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Prostate Cancer 

 

What is Prostate Cancer?

 

     Prostate Cancer is an uncontrolled proliferation of cells in the prostate gland. These malignant cells can multiply, grow and spread to organs and tissues outside the prostate. It is the most common type of cancer in men. Although it is generally seen in later ages, it can occur even in the 30s, especially if there is familial predisposition. For this reason, we advise everyone who has a family member with prostate cancer to go for an annual urology check from the age of 35. If there is no familial predisposition, we suggest the cut off for this age limit to be 45.

 

What are the symptoms of prostate cancer?

 

There is no specific symptom of prostate cancer. The symptoms of prostate cancer are almost identical with benign prostate enlargement. These include difficulty in urination, slow voiding of urine, blood coming from urine, incontinence, weight loss, night sweats, weakness, loss of appetite, abdominal pain, and bone pain.

 

How is prostate cancer diagnosed?

 

The most important point in the diagnosis of prostate cancer is to perform regular routine controls. Because most prostate cancers are diagnosed without any complaints. PSA blood test and digital prostate examination should be performed for diagnosis. In case of any abnormality, a MRI of the prostate may be needed and furthermore,a prostate biopsy may be performed with a needle. This is also a process that will provide your urologist with information about how aggressive the cancer cells may be. If malignant cells are not observed after biopsy; this does not mean that there is no risk of prostate cancer in this patient. In some patients, 2nd or 3rd biopsies may be required during follow-up.

 

Does PSA increase indicate prostate cancer?

 

PSA is a blood test developed to diagnose prostate cancer. The normal limits of PSA may vary for age groups. PSA elevation may have many causes other than prostate cancer. Urinary tract infections are the leading ones. Not everyone with a high PSA is prostate cancer. However, if the PSA value is high, it must be proved that this is not caused by cancer. One of the essential parts of the annual urology control is to perform this test.

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How is Prostate Needle Biopsy Procedure Done?

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It is a small biopsy performed under ultrasound guidance in people with suspected prostate cancer. It can be done with local or general anesthesia. After imaging of the prostate with ultrasound, biopsies are done with a special needle. The gold standard method of this procedure is 'Prostate Biopsy by Mapping', which contains at least 16 parts. In this process, by removing parts from all parts of the prostate, the possibility of skipping an existing cancer is minimized. But if there is a particular area that is suspected to be malignant, which is usually diagnosed by a prostate MRI, than fusion ( targeted) biopsies may be the best option.

 

How is prostate cancer treated?        

 

A very important point to know about prostate cancer is that it is a cancer that progresses very slowly compared to other cancers. Thus, the average life expectancy of the patients can be 15 years and over even without any treatment. Therefore, with early diagnosis and appropriate treatment, most of the patients can live with this disease without affecting their normal life expectancy. In the treatment, first of all the stage of the disease should be understood. Treatment of a disease inside the prostate and a disease spreading outside (metastatic) is very different. Another important point is the Gleason Score, which shows the aggressiveness of tumor cells to be indicated on the biopsy. If the Gleason score is 3 + 3 = 6, we think that a cancer with a better prognosis is expected and if the highest score is 5 + 5 = 10, we think that we are facing a more aggressive tumor. Even following the disease may be an option in the treatment of prostate cancer. However, the gold standard is radical prostatectomy. In this surgery, the prostate is completely removed. The technique of surgery may vary. Nowadays, open surgery, laparoscopic surgery, robotic surgery options well established. In addition, there are treatment options such as Brachytherapy (a type of radiation therapy), Radiotherapy, Hormonotherapy (slowing down the disease by reducing male sex hormone) and Chemotherapy. The most suitable one is determined by the patient's condition.