Main symptoms
- •Urinary symptoms: frequency, dysuria, retention
- •Weak urinary stream
- •Nocturia
- •Haematuria, haemospermia
- •Pelvic and perineal pain
- •Advanced stages: bone pain, weight loss
- •Sometimes asymptomatic (PSA screening)
Risk factors
- ⚠️ Age over 50
- ⚠️ Family history (×2-3)
- ⚠️ BRCA1/BRCA2 mutations
- ⚠️ African origin
- ⚠️ Diet high in animal fats
- ⚠️ Obesity
- ⚠️ Cadmium and pesticide exposure
Management and treatments
Depending on stage and age. **Low-risk localised**: active surveillance (PSA + MRI). **Localised**: radical prostatectomy (CHU Ibn Rochd, Al Kindy) or radiotherapy (25-40 sessions) or brachytherapy. **Hormone therapy** (leuprorelin, degarelix) for advanced. **Chemotherapy** (docetaxel) if metastatic. New drugs: enzalutamide, abiraterone. ALD = 100% reimbursed (INO, CHUs).
Prevention
PSA + digital rectal exam from age **50** (45 if family history, African origin, BRCA). Check every 1-2 years. Diet: limit red meat, favour vegetables, cooked tomato (lycopene), green tea, soy. Physical activity. Healthy weight. Avoid tobacco/alcohol.
Frequently asked questions
When to screen?+
Age 50 (45 if family history, African origin, BRCA). Shared decision with doctor.
Does high PSA mean cancer?+
No — adenoma or prostatitis possible. MRI + targeted biopsy confirm.
Does prostatectomy cause impotence?+
Risk 30-60% erectile issues, 5-15% incontinence. Pelvic rehab + further treatments improve outcomes.
Is active surveillance possible?+
Yes for low-risk localised cancers > 70 or heavy comorbidities. PSA every 3-6 months + annual MRI.