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Preventive examinations in urology and dermatology


In the 20th and 21st centuries, there has been a significant shift in the possibilities of diagnosing and treating diseases. Since the introduction of asepsis in surgical procedures, the discovery and further development of antibiotics, vaccinations, imaging methods, and pharmaceutical products for the treatment of a wide range of diseases have clearly led to an extension of people's lives. With a higher life expectancy, however, come greater demands on health. Oncological diseases (cancer) are perhaps the biggest concern for many people. Relying on the assumption that no one in the family has had cancer is not reasonable because not only genes play a role in the development of oncological diseases. Prevention aims to detect potential diseases in early stages or even prevent them.


Skin tumors and prostate tumors are the most common oncological diseases in the population. Melanoma can occur in people of any age. It is one of the most malignant tumors. Similarly, prostate cancer is the most common cancer in men, besides skin tumors. It mainly affects men aged 60-80 years, but men younger than around 50 years old are not exceptions either. Conversely, testicular cancer mostly affects men aged 18-50 years old. They can grow and metastasize very quickly, but they also respond very well to subsequent treatment. However, it is necessary to detect the disease in time.


The undisputed advantage in the diagnosis of skin tumors is that they appear on the skin and are visible. They are easily examinable. Unfortunately, the fundamental mistake is to rely on examination with the naked eye. Moles need to be examined with a dermatoscope. However, even this examination may not be sufficient nowadays. In this respect, examination with a common dermatoscope is certainly surpassed by examination with a digital dermatoscope. In this examination, the mole is photographed into the computer. The resulting image of the mole is viewed by the doctor on the monitor, greatly magnified, and clearly showing the mole's structure. The doctor can digitally highlight certain phenomena on the mole and thus better evaluate what risk the mole represents in terms of possible development into melanoma and, if necessary, indicate its removal in time. In the case of uncertain moles, the doctor can compare findings in repeated preventive examinations and timely detect changes in the mole that may be a precursor to the development of melanoma. I consider it important to mention that newly formed moles can also pose a risk, and changes in the size or color of a mole (darkening or fading of the mole, or even disappearance of the mole) are important. The experience and erudition of the doctor are crucial, so it is important for mole examinations to be performed by a dermatologist who specializes in this area.


The situation with prostate cancer is somewhat more complicated. Currently, as part of preventive examinations, a cancer marker called PSA (prostate-specific antigen) is determined from blood, which can indicate a higher risk of prostate cancer if elevated. However, this examination is not sufficient. There are also cases of prostate cancer where the PSA is not elevated. Therefore, for prevention, it is important for the doctor to examine the prostate through the rectum with their finger (digital rectal examination). There is no need to fear this examination. Based on these two factors, the doctor will determine the risk of prostate cancer. However, the value of PSA can be misleading because its elevation can result from a mere enlargement of the prostate, prostate inflammation (which you may not even be aware of), or urinary tract infections. Therefore, it is important for a qualified urologist to interpret the results of preventive examinations.


For testicular tumors, self-examination of the testicles is important, and whenever something seems wrong, you should schedule a specialized examination in urology, where the doctor will perform a professional examination, including ultrasound of the testicles. However, some men have difficulty interpreting self-examinations and prefer to leave it to the urologist, who will perform a preventive examination, including ultrasound.


Many people may wonder when they can go for prevention and whether the insurance company will cover it. In this regard, Decree No. 70/2012 Coll. clearly defines which preventive check-ups patients are entitled to and which health insurance companies cover from health insurance. Skin prevention at the dermatologist, examination with a digital dermatoscope, or preventive urological examination is not covered by public health insurance. However, some health insurance companies contribute to skin prevention as part of their benefits and reimburse patients for part of the costs retrospectively.


At our clinic, we specialize in preventive examinations. We operate a counseling service for pigmented nevi (moles), which provides first-rate examination with a digital dermatoscope, along with all the benefits that this examination brings. The examination takes 45 minutes, and all the high-risk moles will be documented. You will be recommended a further course of action and a date for a follow-up according to the findings. In urology, we specialize in the prevention and diagnosis of urological tumors. As part of preventive examination, in addition to the aforementioned examinations, ultrasound of the kidneys, urinary bladder, prostate, and testicles will also be performed. If there is suspicion of the possibility of cancer during prevention, we will indicate further examinations under health insurance, which will help detect this disease and indicate timely treatment.


When should you schedule a preventive examination? For dermatological prevention, schedule an appointment whenever you have a large number of moles on your body, when a new mole appears, when an existing mole enlarges or changes color (darkens or fades), when someone in your family has had melanoma, or simply when you feel you would like to undergo a dermatological preventive examination. For urological prevention, schedule an appointment whenever you feel you would like to undergo one - for younger individuals, mainly for the prevention of testicular cancer, for men over 45 for the prevention of prostate cancer, for men over 40 if there is a history of early-onset prostate cancer (before the age of 60) in their family, and for individuals with a family history of kidney cancer. Further recommendations will be provided by a doctor based on the results of the preventive examination.


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