The Spanish Society of Urology is holding its national congress in Palma from yesterday to Friday. He doctor Joan Beneham GualHead of the Urology Service of the Manacor Hospital Foundation and Juaneda Clinic, as well as an academician of the Royal Academy of Medicine of the Balearic Islands, talks about this event.
What will the congress be dedicated to?
The star topic in urology is the prostate. Thirty percent of conferences are dedicated to their pathologies, be it cancer or benign hyperplasia, due to their prevalence. This leads to a lot of research.
Let’s start with hyperplasty, what happens to the prostate?
The prostate gets bigger every year. By age 50, half of patients experience benign growth. Once you reach 80, most people experience significant growth. This does not always mean worsening of the condition or clinical discomfort for the patient. Not everyone has symptoms.
Will this happen to all of us?
None of us are saved. The main problem is that the symptoms you have are indistinguishable from a malignant neoplasm. In the initial stages, we cannot distinguish one condition from another through the clinic.
So how do you approach them?
This is where we have a great workhorse for early diagnosis. This is the first tumor in men with 35,000 cases in Spain; 600 in the Balearic Islands. It was believed that it is not very deadly, but is third after the lungs and colon. Of these 35,000 cases; 5000 or 6000 die. Every eighth man will be diagnosed. We’re talking about a public health issue. This is almost the same incidence as breast cancer and the same mortality rate. These are mirror tumors.
There is much more awareness about breast cancer…
This is the problem. We must insist on the disclosure of medical data. The EU has established the need to create population diagnostic programs for patients. This is a political decision, in Spain it is done in the colon, breast and cervix, nothing more. Pilot studies are being conducted to determine how to do this.
Women are advised to be attentive and vigilant; is this also relevant here?
This is what we have against breast cancer. Women’s self-exploration makes sense. In this case, no. There are no warning signs that would cause a patient to consult a urologist. It is analytically tested by PSA.
PSA, what is it?
This is a protein that cancer cells produce and which we can detect with modern methods. Without this marker, we made diagnoses late. This is why it is one of the tumors where overall survival has improved the most. After five years, up to 90 percent are cured.
What about treatment?
Laser surgery has revolutionized the surgical treatment of benign prostate hyperplasia. In Manacor we were pioneers.
What about cancer?
The revolution was laparoscopy. It was a devastating change. Various surgical robots have burst into the market, but what matters is that the results are delivered by the expert who does it. At the moment, the robot does not work alone. In the future, we aim to move to telesurgery thanks to the robot. Work thousands of miles away. As well as models with augmented reality and 3D, which will make the operation more accurate.
What would you recommend as a preventative measure for a 50-year-old man?
– If you have a criminal record, you need to live until you are 40 years old. If not, I would recommend a PSA test. This is an analytical method, it costs three euros, and we know what the patient’s risk of developing a tumor is. I consider it necessary, useful and recommend it to my patients. If we make a diagnosis, the chances of a cure are very high. We have to avoid patients for whom we are late, and there are 5-10 percent of them. There is some good news in this group. Much progress has been made.