Speaking about prostate cancer is still surrounded by doubts, 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 a point that needs to be clear: prevention does not start with testing—it starts 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 early stages. This means that many men live with the disease without realizing it.

And this 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 are usually related to the urinary tract:

  • Difficulty starting or maintaining urinary flow

  • Weak or interrupted stream

  • Increased urinary frequency, especially at night

  • Sensation of incomplete bladder emptying

  • Presence of blood in urine or semen

In more advanced stages, the following may occur:

  • Bone pain

  • Unexplained weight loss

  • 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, mainly, early diagnosis.

Some measures have an impact:

  • Balanced diet

  • Regular physical activity

  • Weight control

  • Avoiding smoking

These strategies do not eliminate risk, but they reduce the likelihood of various chronic diseases, including some types of cancer.

Who is at higher risk?

The main risk factors are:

  • Age (mainly after age 50)

  • Family history of prostate cancer

  • Black men (higher risk and more aggressive forms)

This group deserves even more individualized attention.

At what age should prevention start?

This is one of the most discussed points, and here critical analysis is worthwhile.

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:

  • Starting at age 50 for men without risk factors

  • Starting at 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 individualized, after a conversation with a healthcare professional.

How does prevention work within the SUS?

In the Unified Health System, care begins in primary care.

The flow is simple:

  1. Clinical evaluation

  2. Identification of risk factors

  3. Discussion about the need for tests (such as PSA and digital rectal examination)

  4. Referral to a specialist, if necessary

In other words: the system provides the path, but it depends on the patient's initiative to seek care.

If I had to summarize it directly: the biggest problem with prostate cancer is not the lack of testing. It is the lack of informed decision-making.

Talking about the subject, understanding risks, and seeking evaluation at the right time completely changes the outcome.

Ignoring, postponing, or treating it as a taboo still comes at a high cost.

Dr. Rebeca Soares Andrade CRM-GO 39335