For the month of February, the Med-Hive community has chosen as its theme Cancer Awareness.

We continue to join this call, bearing in mind that "cancer" is a generic term that includes nosological entities (diseases), which have as a similar characteristic, the accelerated and uncontrolled multiplication of cells that invade and colonize tissues, organs, apparatus and systems, where it can occur in any part of the body.

In men, in general, the most frequent types of cancer are prostate cancer, lung cancer, colorectal cancer and bladder cancer. On this occasion, we will refer to prostate cancer.

We will begin this tour with basic aspects of anatomy (body structure). We will try to condense the information as much as possible, but it is important to familiarize yourself with it.

The name urogenital is used because the urinary and reproductive systems in men merge and overlap anatomically, by using a common organ, which is the urethra.

Structurally, the male urogenital system is made up of the scrotum, testicles, epididymis, vas deferens, seminal vesicles, ejaculatory ducts, bulbourethral glands, urethra, penis and prostate.

Each organ listed above fulfills a specific task and together, they work in harmony and synchrony for a vital function, which is to contribute to human reproduction, through the production, storage and transport of spermatozoa.

Below is a description of each structure (see diagram):

Scrotum: these are two skin sacs that surround and protect the testicles. They control the temperature in that area, so that it is lower than the body temperature.

Testes: two glands that produce gametes (sperm) and the sex hormone (tetosterone).

Epididymis: two spiral ducts located above each testicle. They store the spermatozoa so that they can mature and become motile.

Vas deferens: two ducts that facilitate the transport of sperm from the epididymis to the seminal vesicles.

Seminal vesicles: there are two seminal vesicles, which produce substances to nourish the sperm.

Ejaculatory ducts: these are two small ducts. They collect fluids and substances to form seminal fluid (semen). These ducts also carry semen from the testicles to the urethra.

Bulbourethral glands: two glands that produce a secretion (preseminal fluid) that lubricates the head of the penis during erection and ejaculation.

Urethra: passageway for urine during urination, preseminal fluid during erection and seminal fluid during ejaculation.

Penis: copulatory and urinary organ. It allows the passage of urine, preseminal fluid and seminal fluid.

• It is a gland located below the bladder (organ that stores urine), in front of the rectum (final part of the intestine) and surrounds the urethra.

• It produces a fluid (prostatic antigen) that protects the sperm and promotes their mobility.

• It functions as a valve during sexual intercourse, stopping the passage of urine and allowing the passage of pre-seminal fluid and semen.

• It protects against germs and bacteria from the outside, favoring the infrequency of urinary tract infections in men.

• It tends to grow as men age.

Prostate cancer is when the cells of this gland are altered in their growth and development, multiplying uncontrollably (malignant) and form tumors.

Some variants of prostate cancer grow slowly and may require minimal treatment, while other types are considerably aggressive and can spread very rapidly.

The occurrence and development of prostate cancer in men under 40 years of age is rare, but after the age of 50, the probability increases rapidly.

It is a type of cancer, with variable symptomatology and without a specific pattern to refer. Sometimes it is asymptomatic (no signs or symptoms) in patients, in others the signs and symptoms that occur are variable.

The signs and symptoms described are related and associated with urinary tract obstruction:

• Pain or burning to urinate.

• Need to urinate more often than usual, during the day and night, or predominantly at night.

• Involuntary loss of urine.

• Weak or interrupted urine flow (urine stream); with the need to strain to empty the bladder.

• Blood in the urine or semen.

• Inability to urinate.

_{Credit: Adrian Swancar Public domain}

• Post-urination dribbling.

• Pain on ejaculation.

• Onset of erectile dysfunction (difficulty maintaining an erection).

• Feeling of heaviness in the rectum or change in bowel habits.

• Persistent pain in the back, hips or pelvis.

• Weight loss for no apparent reason.

• Fatigue.

Keep in mind that the symptomatology described above may occur in diseases other than prostate cancer. For example, Benign Prostatic Hyperplasia (enlargement of the prostate associated with age) can produce similar symptoms as well as a bladder or kidney infection.

The ideal diagnosis is to detect prostate cancer before it generates symptomatology (signs and symptoms), that is, to find it early (incipient), before it spreads, and to initiate treatment in a timely manner.

Although there is no standard test to detect prostate cancer, this slow-growing tumor has methods for its early detection and they are:

• Prostate Specific Antigen (PSA) test:
  It is a blood test, which measures the level of Prostate Specific Antigen (PSA). This substance is produced by the prostate and its levels are usually elevated in patients with prostate cancer. However, other factors and other conditions can increase PSA levels.

_{Credit: Gustavo Fring Public domain}

• Digital rectal examination (DRE), the prostate is palpated through the rectal wall looking for nodules, irregularities, increased consistency, alterations in the borders or abnormal areas of the gland.

These studies must be linked to an adequate physical examination and clinical history that includes personal and family history, pathological antecedents, habits, lifestyles, among other aspects.

The treating physician will be the patient's expeditious guide and together they will conciliate through the pertinent informed consents, the need and approval of these and other studies such as biopsy (small sample of prostate tissue) or imaging (ultrasound, magnetic resonance), etc.

There are several types of behaviors to follow for the treatment of prostate cancer. It will be the patient together with his treating physician, considering the affectation, who will decide the course to follow. Some of the treatments that are carried out:

• Active surveillance: medical control and periodical prostatic antigen.

• External radiotherapy: radiation to the cancerous cells by means of a machine external to the body.

• Brachytherapy: through surgery, radioactive seeds or pills are introduced into or near the tumor to destroy the malignant cells.

• Surgery: operation to remove the prostate (prostatectomy) and the surrounding tissue.

• Radiotherapy plus hormone therapy.

• Chemotherapy: administration of special drugs to reduce the size of the cancerous tumor or eliminate it.

To date, there are no scientifically proven protective factors that guarantee the prevention of prostate cancer.

But it is possible to adopt healthy measures that protect your health in a comprehensive manner, such as :

• Balanced diet, with consumption of vegetables, fruits and whole grains; avoiding foods high in fat and refined sugars.
• Drinking between two and three liters of water a day.
• Develop physical activity, according to age.
• Avoid smoking and reduce alcohol consumption.
• Every man over 40 should have an annual medical evaluation specialized in the urogenital sphere and undergo PSA and DRE; especially those with a family history of prostate cancer.

In tune, practice self-care, pay attention to the signals your body gives off, such as warning messages through signs and symptoms.

Go regularly to your health controls, with specialized assessment and periodic diagnostic tests, only in this way there will be an early detection of cancer.

Para el mes de febrero, la comunidad Med-Hive, ha decidido como tema la Concientización sobre el Cáncer.

Seguimos sumándonos a esta convocatoria, teniendo en cuenta que "cáncer" es un término genérico que incluye entidades nosológicas (enfermedades), que tienen como característica similar, la multiplicación acelerada e incontrolada de células que invaden y colonizan tejidos, órganos, aparatos y sistemas, donde puede presentarse en cualquier parte del cuerpo.

En los hombres en general, los tipos de cáncer más frecuentes son el de próstata, el de pulmón, el colorrectal y el de vejiga. En esta ocasión, nos referiremos al cáncer de próstata.

Comenzaremos este recorrido con aspectos básicos de anatomía (estructura corporal). Intentaremos condensar la información al máximo, pero es importante que se familiarice con ella.

La denominación urogenital se utiliza, porque los sistemas urinario y reproductivo del hombre, se fusionan y se superponen anatómicamente, mediante un órgano común, que es la uretra.

Estructuralmente el aparato urogenital masculino, está formado por el escroto, los testículos, el epidídimo, los conductos deferentes, las vesículas seminales, los conductos eyaculadores, las glándulas bulbouretrales, la uretra, el pene y la próstata.

Cada órgano mencionado cumple una tarea específica y juntos, trabajan en armonía y sincronía para una función vital, que es contribuir a la reproducción humana, mediante la producción, el almacenamiento y el transporte de espermatozoides.