Almost 17 Swiss citizens on average are diagnosed with prostate cancer every day. Overall, about 7,100 people end up being treated for this neoplasm every year; in Ticino there are almost three hundred cases found. But beyond the statistics there is a world made up of medical research, the arduous achievements of science, work, surgical interventions and therapies, suffering and hopes. «But above all of prevention. Because the culture of prevention is the first cure for this type of cancer. It is thanks to prevention that many human lives can be saved», explains Professor Andrea Gallina, head of the Urology Service of the Lugano Regional Hospital and professor of urology in the Faculty of Biomedical Sciences of USI, Institute of Human Medicine. Gallina is part of the multidisciplinary team of the Prostate Center of Italian Switzerland which two years ago obtained the «Certified European Prostate Cancer Centre», issued by Oncozert of the Deutschen Krebsgesellschaft (DKG).
The certificate is a guarantee
«The certificate, which is confirmed every year through the verification of precise standards, is a guarantee for the patient, because it certifies that at the Ente Ospedaliero Cantonale in Ticino one can be assisted according to international protocols, therapeutic offers and a high internationally recognized level. Ticino residents therefore do not need to go to clinics or hospitals in other cantons or other countries. Furthermore, here the doctors speak Italian and this is an advantage. So much so that patients of Italian mother tongue also arrive from Zurich. Evidently they feel reassured even when they have to face psychologically delicate and clinically complex situations», underlines Dr. Ursula Vogl, EOC medical oncology department head and clinical manager of the Prostate Center of Italian-speaking Switzerland.
A bit like women who periodically perform regular checkups such as mammography or gynecological examinations
The quality of care and diagnosis in Ticino is therefore a reality. Not from today, however. «But – adds Gallina – a taboo must still fall on the altar of reasonableness. Because anyone aged 50 or even younger must understand that monitoring our facilities is important. We must understand if the disease is present as there are often no specific symptoms. Furthermore, once its presence has been ascertained, we need to know if we will find a small feline, a kitten, or if we will find an aggressive tiger. Many men, on the other hand, do not undergo the tests, which start with a blood test, the PSA, due to a cultural issue. Instead to discover neoplasms in their first phase, in reduced dimensions and without a metastatic diffusion, that is when it is still possible to cure them, it is necessary to undergo our tests. A bit like women who periodically perform regular check-ups such as mammography or gynecological examinations”. Gallina underlines another aspect: «We also place a team of clinical psychologists at the disposal of patients, they are fundamental professional figures because learning that you have a tumor is a difficult shock to process, but you still need to find mental energy to move forward, to react and face the course of treatment”.
Familiarity is often a factor
Checks should always be done, especially if you have a family member who has already had a tumor of this kind. In this case it is better to anticipate them, starting from the age of 45. In principle, regular check-ups should begin at the age of 50, as all the European studies say «There is nothing complicated – Gallina insists – you do a blood test, the PSA, a urological examination with palpation of the prostate. I understand, as I was saying, that culturally there is often a certain aversion to these exams but the “annoying” parts last 15 seconds and are not medieval torture. These checkups can save lives with timely diagnosis. We also offer genetic counseling, since prostate cancer has a hereditary component in about 12% of cases». On this front, the EOC Center can count on the contribution of the IOR (Institute for Cancer Research) of Bellinzona, where there are various specific study and research groups.
Periodically, to bring down the fear barrier, the EOC launches awareness campaigns. According to the Center’s approach, cancer must be fought with a global approach, in all its facets, fixing the diagnosis and planning treatments, taking into account how it can develop and the possible variants. But this is only possible, as happens in Ticino, with integrated and personalized care for each patient. «Today, multidisciplinarity is important, which we put into practice with a team of specialists: urologists, radiotherapists, specialized nurses, psychologists, pathologists and radiologists, all with particular experience in prostate cancer. Then there is robotic surgery which hits to the millimeter, reducing side effects and radiotherapy is also increasingly precise, eliminating tumor cells», explains Dr. Vogl. The Center can count on advanced tools such as, for example, the Da Vinci Xi robot, new generation magnetic resonance equipment, a specific CAT-PET for prostate cancer. Gallina also insists on the concept of multidisciplinarity: “In our weekly meetings – he says – at least twenty people are often connected to discuss and compare current cases, there is an exchange of experiences, advice, stimuli that allows us to offer the patient the most suitable treatment path for your characteristics and needs, providing the opinion of internationally recognized prostate cancer experts”.
90% of patients five years after diagnosis survive and in general not only making the disease chronic but with a good quality of life and this is important
Lately there have also been cases of young people who have been found to have prostate cancer. «However, they are very rare cases – explains Dr. Vogl – which come to our attention only thanks to timely checks. For some patients, the additional risk is not only determined by relatives who have had prostate cancer but also by a family history of breast cancer. In the face of a “family syndrome” a culture of prevention has therefore grown which leads to sensitizing everyone, from the family doctor, to relatives and patients, towards an early diagnosis. We see it from our case history».
The cure rate
Fortunately, thanks also to these awareness policies, the percentage of recovery from this neoplasm has grown. Recent studies by the National Cancer Institute state that 90% of patients survive five years after diagnosis and in general not only making the disease chronic but with a good quality of life and this is important. «But above all – explains Dr. Vogl – we are managing to tailor an increasingly personalized treatment to each patient. Today, with research that has progressed, with robotics that allow you to carry out precise and less invasive operations, with nuclear medicine that has brought new discoveries, we have made good progress. Furthermore, even when radiotherapy is used it no longer causes damage to the organs close to the one affected by the tumor, we can really avoid aggressive treatments ».