic is that they have more frequent sex with multiple partners, but nothing is really proved and we can not scientifically explain.

Behind the term “prostatitis” lie essentially two main types of disease:

• Acute prostatitis, caused mostly by an attack of bacteria, which causes a high fever and urinary symptoms;
• Chronic prostatitis, the source of recurrent pelvic pain and more diffuse. It can be bacterial or nonbacterial.

Each of these forms presents the causes, symptoms and treatments clean, we detail Dr. Patrick Coloby Hospital Rene Dubos (Pontoise).

2. Acute prostatitis, an infection should not be overlooked

As with cystitis in women, prostatitis usually reflect acute bacterial infection, most often bacteria of intestinal origin. But the frequency of these infections remains less masculine because the urethra in men, is longer than in women. Certain sexual practices (anal intercourse), acquired or congenital abnormalities of the urinary tract (narrowing or obstruction of the urethra, bladder abnormality ,…), instrumental maneuvers urological (prostate biopsy, endoscopy, urinary catheterization ) can promote these prostatitis.

“The symptoms are the same as for influenza-like illness, associated with urinary symptoms: high fever (39 ° C) with chills, accompanied by pain or burning on urination, desires more frequent, discomfort even a pain in the perineum, “said Dr. Patrick Coloby.

In addition to these symptoms, diagnosis based on palpation of the prostate is painful and possibly the presence of cloudy urine. Additional tests may seek to identify the bacteria involved (Urine culture – urinalysis – urethral …).

The lack of treatment can lead to complications that should not be overlooked.According to Dr. Coloby, “is a medical emergency since it is the infection of a tissue. If not treated quickly so may lead to complications, abscess of the prostate, or sepsis.The treatment relies mainly on antibiotics for 3 or 4 weeks. ”After the treatment of infectious episode, it is useful to take stock in search of a predisposing cause, including a congenital or acquired abnormality of the urinary tract, thereby preventing or lessening the risk recidivism, “says Dr Coloby.

3. Chronic prostatitis remains mysterious

The symptoms of chronic prostatitis are less specific: perineal discomfort or pain that radiates into the scrotum or penis. These are all signs that may anxiety of the patient.According to Dr. Coloby, “Given the finding of pelvic pain, the first question to ask is whether it is a chronic bacterial prostatitis or chronic nonbacterial prostatitis. To find out, we do samples of semen and urine, or prostatic secretions after prostatic massage.

The treatment of chronic bacterial prostatitis is taking antibiotics for 8 weeks after which a cure can be obtained. But if no seed is detected, the ignition remains partly mysterious. One suspects generally poor coordination between the bladder and urinary sphincter or muscle of the urethra, the influence of stress on the muscle tone …

It is important, in both cases to take the time to talk with the doctor to try to determine all the factors involved (urinary factors, dietary, sexual, influence of stress, practice sports, especially cycling) in triggering the pain. The prescription of alpha blockers (Dysalfa ®, Hytrin ®, Xatral ® for example) that allow an improvement in voiding sometimes gives good results in cases of inflammation. The anti-inflammatory and analgesic relief, therapies against the stress have been shown to give good results.Each patient’s treatment, and long talk together with the urologist.

Faced with these inflammation of the prostate, it is customary to remove alcoholic beverages (especially beer), soft drinks, spicy food, tea or coffee and avoid cycling.