Prostate Cancer

PROSTATE CANCER

The prostate is a gland that is part of the male reproductive system. It is located below the bladder. Cancer can develop as a result of uncontrolled growth of prostate cells. Prostate cancer is among the most common cancers in men, both in Türkiye and worldwide.

Prostate cancer is a disease that can be diagnosed early and treated. For early diagnosis, it is extremely important for men to have regular check-ups with a urologist from the age of 50, and from the age of 40 for those with a first-degree relative with prostate cancer.

Prostate cancer is divided into stages according to how it has spread. Staging evaluates whether the prostate tumor has advanced into surrounding tissues such as the bladder or rectum and whether it has affected the lymph nodes and bones.

Although the exact cause of prostate cancer is not known, the risk factors can be listed as follows:

• Age (older age, men over 55)
• Hereditary or genetic factors (people with a first-degree relative with prostate cancer have twice the risk of developing this cancer compared with others. Because they are considered high risk, they should see a urologist regularly from the age of 40)
• Environmental factors
• Race (most common in Black men)
• Diet (eating habits rich in saturated fats and red meat and poor in vegetables and fruits)

Prostate cancer usually develops slowly and causes no symptoms in its early stages; sometimes it may go unnoticed for years because it causes no symptoms. Nevertheless, the following complaints may occur:

• Frequent urination
• Getting up at night to urinate
• Intermittent urine stream
• Difficulty urinating
• Painful urination
• Blood in the urine
• Blood in the semen
• Pain during ejaculation
• Discomfort in the groin area
• Erectile dysfunction

If prostate cancer progresses or spreads before it is detected, other symptoms such as bone pain or bone fractures may also occur.

Diagnosis

• Prostate-specific antigen (PSA) blood test (PSA: a protein produced by cells in the prostate; the higher its level in the blood, the more advanced the prostate cancer is likely to be)
• Digital rectal examination
• Transrectal ultrasound
• Advanced PSA testing
• Computed tomography
• Bone scintigraphy
• Pathological examination (needle biopsy samples)
• Insulin-like growth factor (associated with increased prostate cancer risk)

Stages of Prostate Cancer

Staging in prostate cancer is based on the extent of the tumor's spread within and around the prostate.

• Size of the tumor
• Spread of the tumor within the tissues of the prostate or around it
• Spread of the cancer to the lymph nodes
• Spread to other parts of the body

EARLY DIAGNOSIS AND TREATMENT SAVE LIVES!

As with all cancers, healthy eating habits, physical activity and maintaining a healthy weight can reduce the risk of cancer.

Prostate Cancer Treatment

Different treatment options are available depending on the stage and characteristics of the disease.

Treatments for early-stage prostate cancer:

• Active surveillance (avoiding overtreatment of patients with clinically insignificant prostate cancer and monitoring them closely according to an active surveillance protocol)
• Watchful waiting (monitoring the patient without treatment)
• Surgery (radical prostatectomy, RP)
• External beam radiotherapy
• Brachytherapy (a type of radiotherapy used in cancer treatment)

Depending on the situation, older men may sometimes receive hormone therapy or drug therapy (chemotherapy) before or after radiotherapy. When deciding on the treatment, the person's general health, the stage and grade of the prostate cancer, the PSA level and the possible side effects of treatment are evaluated.