Prostate cancer is one of the most common cancer types in men and its frequency is 28 per hundred thousand in the world. According to the data of the American Cancer Society, it has been reported that the lifetime risk of encountering prostate cancer for men is 16.7%, and the risk of loss of life is 2.5%. One out of every 5-6 men has a lifetime risk of developing prostate cancer. While one person is diagnosed with prostate cancer every 3 minutes in the world, prostate cancer- related deaths occur every 14 minutes.
Prostate cancer is among the cancer types with high treatment success when caught at an early stage. Since it is usually an asymptomatic cancer in its initial stage, every man from the age of 40 should have an annual prostate examination and blood tests. Among the surgical applications that have a very important place in the treatment of prostate cancer, with the "da Vinci Robotic Surgery System", which is a revolutionary in the medical world, the patient not only has a cancer-free life, but also has important privileges in terms of quality of life. With robotic surgery, it is possible to better protect the nerves that provide urinary retention and the continuation of sexual life.
Where is the prostate gland located and what functions does it have?
The prostate, which is a part of the male reproductive system , is a gland that surrounds the outlet of the urinary bladder, just below the urinary bladder, in front of the intestines. The prostate, whose main task is to produce the liquid that protects the sperm and to keep the sperm in this liquid in a healthy way, also prevents urinary incontinence by squeezing the mouth of the bladder with the sphincter muscles. The prostate capsule, which is divided into three regions surrounded by a capsule, separates the prostate from other parts of the body.
What is Benign Prostate Enlargement?
As men age, the prostate gland also enlarges. This growth is called benign prostatic hyperplasia (benign enlargement of the prostate) and is usually seen in the transitional region of the prostate surrounding the urinary tract (urethra). An enlarged prostate can block the bladder or urethra, preventing the flow of urine. Men may experience frequent, painful, bloody urine or semen, and may experience stiffness and pain in the lower back. These symptoms may be the result of benign enlargement of the prostate or may occur as a sign of cancer.
What is Prostate Cancer?
Prostate cancer develops in the prostate, a small walnut-shaped gland that is part of a man's reproductive system. Prostate cancer occurs when cells in the prostate gland grow out of control. Cancerous cells first show uncontrolled growth and spread into the prostate. Then it extends into the capsule surrounding the prostate, pierces the capsule and spreads outward from the prostate. Prostate cancer, unlike benign prostate gland enlargement, does not originate from the center of the prostate, but from the region close to the capsule, away from the center. For this reason, urinary complaints in prostate cancer bother the patient at a later stage. During the period of growth and spread, it can spread to nearby organs, the lymph system and other parts of the body through the bloodstream.Prostate cancer has a slow course and the tumor can spread to bones and other organs by showing a very aggressive character.
Prostate Cancer Symptoms
Symptoms of prostate cancer may occur depending on the progression of the disease. In this respect, it is an insidious disease. Especially in the early stages, no symptoms and complaints may be seen. When prostate cancer symptoms appear, regular doctor check-ups are of great importance in the success of treatment, as the patient may lose some of their treatment chances.
Prostate cancer symptoms can be listed as follows;
Decreased strength in urine flow
Blood in the semen or urine
Pain during ejaculation
Discomfort in the groin area
These symptoms that herald prostate cancer can sometimes be an indication of benign prostate enlargement. Similar symptoms and complaints can be seen in benign prostatic hyperplasia (benign enlargement of the prostate) that develops due to enlargement of the prostate gland. If prostate cancer has spread to other parts and organs of the body, it may also give symptoms related to that area. For example; like bone pain if it has spread to the bone...
Prostate Cancer Risk Factors
The exact cause of prostate cancer is not known. Prostate cancer occurs when some prostate cells grow out of control due to genetic defects at the cell level and replace normal cells. It can then spread to surrounding tissues and, in advanced levels, to distant organs.
Prostate cancer causes and risk factors can be listed as follows;
Inherited or Genetic Factors
9% of prostate cancers are hereditary, and in 15% of those with prostate cancer, the disease is inherited from first-degree male relatives. The mutation in the BRCA2 gene, which is known to be associated with breast and ovarian cancers in women, has also been observed to increase the risk of prostate cancer in men.
Non-Genetic (Environmental) Factors
Environmental factors are more effective than genetic factors in prostate cancer . For example, a Chinese living in China has a much lower risk of developing prostate cancer than an American, while the same Chinese individual begins to have a similar prostate cancer risk to an American when they live in the United States for a long time.
Effect of Age
The risk of prostate cancer increases with age. Prostate cancer, which is rare in men under 50, is more common in men over 55. It is known that 1 out of every 6 men will be diagnosed with prostate cancer during their lifetime.
Race factor is also important in prostate cancer. Prostate cancer is most common in black men, followed by white men. It is also rarely seen in males living in Asia/Pacific islands.
The direct effect of nutrition on prostate cancer has not been proven. While previous research has shown that selenium and vitamin E can reduce the risk of prostate cancer, clearer results from subsequent research have shown that neither provides benefits. However, since a healthy diet reduces the risk of cancer, consuming unhealthy foods can directly increase the risk of prostate cancer.
Prostate Cancer Diagnosis
If there is a possibility of prostate cancer based on the results of the patient's PSA blood test and/or rectal finger examination, the suspicion must be confirmed by biopsy. Prostate cancer is diagnosed as a result of one or more biopsies of the prostate gland. The biopsy determines the patient's existing benign prostatic hyperplasia, cancer, or other existing medical problems. During the biopsy, a few small samples are taken from the prostate tissue by entering the rectum with the help of a needle. These tissue samples are examined under a microscope to detect cancer cells.
The following scans are performed to diagnose prostate cancer;
PSA Blood Test
The level of PSA in the blood of a patient diagnosed with prostate cancer is equal to the amount of cancer in his body. PSA (Prostate Specific Antigen) is a protein produced by cells in the prostate, and the higher the amount in the blood, the more advanced prostate cancer is. At the same time, the PSA level is extremely helpful in following the success of the given treatment or in determining the post-surgical reinstatement.
It is one of the most widely used prostate cancer screening tests. By checking the patient's prostate with a finger, abnormalities are checked according to its size and characteristics.
During transrectal (rectal) ultrasonography, a small probe is inserted into the rectum. The probe emits high-frequency sound waves that produce echoes and bounce off the prostate. Using these echoes, the computer creates the picture with a sonogram, which can show abnormal areas. Research continues that transrectal ultrasonography reduces the vital risk of prostate cancer.
Enhanced PSA Testing
Development of the PSA test is ongoing for more specific results on pancreatic cancer. The clearer the PSA results, the less the patient worries and the less need for other tests.
Insulin-Like Growth Factor
Insulin-like growth factor (IGF) is an important growth and antiapoptotic (cell death-inhibiting) factor for cancer cells in many cancer types. Insulin-like growth factor binding protein-3 (IGFBP-3) stimulates IGF-1-independent apoptosis (cell death) and inhibits growth. Recent research indicates that elevated IGF-I and low GFBP-3 levels, or both, are associated with an increased risk of prostate cancer.
Early Detection of Prostate Cancer
In prostate cancer, as in other cancers, mortality rates can be reduced by early diagnosis. Another benefit of early diagnosis is that side effects related to prostate cancer treatment are kept to a minimum. To detect prostate cancer early, blood test measuring the protein level known as Prostate Specific Antigen (PSA), digital-rectal examination and/or transrectal (rectal) ultrasound methods are used. However, screening in prostate cancer is a complex and controversial issue, and sufficient evidence has not yet been reached that it reduces the vital risk factor. Moreover, all screening tests carry some risks. It is important to discuss the uncertainties of benefits and possible harms with a specialist doctor before prostate cancer screening tests.
Prostate Cancer Stages
Prostate cancer is divided into five stages according to its spread. The most important criteria in staging are whether the prostate tumor has spread to surrounding tissues such as the bladder or rectum, and whether it affects the lymph nodes and bones. The Gleason score, which indicates the tumor grade, and the PSA level are also important for determining prostate cancer stages.
Prostate Cancer Treatment
In the treatment of prostate cancer, different treatments may be preferred depending on the cancer's growth rate, spread, general health status of the patient and the effectiveness of the treatment, as well as possible side effects. If prostate cancer is at an early stage, follow-up rather than immediate treatment may be recommended. Surgery is one of the most common and effective treatment methods in prostate cancer. Robotic, laparoscopic and open surgical methods are available, and each surgical method should be preferred according to the patient. The aim of the surgical approach is to remove the entire prostate. In appropriate cases, the nerves around the prostate that help erection in the penis can be preserved.
The preferred surgery in early stage prostate cancer is laparoscopy. Again, prostate radiation therapy (radiotherapy) in the early stage is an important treatment option in suitable patients. Laparoscopic surgery provides the patient with a comfortable operation and has high success rates in terms of cancer control. After these operations performed through 4-5 small holes, the patient has less pain and can return to his daily activities in a short time. Since there is no surgical incision, these surgeries also provide cosmetic patient satisfaction to a great extent. Major advances in the diagnosis and treatment of prostate cancer are making this disease a feared disease.
Treatment By Prostate Cancer Stages
If prostate cancer is in stages 1 and 2, it can be treated with surgery or radiotherapy. Then, hormonal treatment can be started or action can be taken according to the patient's condition. In the treatment of prostate cancer, the third stage plan should be either surgery or radiotherapy. According to the studies, 5 months of chemotherapy after surgery and radiotherapy can increase the life expectancy in prostate cancer.extended has been determined. In patients with a PSA greater than 40, lymph node involvement, or a Gleason score greater than 7, chemotherapy should be considered in addition to hormonal therapy after surgery or radiotherapy. The main treatment for stage 4 prostate cancer should be hormonal therapy. With hormonal therapy, the patient's ovaries can be removed surgically or the male hormone can be blocked with injections every 1-3 months. After 2010, there have been many innovations in the treatment of stage 4 prostate cancer. The life expectancy of some drugs and chemotherapy in the 4th stagehas been shown to increase markedly. In addition, some agents have been developed that are used in cases where traditional hormone blocking drugs do not work. Although the prostate cancer vaccine was tried, it did not show the expected effect. The efficacy of radiotherapeutic agents has been demonstrated only for patients with bone metastases. In addition, treatments with PSMA combined with radioactive Lutetium in prostate cancer are also possible in Turkey.
Da Vinci Robotic Surgery
Prostate cancer surgeries performed with the Da Vinci Robotic System are especially important for the patient not to experience loss of sexual function after the surgery. For the experienced laparoscopic surgeon, the arms of the da Vinci robot with 3D, high definition quality and 10-20 times magnification, 3D and 540° movable arms can easily protect the nerves and veins in the body and even in the most difficult places, and can remove the cancerous prostate and radically remove the prostate. provides a cure.
FREQUENTLY ASKED QUESTIONS ABOUT PROSTATE CANCER
What is the prostate gland?
The prostate gland is part of the male reproductive system. The gland makes fluid that mixes with semen during ejaculation. This fluid helps protect sperm.
Who is at higher risk of prostate cancer?
Men over the age of 55 are more prone to the disease. The risk of developing prostate cancer increases as you get older. As a matter of fact, about 60 percent of prostate cancers occur in men over the age of 65. Other risk factors for prostate cancer include:
Ethnicity (black men have the highest risk)
Family history of prostate cancer
What are the complications of prostate cancer?
Some aggressive cancers spread quickly beyond the prostate. (metastasize). Prostate cancer most often spreads to the bones and lymph nodes. It can also develop in the liver, brain, lungs, and other organs.
What is prostate ultrasonography examination?
Ultrasonography is a diagnostic method used in the examination of internal organs by making use of sound waves with a frequency that is too high for the human ear to hear. The device consists of a console containing a computer and electronic components, a video display screen and a probe used to scan the body. Ultrasonographic examination, which is used to detect benign and malignant growths of the prostate, is called Trans Abdominal Ultrasound (TAUS) if it is performed through the anterior abdominal wall, and Trans Rectal Ultrasound (TRUS) if it is performed through the anus.
How is Prostate Ultrasonography Examination Performed?
In the TAUS procedure, the ultrasound probe is placed on the abdomen, and the prostate is visualized with the strengthening effect of the ultrasonography waves. The bladder must be full for this procedure. It is sufficient to drink 1.5 liters (approximately 6 glasses) of water 1.5 - 2 hours before the procedure. In the TRUS procedure, the prostate is visualized through the rectal canal with a sterile coated special ultrasonography probe. Since this process requires bowel cleansing; It is necessary to drink a laxative after dinner the day before and to empty the bladder just before the procedure.
What are the benefits of prostate ultrasonography?
An important advantage of ultrasonography in prostate control is that it does not harm the patient. Its easy application, low cost and no ionizing radiation are other obvious advantages. In the transabdominal ultrasound procedure, the size, weight and anatomical shape of the prostate are determined. In the transrectal ultrasound procedure, the tissue details of the prostate are also evaluated. During this procedure, blood supply of suspected cancerous areas can be evaluated with Color Doppler and Power Doppler methods, and biopsy can also be performed in the same session with pre-preparation condition. Ultrasonography examination can provide detailed information about the patient's prostate to the physician, assist in reaching the correct diagnosis and planning the appropriate treatment.
What precautions can be taken against prostate cancer?
There are effective measures that can reduce the risk of prostate cancer, from healthy and proper nutrition to lifestyle. Lycopene, which gives color to red fruits such as tomatoes, watermelon, rose hips, pink grapefruit, and papaya, is a powerful antioxidant. There are many studies showing that isoflavone, which has anti-inflammatory properties, provides protection against prostate cancer. Consuming pomegranate, especially pomegranate juice, keeps the PSA level under control and has protective properties against prostate cancer. In addition to its anti-inflammatory properties, turmeric is a great protector against prostate enlargement and prostate cancer due to the curcumin it contains. On the other hand, there are various studies that show that regular physical activities also reduce the likelihood of developing prostate cancer.
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