Prostate cancer signs-signs and diagnosis

Prostate cancer

It is the most common cancer in men after skin cancers. One out of every 6 men will get prostate cancer in their lifetime. Its incidence increases with age. The risk is increased in those with a family history of prostate cancer. Except for genetic predisposition, the exact cause is unknown. High-fat and protein diet, previous infections, smoking and exposure to other carcinogens increase the risk of prostate cancer.

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Symptoms-Signs and Diagnosis

In the beginning, there may be symptoms such as difficulty urinating and frequent urination, just as in benign prostate enlargement. In advanced stages, there may be hip and back pain, bloody urination. But it is mostly asymptomatic, so PSA measurement and digital rectal examination are required.

When digital rectal examination is performed during the controls that are recommended for every man over 50 years of age, it can be detected with suspicion by the presence of hardness and irregularity in the prostate or a high level of PSA measured only in the blood. If prostate cancer is suspected, a biopsy of the prostate tissue is required to confirm the diagnosis. It is done with the help of a finger-thick ultrasound probe inserted through the rectum and a needle attached to it. During the procedure, local anesthesia and, if necessary, sedatives are given to ensure that no pain is felt. Multiparametric prostate MR is performed in order to determine the location of the primary lesion with negative biopsy results and with continued PSA elevation or pre-biopsy. Subsequently, MR-ultrasound fusion biopsy, which combines the location of the lesion on MR and images on transrectal ultrasound, has been widely applied recently.

If the biopsy result is taken as prostate cancer, abdominal tomography or pelvic MR and bone scintigraphy or PSMA-PET are requested according to the physical examination findings and blood PSA level.

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