It was just after 9 am when the first buses from various parts of the country, especially the northern region, parked around the Gulpilhares Stadium, in Vila Nova de Gaia. Several teams of players jumped out excitedly from the comfort of the benches, confronting the cold morning as they exited their vehicles. “You’re warming up now,” said someone in the group made up mostly of elderly people of both sexes, even though men were in the majority. They went to the pavilion where a new round of “walking football” (WF) games organized by Rutis was scheduled for last Tuesday morning (December 3rd). This aspect of football was designed for those who are no longer able to play it normally due to their age. The regulations say that you cannot run or lift the ball above the waist line and teams of six players must have at least one woman.
At 10 am, four teams, two in each half of the large pavilion attached to the stadium, were already starting the day. Meanwhile, members of the remaining teams were having fun around the playing rectangles, observing and joking with their opponents. More than a sport, WF is a party that promotes health, through active aging and social interaction. It was this concept that sparked the interest of the pharmaceutical company Johnson & Johnson Innnovative Medicine in an awareness campaign in partnership with Rutis, the Portuguese Association of Urology and the Portuguese Association of Prostate Patients.
Walking football was born in 2011, in England, and arrived in Portugal in 2017. It is a sport aimed at people over 50 years old. Teams are made up of six players without goalkeepers. The playing field is similar to futsal, with goals measuring three meters by one meter, often adapted. The ball cannot rise above one meter in height. Running is prohibited, a difficult rule to comply with and when broken, a free kick is awarded to the opponent. There are currently, in Portugal, 92 teams and around 980 players distributed across the continent and islands.
Raise awareness and prevent
“This modality is an excellent way to promote men’s health”, explains to O Jogo, Pedro Nunes, president of the urologists. “Physical activity and combating a sedentary lifestyle are part of the fundamental pillars of men’s health. These initiatives are ideal for raising awareness not only among men, but also health authorities about the importance of this type of pathology.” Nunes was one of the players who joined the Johnson & Johnson team that morning formed with some partners participating in the campaign. Another “athlete”, João Condeixa, Director of External Affairs at Johnson & Johnson Innovative Medicine, added explanations to the purpose of the initiative. “We want to raise awareness about prostate diseases, especially cancer, and it is precisely these people who we must alert to the need for early diagnosis.”
The association with the WF network of senior universities guarantees the pharmaceutical company to take the message to several tournaments throughout the country, involving, on average, around 100 people each day of competition. In each venue, information leaflets are distributed about prostate diseases and the symptoms to pay attention to. “In this campaign we have also developed two webinars that can be seen by any member of Rutis. There are 45,000 members, which demonstrates the importance of the partnership we are developing”, added the person responsible for Johnson & Johnson, also remembering the series of newsletters being distributed which highlight the different myths related to the prostate, from the issue of urinary incontinence to sexual dysfunction. “These are very deep-rooted myths that often lead to fearful patients not going to see a doctor.”
Postponing screening is the worst option. Arriving late to the doctor in many cases represents clinical conditions that are already very complex and, sometimes, unresolvable. Urologist for 25 years, Pedro Nunes confirms, but tries to reassure: “There are many prostate cancers that are even indolent. We currently have a range of diagnostic tests and treatments that we can offer men and that break the taboo that prostate cancer and its treatments put a man’s masculinity at risk. I think that we should be less and less afraid of this and, therefore, we encourage men not to fear these problems”. Silent by nature, prostate cancer is, at an early stage, a disease that goes unnoticed and without complaints, which is why it is important that any man, over the age of 50, seeks out a doctor to be diagnosed.
Play to beat cancer
Emanuel, 63 years old, now resting after the first walking football match ever held, is the prototype of the man that doctors and specialists are trying to raise awareness of the cause.
Standing next to the touchline, he is ready to exchange a few words on the subject. But it took convincing. “I’m not old yet and I don’t want to hear about the prostate. I feel fine.” For a moment, he feels some embarrassment. “Well, actually I’ve been noticing that I have to get up more and more often during the night to urinate.” The conversation had barely started when Emanuel’s wife approached curiously. As soon as he realizes the matter, he exclaims: “He’s scared!” Laugh. “I hope my husband is telling you about our conversations about the prostate and my repeated warnings to go to the doctor and get tested.” Maria, however, took the reins of the conversation and explains that she is trying to convince her husband, but reassuring him, at the same time, because she has been reading about the topic. She follows him whenever she can and was pleased to learn that Rutis’ games now have the support of the “Don’t Stay Out of the Game” campaign.
Just as women’s participation in walking football is important, whether playing or simply accompanying their partners, in monitoring men’s health they are often decisive, especially in the way of openly addressing problems. José Graça, vice-president of the Association of Prostate Patients, gives the example of public figures. “Women talk openly about breast cancer. Men don’t do that about the prostate. We see female public figures talk about breast cancer, but men are very reluctant to speak out on this issue.” João Condeixa also adds that “women are very used to being followed by doctors from an early age, which is no longer the case with men who normally only go to the doctor very late. It is necessary to break this cycle and also bring this issue into conversations between parents and children, to end the stigma that the man who complains and seeks help is not a man with a big h”.
PSA analysis is one of the fundamental pillars of prostate cancer screening. It should be done by all men over the age of 50 regardless of individual risk factors, namely family history and ethnicity.
The first-person experience
After also playing in one of the moments of the game between the prostate team, as the mixed formation from Johnson & Johnson was called, and the team that came from Guarda, José Graça talks about the experience he has had since he was diagnosed with this cancer 20 years ago. “Above all, men are afraid. We think that going to the doctor means discovering problems, when in reality it means confirming our health. I had this problem and I changed a lot. After the screening I started to be much more careful, luckily I went to the doctor in time. It is estimated that 85% of cases discovered in time are resolved, as was mine.” The patient association member warns of some symptoms that need to be paid attention to. “Very frequent urination at night could be a sign, but be careful: only doctors can and should diagnose health problems.” Graça remembers that there are symptoms that can only reveal an enlarged prostate, which does not necessarily mean more serious complications, as is the case with benign prostatic hyperplasia, which, in essence, is an enlarged prostate, or prostatitis, an inflammation of the gland. “It’s the detection of these signs that needs to be done.”
Get around myths
Do urinary complaints mean prostate cancer?
Prostate cancer does not cause urinary complaints or local complaints, at least in the early stages. Prostate cancer often has no symptoms and, when they do, it is a sign that the tumor is already in a serious and advanced state.
Do prostate diseases mean loss of erection?
Prostate diseases, whether benign or malignant, do not necessarily result in changes in erection, although some changes in the urinary system can alter sexual dynamics, desire or ejaculation;
No sex after prostate cancer?
It is currently possible to ensure that the majority of patients resume gratifying erectile function after a few months.
Do prostate surgeries lead to erectile dysfunction?
Benign tumors and prostate cancer are different diseases and the surgeries required are also different. Interventions carried out in cases of benign tumors are designed to alleviate urinary complaints and act away from erection mechanisms. In the treatment of prostate cancer, surgery requires the total removal of the gland, so there may be some interference with urinary continence and erectile function;
Does prostate cancer only appear at very old ages?
Four in ten cases of prostate cancer are diagnosed in men under 65 years of age. If you have a family history or belong to an ethnic group with a higher incidence of this cancer, you should start screening earlier – from 45 years of age.
Advanced line to attack
Prostate cancer is the fourth most common cancer in the world and the second most common in men. GLOBOCAN 2025, the database of the International Agency for Research on Cancer, estimates that, on average, per year, around 7,500 men are diagnosed with prostate cancer, but that the majority will not die from the disease. Still, each year, more than 2,100 men will die from prostate cancer in Portugal. PSA (Prostate Specific Antigen) analysis is the first step in an advanced line to diagnose and kick the disease. It is a simple blood test that measures the levels of protein produced by the prostate, which is essential for the screening and early diagnosis of problems, especially cancer. In addition to the PSA, imaging exams and physical evaluation of the rectal examination are also added, which allows the size, shape and texture of the prostate to be assessed, looking for nodules or hard areas that may indicate the disease, which is crucial for early detection, even when the cancer is asymptomatic.
Attacking early is the best strategy, as was also seen on the two fields in the Gulpilhares pavilion. It was just after noon when the referees’ final whistles sounded. Another Rutis walking football tournament had concluded. The “Don’t Stay Out of the Game” campaign has already started to raise awareness. Between healthy sports and conversations with friends, it is easier to eliminate fears, myths and lack of knowledge about prostate issues.
