Key Topics Prostate Awareness Day Defined

Main Category: Prostate / Prostate Cancer
Also Included In: Urology / Nephrology;  Cancer / Oncology
Article Date: 05 Sep 2007 - 2:00 PDT

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Shame and undetected symptoms are among the key reasons why middle-aged European males neglect to seek medical help when experiencing prostate ailments. Medical experts say a lot more needs to be done to boost awareness on prostate diseases among Europeans.

"As men get older, the risk of prostate disease increases. Family history, African ancestry and a diet high in animal fat and low in fruit, vegetables and fish may also increase the risk of prostate disease. All men, especially those above the age of 50, should be aware of this and visit their urologist if they are worried," according to the European Association of Urology (EAU).

The prostate is a small gland the size of walnut that lies below the bladder is responsible for producing the clear fluid that carries sperm and grows slowly as men get older. Doctors say men above 50 years old are the most vulnerable to prostate ailments such as enlarged prostate (benign prostatic hyperplasia or BPH), acute and chronic prostatitis and prostate cancer.

Prostate ailments, particularly early malignant cancers, often remain undetected and recent studies show that timely diagnosis and medical therapy can prove to be beneficial in most cases. In a campaign to alert people of the need for timely intervention, national urological societies across Europe are holding an annual Prostate Awareness Day on September 14. The EAU is among the key organisations that are supporting pan-European efforts to clarify and bring to the public current issues and developments on prostate diseases.

This year, the EAU has defined a few key issues:

- Prostate cancer can only be cured when it is detected in its early stages, i.e. when the disease is organ-confined. The PSA test (a simple blood test) and PSA kinetics - PSA velocity or PSA doubling time - are helpful tools to recognise patients at risk for having prostate cancer.

- Cancers diagnosed at an early state of development do not always need treatment. Active monitoring is a reasonable option that still allows to initiate treatment during follow-up when needed.

- Hormonal therapy severely impacts quality of life but when needed, the side effects can be reduced by instructions about nutrition, physical activity and psychological support.

- Most men will develop benign prostate disease and many of them will develop complaints for which medical and surgical treatments are available and both are generally highly effective.

The EAU is distributing promotional materials such as posters and brochures in support of initiatives from other medical institutions. To access the promotional materials, please visit European Prostate Awareness Day: European Association of Urology.

EAU to launch online Prostate-Risk Indicator

The European Association of Urology (EAU) will soon launch an online prostate cancer risk assessment tool that will aid urologists, family physicians and men aged 55 years and older to properly evaluate the chance of developing prostate cancer.

Developed by the Rotterdam group of the European Randomized Study of Screening for Prostate Cancer (ERSPC), the Prostate-Risk Indicator is the first of its kind to predict the risks of men using a multivariate-based assessment. Screening for prostate cancer, now the second leading cause of cancer death in men in Western Europe and the US, involves three diagnostic tests which may indicate prostatic biopsy, namely: the digital rectal examination (DRE), the transrectal ultrasonography (TRUS) and the serum PSA (Prostate Specific Antigen) level.

According to Prof. Fritz Schröder, chairman of the ERSPC's Scientific Committee, the indicator serves to provide men with balanced information on risks and benefits of undergoing testing for prostate cancer and whether he should proceed to consult his family doctor.

The indicator is based on data gathered in the Rotterdam area study on the first 6,288 participants who underwent screening. The men in the study were tested for PSA and any abnormalities in their prostates were also evaluated by DRE and ultrasound. The indicator works in four assessment levels and is applicable to men aged 55 to 74 years old, but not to men of African-American descent.

Levels 1 and 2 are meant to inform men who want an initial risk assessment. At Level 2, a PSA determination will have to be added and the question whether to consult a urologist could be answered at this stage. At Level 3, which takes into account the DRE result and TRUS determination of prostate volume, more solid information is provided about the chance of having a positive biopsy. Level 4 is applicable to men who have a positive biopsy and the assessment includes biopsy related parameters that will enable both urologist and patient to make a decision whether to undergo active treatment or active surveillance.

The English version of the Prostate-Risk Indicator, owned by the Dutch-run SWOP (Stichting Wetenschappelijk Onderzoek Prostaatkanker or the Foundation for Prostate Cancer Research), will be licensed to the EAU which in turn will offer the tool on one of its official website pages. A Dutch version of the indicator has been completed and both the Dutch and the English versions will be officially launched on September 15, which marks the European Prostate Awareness Day.

European Association of Urology