Prostate Cancer

  1. Prostate Center
  2. Prostate Cancer and Treatment
Prostate Cancer and Treatment The most important risk factors for prostate cancer include age and family history.

Prostate cancer is the most common type of cancer in males. And it is the second most frequent among cancer-related mortalities. The risk of a healthy male getting prostate cancer in his life is approximately 17%. Meaning, one in every six males suffers from prostate cancer.

Prostate Cancer Risk Factors

The most important risk factors for prostate cancer include age and family history.

Age: The incidence of prostate cancer increases with age. Microscopic prostate cancer is detected in 50% of the males over the age of 70 and in almost all of the males over the age of 90.

Genetic factors: Genetic and environmental factors also antipyretics the onset and progression of prostate cancer.

The fact that prostate cancer is seen at different rates in different ethnic groups and more frequently in individuals with familial history of cancer.

A study has found that the incidence of prostate cancer increases in individuals immigrating to America from Asian countries in which the incidence of prostate cancer is low. Therefore, diet and environmental factors are believed to play a role in the development of prostate cancer. However, these factors are not exactly known.

For example, while there are studies showing that exposure to cadmium found in cigarette, saturated fat-rich diet, obesity and alcohol increase the risk of prostate cancer, it remains to be proven.

That said, these environmental factors must be taken into consideration for protection against prostate cancer as with other cancer types.

There are studies showing that dark-colored fruits and vegetables (e.g., tomato, carrot) containing "lycopene" decrease the incidence of prostate cancer. Also, soybean and omega-3-rich diet have been demonstrated to risk of prostate cancer.

Prostate Cancer and Treatment For individuals delaying screening test and routine follow-ups, the treatment for prostate cancer is also delayed.

Prostate Cancer Symptoms

Localized (prostate-limited) prostate cancer usually develops without causing any symptom. Rarely, symptoms such as burning, difficulty with urination, blood in urine and blood in semen may occur.

For individuals not undergoing screening test or delaying his routine follow-ups despite being diagnosed, the treatment for prostate cancer is also delayed.

In these cases, the disease starts to progress. Bone metastases may occur at advanced stages of prostate cancer. This may cause generalized bone pains, and sometimes, fractures.

How to Early Diagnose Prostate Cancer?

Today, there is no early diagnosis method revealing a healthy male will develop prostate cancer.

Increasing age, ethnicity and genetic predisposition are all established risk factors for prostate cancer. In light of these risk factors, patients should undergo tests for early diagnosis.

While in males without familial history of prostate cancer, the screening for prostate cancer is recommended after the age of 50, in males with familial history of prostate cancer, the screening for prostate cancer is recommended after the age of 45 due to the increased risk.

Screening methods are rectal examination (for prostate) and PSA assessment by blood analysis.

PSA Test and Prostate Examination for Cancer Diagnosis

Prostate cancer can be diagnosed early using PSA (prostate-specific antigen) test studied in blood sample. Early diagnosis of prostate cancer is important for having more treatment options.

PSA value increases inherently with the increasing age.

Normal range is;

For 40-49 years of age 0 - 2.5 ng/ml

For 50-59 years of age 0 – 3.5 ng/ml

For 60–69 years of age 0 – 4.5 ng/ml

For 70 years of age or older 0 – 6.5 ng/ml

Other than cancer, PSA may also elevate in benign prostate hyperplasia , prostatitis ,after sexual intercourse, after biopsy, after rectal prostate examination, in urinary tract infection, and after urinary tract interventions (catheter placement) and operations. Thus, while every PSA elevation does not mean cancer, low levels are not adequate to rule out cancer.

Prostate cancer is detected in one in 5 patients with values within normal range.

Therefore, for the diagnosis of prostate cancer, prostate examination can be considered together with PSA value. With this examination, it is possible to get an idea regarding the presence of prostate cancer without using PSA value. Several additional techniques can be performed for the diagnosis of prostate cancer in patients with suspected results.

Multiparametric MRI

In patients with suspicion of prostate cancer, three different parameters are assessed together and the focus with cancer suspicion in prostate can be detected using this imaging modality. Using one of these parameters (diffusion), the increase in cellular intensity of the body is detected. As cancerous cells are more intense, they emit higher signals. Using another parameter (perfusion), the tissue vascularization intensity is detected.

As cancerous tissues are perfused more, they have more vascularization and can be distinguished from the healthy tissue. Using another parameter (spectroscopy), chemical analyses of the cancerous tissue and healthy tissue are performed, and the tissues are distinguished based on the choline ratios produced by cell lysis.

Information regarding the presence of tumor in a patient is obtained by scoring these abovementioned parameters obtained using multiparametric prostate MRI.

Using multiparametric prostate MRI, it can be detected whether the tumor exceeded prostatic capsule and possible lymph node metastases. However, these MR images provide guiding for the patient's biopsy. In conclusion, the definitive diagnosis of cancer can only be made by biopsy.

MRI Fusion Biopsy

In this method, previous multiparametric MR images of the patient can be transferred to the ultrasound device for biopsy, and the exact localization of the tumor can be determined.

Thereby, the specimen is not collected “blindly” as with conventional biopsies, but directly collected from suspicious focus by “targeting”. As the exact localization of the tumor or suspicious focus can be determined, collecting less specimen may be sufficient instead of collecting many specimens.

Fusion biopsy can be applied via two methods:

One of this is transperineal method through the skin on perineal region. This method can be performed using general or local anesthesia.

Another one is transrectal method through rectum. This method can also be performed using local anesthesia.