Prostate cancer is the most common type of cancer in men in western countries, according to data from the American Cancer Society, and it accounts for about a quarter of all cancer cases. In our country, it is one of the most common types of cancer together with lung cancer in men. In recent studies, although a man’s lifetime risk of developing prostate cancer is between 15-20%, the risk of death due to this disease is reported to be around 3%. This is related to the fact that although prostate cancer is a common cancer, it has a very high chance of recovery, especially when it is diagnosed at an early stage and a correct treatment scheme is applied.
What are the Symptoms of Prostate Cancer?
Prostate cancer does not have typical early symptoms and it manifests itself only with complaints that occur in the advanced period. At this stage, it may not be possible for the person to get rid of this disease. For this reason, it is very important to detect the disease at an early stage when it is limited to the prostate, that is, it does not give any clinical symptoms. Even if men do not have any complaints, it will be possible to apply to a urologist once a year for prostate examination after the age of 50 only by raising awareness of this disease.
What are the Risk Factors in Prostate Cancer?
As with many types of cancer, no single agent or process responsible for this disease has been identified. However, there are three definite risk factors for prostate cancer. These are age, ethnicity, and genetics.
Prostate cancer incidence increases with increasing age. For example, only 2% of all cases are under the age of 50. Again, in epidemiological studies, it has been shown that prostate cancer has both familial inheritance and genetic aspects. For this reason, it is recommended that people with prostate cancer in their family should be screened at an earlier age and at more frequent intervals compared to the normal population. Ethnic origin is most common in the black race living in America, and lowest in East Asia. However, when a person of East Asian origin immigrates to America, it has been shown that the risk of prostate cancer increases again. This suggests that environmental factors other than ethnicity (diet with high fat and low fibrin) constitute a risk factor in the development of prostate cancer.
How Is Prostate Cancer Determined?
Measuring the blood level of a protein called PSA, which is secreted from the prostate and passes into the blood to a certain extent, and finger examination of the prostate from the anus are the first step in diagnosis. A high PSA level does not mean that it is absolute cancer, while a low level does not mean that there is no cancer. However, if findings suggestive of prostate cancer are detected in these two examination methods, tissue sampling with prostate biopsy is required to make a definitive diagnosis.
How Is Prostate Biopsy Performed?
Classical prostate biopsy is performed by entering from the anus with ultrasound guidance, and tissue samples are taken by blindly shooting 10-12 points of the prostate. However, with this method, only 70-75% of prostate cancer cases can be diagnosed, and a significant portion of cancer cases are missed. Repeated biopsies are recommended for patients who are not diagnosed with cancer after biopsy, but the suspicion of cancer continues, which creates a serious risk of infection, bleeding and pain.
The MR Fusion Biopsy Method, which has been developed in recent years, is a highly sensitive “smart biopsy” method that detects cancer-suspicious foci in the prostate and enables point shooting for these targets. This method has a very high accuracy rate (98%) in the diagnosis of prostate cancer, cancer cases are not missed and repetitive biopsies are not required as in standard biopsies.
What Are The Treatment Options?
Treatment selection in prostate cancer is made by considering the pathological characteristics of the tumour (stage, grade, etc.) as well as the age and general health status of the patient.
There are treatment options such as Surgical Treatment (Radical Prostatectomy), Radiation Therapy (Radiotherapy), Focal Therapies (HIFU), Hormone Therapy, Drug Therapy (Chemotherapy) or Active Follow-up, and considering the above-mentioned criteria, the patient, his family and the doctor together a decision made will be the best approach.
Surgical Treatment (Radical Prostatectomy)
Radical prostatectomy surgery is the procedure of removing the prostate completely and it is the most effective treatment method in the disease that has not spread. The 10-year survival rate of patients who underwent radical prostatectomy operation is over 90%. Therefore, radical prostatectomy is the most preferred among all treatment methods.
The location of the prostate tissue is very close to the nerves that provide sexual functions and the structures that provide urine retention. During this surgery, it is important not to damage the structures that provide urine retention and to protect the nerves that provide sexual functions.
The most important advantage of the operation performed with robotic surgery over open surgery is the more comfortable protection of the nerves that provide sexual functions and the structures that provide urine retention. Smaller incisions, less blood loss, and faster discharge are other advantages of robotic surgery compared to open surgery.
HIFU (High Intensity Focused Ultrasound)
Hifu is the process of destroying cancer cells in the prostate with the help of high intensity focused sound waves. With the ultrasound source placed from the anus under general anesthesia, the targeted points in the prostate tissue are destroyed and destroyed by the high heat energy generated by HIFU.
The HIFU method, which has been prominent as a non-surgical treatment method in prostate cancer cases in recent years, provides great advantages. Especially with the latest version of HIFU technology, only the diseased area of the prostate can be treated without damaging the surrounding tissues, so risks such as urinary incontinence or sexual dysfunction, which are among the possible side effects of classical surgery, are eliminated.
NOTE: The content of the page is for informational purposes only, please consult your doctor for diagnosis and treatment.