Speaking about prostate cancer is still surrounded by doubt, fear and, often, silence. But in practice, the biggest problem is not the disease itself—it is delayed diagnosis due to lack of information or avoidance of the subject.
Based on what is recommended by the Ministry of Health, the Unified Health System, the National Cancer Institute and the Brazilian Society of Urology, there is one point that needs to be clear: prevention does not begin with testing—it begins with the decision to take care of yourself.
Why is prostate cancer silent in the early stages?
In most cases, prostate cancer does not cause symptoms in the early stages. This means that many men live with the disease without noticing it.
And that is the critical point: when symptoms appear, the condition is usually already more advanced.
What are the most common signs and symptoms?
When present, symptoms tend to be related to the urinary tract:
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Difficulty starting or maintaining the urine stream
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Weak or interrupted stream
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Increased urinary frequency, especially at night
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Sensation of incomplete bladder emptying
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Presence of blood in the urine or semen
In more advanced stages, the following may occur:
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Bone pain
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Unexplained weight loss
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Persistent fatigue
A strategic point: these symptoms are not exclusive to cancer and may be related to benign conditions. But ignoring them is a mistake.
Is there a way to prevent prostate cancer?
Here it is important to adjust expectations.
There is no way to completely prevent prostate cancer. What exists is risk reduction and, above all, early diagnosis.
Some measures have an impact:
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Balanced diet
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Regular physical activity
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Weight control
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Avoiding smoking
These strategies do not eliminate risk, but they reduce the probability of various chronic diseases, including some types of cancer.
Who is at higher risk?
The main risk factors are:
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Age (mainly after age 50)
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Family history of prostate cancer
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Black men (higher risk and more aggressive forms)
This group deserves even more individualised attention.
At what age should prevention begin?
This is one of the most discussed points and here critical analysis is warranted.
The Ministry of Health and INCA do not recommend mass population screening for men without symptoms, precisely because of the risk of overdiagnosis and unnecessary treatments.
The Brazilian Society of Urology recommends:
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From age 50 for men without risk factors
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From age 45 for men at higher risk
In practice, this is not a contradiction—it is a difference in strategy.
The central point is: the decision should be individualised, after discussion with a healthcare professional.
How does prevention work within the SUS?
In the Unified Health System, care begins in primary care.
The process is simple:
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Clinical assessment
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Identification of risk factors
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Discussion about the need for tests (such as PSA and digital rectal examination)
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Referral to a specialist, if necessary
That is: the system provides the pathway, but it depends on the patient's initiative to seek care.
If I had to sum it up directly: the biggest problem with prostate cancer is not the lack of testing. It is the lack of informed decision-making.
Talking about the topic, understanding the risks and seeking evaluation at the right time completely changes the outcome.
Ignoring, delaying or treating it as taboo still costs dearly.
Dr. Rebeca Soares Andrade CRM-GO 39335