Sevilla FC head coach Eduardo Berizzo revealed recently that he is suffering from prostate cancer, through a statement issued by the club. His is one of 33,000 cases diagnosed in Spain each year. Berizzo is suffering from a prostatic adenocarcinoma, the most common histological type of cancer among Spaniards, although it is the third in terms of mortality after lung and colon cancers.
“Most patients who are diagnosed with prostate cancer can survive this tumour thanks to the existence of treatments which, if applied in the early stages, can cure or ensure a long survival which in general is free of symptoms,” says Dr Santiago Méndez, a doctor with Infocáncer.
“Independently of the histological area where the tumour is located, you have to take into account its level of aggressiveness, because not all prostate tumours are the same, and that has to be studied through pathological anatomy and also by expansion studies.”
Although Berizzo is 48, the incidence of this type of tumour tends to increase from the age of 50 and develop in the peripheral area of the prostate gland. In the early stages there may be no syptoms and when these do occur, when the illness is more advanced, it can result in bone pain, paraneoplastic syndromes or other general symptoms which can even be confused with other pathologies of the lower urinary tract. If is it suspected, or there is a history of prostate cancer in the family, tests of the prostate-specific antigen (PSA) or rectal examination (palpating the prostate via the rectum) are carried out. If the levels are high or there are nodules, then a prostatic biopsy and transverse ultrasound of the prostate are carried out.
“We can't give a diagnosis purely from the symptoms,” explains Dr Méndez. “In order to be certain we need to take a sample of the prostate tissue, and that will be examined by the anatomopathologist. Nowadays there are also some very simple tests such as multiparametric nuclear magnetic resonsance to show up lesions which would otherwise be difficult to spot.”
The treatment depends on the circumstances of the patient, the characteristics of the tumour and where it is located. “If it has not left the prostate it is potentially curable,” says Dr Mendez, who explains that there are two types of treatment.
First, curative treatments, which are surgery (radical prostatectomy) and the two types of radiotherapy: external or brachytherapy. Secondly, those which increase survival by controlling the illness and stopping or slowing down its growth, such as hormonal androgen suppression therapy.
“In recent years we have been trying to control the patients who are not responding to the usual treatments with certain chemotherapy and immunotherapy medications,” he says.
The patient's work and professional life need not be affected, as long as the treatment is chosen well and there are no undesirable and unexpected side effects. A patient with prostate cancer can, in general, lead a normal life, as Berizzo's football club indicated in its statement: “Our trainer will continue to work as normal.” However, “any treatment can have possible side effects,” says Dr Méndez. He is referring to erectile dysfunction or urinary incontinence due to the surgery, although this is increasingly less common thanks to advances in the techniques. With radiotherapy, which can affect healthy tissues around the target area, the bladder or rectum may be irritated, although this is also becoming less frequent nowadays.