6 February 2019 - 15h55
On the occasion of World Cancer Day, on Monday 4th February, the Princess Grace Hospital (CHPG) organised two conferences: the first on breast cancer, and the second on prostate cancer that took place last night at the Lycée Technique et Hôtelier de Monaco. The objective was to raise awareness on this subject, often feared by men.
Last night, the first rows of the auditorium of the Lycée Technique et Hôtelier were almost full. About forty people were eagerly awaiting the conference. Six experts in specific fields debated with an attentive audience. “Why talk about this cancer?” asks Dr. Georges Garnier, oncologist, “It is the most common cancer in men, especially in people over 50 years old.” There have been about 48,000 new prostate cancers every year in France, including about 8,300 deaths. Georges Garnier explained that: “Despite the progress in oncology, there are still many deaths.”
What do we really know about the prostate?
A taboo organ in the male conscience, the prostate has a mechanical functionality on continence and urinary comfort, as well as an essential role in sexuality, “40% of ejaculation comes from the prostate” notes Dr. Xavier Carpentier, urologist, before stating that “without the prostate we would not exist!”
Checking the health of the prostate starts with a blood test. Doctors look for an activity marker: Prostate Specific Antigen or PSA. This substance is naturally produced by the prostate gland and is present in the blood of all men. When the gland is abnormal, the concentration (level) of PSA in the blood rises. The PSA test therefore reveals a possible prostate abnormality. But this anomaly does not necessarily mean cancer, other factors can cause this rise in PSA. Xavier Carpentier explained that “there is no single test for this cancer. To establish a diagnosis, the doctor must carry out a digital rectal examination (DRE).”
DRE: Prudishness and anguish
Men are often apprehensive of DRE, which is an essential part of cancer detection. “It is a very simple examination, but very important in the screening process. Despite technical advances in imaging, finger sensitivity remains the best way to define the elasticity of prostate tissue,” says Xavier Carpentier. Indeed, thanks to this method, nodules as well as the evolution of prostate tissue can be observed, which allows a diagnosis to be made.
What are the treatments?
The third pillar that is essential for diagnosis is the MRI used to guide biopsies. Dr. Jean Michel Cucchi, radiologist explained: “Thanks to technological advances in imaging, we can avoid surgery for small nodules.” Another method is the PET nuclear medicine technique. This method makes it possible to monitor and anticipate the evolution of prostate cancer. It is particularly recommended for detecting possible recurrences after treatment, for example when the PSA level increases again unexplained. “Thanks to PET, we have metabolic images of the lesion and can observe lesions that remain invisible to MRI,” explained Professor Marc Faraggi. As for radiotherapy, a technique that uses ionizing radiation to destroy cancer cells, radiologist Dr. Nicole Guiochet explains, “Our machines are so precise that we are now able to avoid irradiating healthy organs.”
“We must be able to provide a tailor-made treatment”, said Dr Hervé Quintens, a surgeon-urologist, the objective of doctors is not only to treat patients, but also to guarantee a quality of life. The CHPG now has ‘surgical robots’ at its disposal. The precision of the interventions helps to prevent urinary incontinence and erectile dysfunction.
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