Prostate Cancer and Treatment

What is Prostate Cancer?

The prostate gland is a walnut-sized organ that is located under the bladder and surrounds the urinary tract called the urethra. Prostate cancer is a malignant tumoral formation that occurs as a result of abnormal and uncontrolled proliferation of these prostate gland cells. Cancer cells usually develop from the outer part of the prostate, which we call the crust. Prostate cancer is the second most common type of cancer in men. Men’s lifetime risk of developing prostate cancer is 17%.

What are the risk factors for prostate cancer?

Known risk factors for prostate cancer:

Advanced age: While it is very rarely observed under the age of 40, the risk of occurrence increases after the age of 50. The majority of patients diagnosed with prostate cancer are over the age of 65.

Ethnicity:Some races around the world have a higher incidence of prostate cancer.

Genetic predisposition . About 10% of prostate cancers are hereditary, and in 15% of those with prostate cancer, the disease is inherited from first-degree male relatives. The risk is increased if a first-degree male relative (father, brother, uncle) has prostate cancer. If there is only one person in the family with prostate cancer, the risk increases 2 times, and if there are more people, the risk increases 6-11 times.

Nutrition: The direct effect of nutrition on prostate cancer has not been proven. However, since a healthy diet reduces the risk of cancer, consuming unhealthy foods can directly increase the risk of prostate cancer.

From what age should be screened for prostate cancer?

When prostate cancer is caught at an early stage, treatment success is very high. Therefore, it should be diagnosed and treated before it is too late. It is a type of cancer that usually does not show symptoms in its initial stage. If there is a family history of cancer (for example, the father too..) from the age of 40, if there is no family history after the age of 50, every man should have a prostate examination and blood tests.

What are the symptoms of prostate cancer?

Recognition of the disease at an early stage is only possible with regular screening. Disease symptoms are uncharacteristic and can be seen in other prostate diseases. Common symptoms of prostate cancer include; Urinary difficulty, weak urine flow, frequent urination, blood from urine or semen, pain during ejaculation and erection problems are known to be counted. These symptoms may also occur in some other conditions, such as benign prostatic enlargement, inflammation of the prostate, and are not obvious signs of prostate cancer. If prostate cancer has spread beyond the organ, which often spreads to the bone, it can cause severe pain in the lower back, hips or legs. Apart from this, it can affect any internal organ and symptoms related to the organ it is involved in may occur.

How is prostate cancer diagnosed?

The diagnosis of prostate cancer can be made at an early stage and before the disease spreads, with the help of screening. There are two basic methods: PSA (prostate specific antigen) and digital prostate examination. If both or either is suspected, a prostate needle biopsy is taken to confirm the diagnosis. If the biopsy results in a tumor, the diagnosis is confirmed.

What is the PSA test?

It is a blood test. PSA is a protein produced by cells in the prostate, and the higher its amount in the blood, the more advanced prostate cancer may be. Not all PSA elevations mean cancer. For example; In some cases, such as inflammation of the prostate, insertion of a catheter in the urinary tract, prostate examination, PSA may also increase.

How is a digital prostate examination done?

The patient is placed in a suitable position and the size, shape, consistency-hardness of the prostate, and whether there is a tissue protrusion on it, which we call a nodule, are investigated with a finger from the anus.

How is a prostate biopsy done?

It is applied to patients at risk and suitable for prostate cancer. It is applied under local or general anesthesia. With the help of an ultrasound tip inserted through the anus, 8-12 pieces are taken from the prostate with a needle. The pieces taken are subjected to pathological examination and whether there is cancer in the tissues, and if there is cancer, the grade of the cancer (aggressiveness) is examined and reported.

What is prostate MRI?

In recent years, suspicious foci of prostate cancer in the prostate can be identified with MRI. Multiparametric prostate MR can identify cancer foci in the prostate, especially in patients who have had a biopsy before and have high PSA levels.

How is staging done in prostate cancer?

In patients diagnosed with prostate cancer, additional imaging methods are needed to find out whether the disease has spread outside the prostate (especially to the bones and lymph nodes). These;

  • Bone scintigraphy

  • PSMA PET-CT

  • Abdominal CT / Abdominal MRI

How is prostate cancer treated?

Patients who are definitively diagnosed with biopsy should be staged first. Different treatments may be preferred depending on the growth rate, degree, spread of the cancer, the general health status of the patient and the effectiveness of the treatment, as well as possible side effects.

Operation

Radiotherapy

Hormonotherapy

Chemotherapy

monitoring

What are the surgical treatment options in prostate cancer?

  • open surgery

  • laparoscopic surgery

  • robotic surgery

The aim of the surgical approach is to remove the entire prostate. The oncological and functional results of these three methods are similar to each other.

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