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Prostate cancer is the most common malignancy in the male population of the Western world. However, modern oncology has changed the narrative: diagnosis no longer necessarily implies immediate surgical intervention. The so-called “calm strategy”, active monitoring and the approach of a multidisciplinary team are today essential tools that ensure not only survival, but also the quality of life of the man.

The PSA is a test that all men know. But is it always reliable? When should the test begin?

The PSA is a particularly useful pre-symptomatic screening tool, as long as it is interpreted correctly. An elevated value does not necessarily mean cancer, as it can be due to inflammation or benign prostatic hyperplasia.

Traditionally, screening is recommended after age 50. However, as the age of diagnosis is decreasing, modern guidelines recommend: 

• at 45 years:a baseline for all men.

• before 45 years: If there is a family history. 

It is worth noting that a PSA value of “4”, often considered the upper limit of normal, for a 45-year-old man may not be normal and require further investigation.

Many patients request immediate surgery. What is active surveillance and when is it recommended?

Prostate cancer often progresses very slowly and, in many cases, especially in older men or in very early stages, the disease can be clinically “innocent”. 

Active surveillance means that we do not proceed immediately with surgical or other invasive treatment, but we closely monitor the biological behavior of the tumor with regular tests. In this way, we avoid unnecessary interventions, which may be accompanied by undesirable effects, such as:

• urinary incontinence

• erectile dysfunction

The goal is to intervene only when and if the disease shows signs of aggression, preserving the patient’s quality of life for as long as possible.

What role does the interdisciplinary team play in the correct treatment decision?

Multidisciplinary treatment is crucial in prostate cancer, as the first treatment
conduction. Although this is a more limited recording, it can highlight significant rhythm disturbances, such as atrial fibrillation. In cases where the recording on the wrist is not sufficiently clear and sharp, repositioning the device higher on the wrist or rarely on the ankle may improve the quality of the signal, facilitating medical evaluation. 

2. Photoplethysmography (PPG – the “green light”)

The sensor on the back of the device emits green light, which penetrates the skin and detects changes in blood flow in the capillaries. This technology, known as photoplethysmography, allows for continuous monitoring: 

• the frequency and regularity of heartbeats,

• the burden of arrhythmias (such as atrial fibrillation episodes),

• indicators associated with increased stress or disturbances in the quality of sleep.

Telemedicine and remote areas

One ​​of the most important advantages of smartwatches is their contribution to telemedicine and the monitoring of patients living in island or remote areas. The ability to send data in real time allows for early symptom assessment and, in some cases, reduces the need for Holter monitoring, as the device provides continuous recording on a 24-hour basis.

The Limitations of Technology

Despite progress, there are clear limits to the use of wearables: 

• Blood pressure: Measuring blood pressure via a smartwatch cannot currently replace the reliability of conventional blood pressure monitor with cuff. For the correct diagnosis and regulation of hypertension, the classic method remains the appropriate one. 

• Psychological burden: Constant monitoring and excessive preoccupation with measurements may cause stress in some
  Cancer is the cause of almost ten million deaths annually, statistics that make it the leading cause of death worldwide, according to the World Health Organization, with breast, lung and colon cancer being among the most common types of malignancy.

  However, there is some good news, as the progress of medical technology and science paves the way for the emergence of new therapeutic options with better oncological results, less burden on patients and ultimately a longer life expectancy and better quality of life.

  20 years ago, almost 100% of patients diagnosed with cancer received only cytostatic chemotherapy, guided exclusively by the origin of the tumor, while having to deal with the serious side effects and sometimes uncertain results of this therapeutic model.

  Developments in treatment

  In the last two decades, there have been significant developments in cancer treatment research. Drug treatment has been enriched with two new weapons, immunotherapy and targeted therapy, which come to complement or even replace classic chemotherapy.

  Today, over 50% of our patients are treated based on immune biomarkers and molecular characteristics of the tumor, regardless of their origin, and we have excellent results.

  Immunotherapy

  Immunotherapy is a therapeutic approach that uses a patient’s own immune system to fight cancer. This can be done in two ways:

  • Stimulating or enhancing the immune system’s natural defenses to identify and destroy cancer cells
  • Preparing substances in a laboratory that simulate components of the immune system responsible for identifying and destroying cancer cells

  In recent decades, immunotherapy has become an important part of the treatment plan for certain types of cancer (such as melanoma, lung, breast, digestive and urinary tract cancer) and can be applied independently or in combination with other types of treatment.

  Targeted therapy

  Conventional chemotherapy works by destroying all rapidly multiplying cells, both healthy and cancerous. In contrast, targeted therapy uses drugs that are designed to “target” cancer cells, without affecting healthy cells in the body.

  This is achieved at the cellular level. Cancer cells need specific molecules, often in the form of proteins, to survive, multiply, and spread. These molecules are usually produced by the genes that cause cancer, as well as by the cells themselves.

  Targeted therapy is designed to interfere with these molecules by blocking their function, thereby slowing or even stopping the spread of cancer.

  The purpose of the above treatments is either to completely eliminate the cancer (cure) or to transform it into a chronic disease with which the patient can live.

  Always having the patient as a priority, the Athens Medical Group takes action and significantly improves the conditions of its services, with valid diagnosis programs, by upgrading the Day Hospital Department, by creating an independent clinic for solid tumors and hematology, by using radiological and radiotherapy latest generation techniques