Prostate cancer can also occur at 36. Dr. Dmitrii Grumeza, Urolog MedLife: “Unfortunately, oncological diseases are rejuvenating”

A diagnosis of urological cancer discovered too late can radically change the patient's chances of survival. “Cancer does not come with clear signs at first. Therefore, it is essential for men to perform the necessary analyzes from 40 years or from the first unusual events,” says Dr. Dmitrii Grumezaspecialist urologist at Hyperclinica MedLife Floreasca.

In his practice, Dr. Grumeza is facing five main types of urological cancer, in the order of frequency: prostate cancer, urinary bladder (or urothel), renal cancer, testicular cancer and penian cancer. For all, modern medicine can provide effective solutions, provided they are detected as early as possible. “In all types of urological cancer, the prognosis depends on the stage in which the disease is diagnosed. If it is detected early, the chances are very good, but if it reaches an advanced stage, things become complicated. Unfortunately, fear, shame or lack of medical education causes many patients to neglect their problems until they evolve.”

Prostate cancer: “The danger“It's the lack of symptoms

Prostate cancer is a major concern for men's health, being the most common type of urological cancer. According to studies in 2024, it represents about 15% of total cancers diagnosed in men globally.

The main problem represented by this type of cancer is that, in the early stages, it does not give symptoms to send the patient to the doctor. “Especially in young people – until 45 – there are not much symptoms. This is the danger of prostate cancer,” warns Dr. Grumeza.

The PSA test (specific prostate antigen), a simple blood test, remains the key instrument in the early detection of this condition. If in the past it is recommended to perform the PSA test after the age of 50, today the medical reality has changed. “Now it has the whole meaning to start screening from the age of 40. Unfortunately, the oncological diseases are rejuvenating,” says the doctor.

The urologist tells that he had patients with prostate cancer in the office of only 36 or 39 years – rare cases, but serious enough to change the rules of the game. “These cases keep them in mind, you can't forget them,” says the young doctor. That is why its main recommendation for all men is to go to the urologist for an initial assessment at 40. If the results are normal, the control can be repeated at 3-5 years. Otherwise, additional investigations are required.

Why is PSA so important

PSA is a blood test that measures the level of prostate specific antigen. Increasing its level may indicate the presence of prostate cancer, but also benign conditions, such as benign prostate hyperplasia. “If the PSA values ​​are successively high, we do a free PSA and, possibly, a multiparametric prostate MRI. It is only after the MRI, if the suspicion is maintained, we move on to the prostate biopsy,” explains the doctor.

According to the data of the National Institute of Public Health (INSP), in Romania, the incidence of prostate cancer is increasing, with about 5,000 new cases annually. And cancer projections in our country estimate that in the range 2020-2040, the incidence of prostate cancer will increase an increase of 21.8%.

The cancer of the bladder and the renal one – closely related to smoking

Urinary or urotal bladder cancer, the second most common urological cancer, is associated, in about 50% of cases, with smoking, according to the International Agency for Cancer Research (IARC). “In young patients, cases of bladder cancer I met especially for smokers or people exposed to toxic substances,” confirms from his own experience the urologist. Smoking also doubles the risk of kidney cancer, the same source shows. The lower the number of smokers, the less such cases will meet, the optimistic Dr. Grumeza.

In the case of urotal cancer (bladder cancer), often, the first sign is hematuria – the presence of blood in the urine. “At first it can be microscopic hematuria, detected only at the urine summary. In more advanced stages, the blood is visible,” warns the specialist. In these cases, the investigation of first intention is the ultrasound, followed by cystoscopy or computerized tomography, to confirm the diagnosis.

Renal cancer is another silent pathology. “Patients usually come for either hematuria or other non -specific symptoms. Therefore, the first investigation is also abdominal ultrasound, followed by CT,” explains Dr. Grumeza. In addition to smoking and exposure to toxic substances, age is a risk factor for renal cancer: it is more common in people over 45 years.

Romania has registered in the last decade an increase of 7% of the incidence of kidney cancer, compared to a decrease of 16% at the European Union level, according to the country profile on cancer 2025.

Testicular cancer predominantly affects young people

Unlike the other types of urological cancer that usually occur after 40-45 years, testicular cancer predominantly affects young men, between adolescence and 30 years. “Usually, patients come for a tangible, tougher tumor mass. My recommendation is for any boy to feel his testicles in the shower. There is nothing embarrassing to take care of your body,” says Dr. Grumeza.

Early detection often means saving life: “If it is detected in time, we do orhiectomy (no – surgical removal of the affected testicle) and the patient can lead an absolutely normal life.”

Penian cancer – the rarest, but with direct connection with HPV

Although very rarely, Penian cancer is a reality and is often associated with persistent infection with HPV (human papilloma virus). “Unfortunately, patients who develop this disease ignore the presence of condylomas or lesions on the penis for years,” says the urologist.

The diagnosis is made by biopsy, and for the assessment of the extension, MRI or Pelvic CT is recommended.

Symptoms ignored that can signal cancer

According to the urologist, the main symptoms that should send an emergency patient to the urologist are: hematuria (blood in the urine), urination disorders (weak jet, incomplete bladder emptying), pain or genital discomfort, tangible formations in the testicles, uk. Even if these symptoms do not always indicate cancer, their presence requires a medical consultation.

“We have had cases in which a simple routine control led to the detection of prostate cancer in completely asymptomatic patients,” says Dr. Grumeza. In these situations, the high PSA test, followed by additional investigations, led to diagnosis and treatment in early stages, with very high chances of healing.

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