Prostate cancer is the most common type of cancer in men. It is the second leading cause of cancer-related mortality in men. The prostate is a glandular organ found in men, approximately the size of a walnut, located below the bladder, and producing various secretions for reproductive functions.
This disease, which is generally seen in individuals over the age of 65, may not cause any symptoms in its early stages. However, if left untreated, it can grow over time and cause compression of the urethra. In such patients, certain complaints related to urination may occur.
In some patients whose diagnosis and treatment are delayed, cancerous tissues may not remain limited to the prostate and may spread to surrounding tissues. So, how is prostate cancer diagnosed? You can read our guide for diagnosis and treatment methods.
How Is Prostate Cancer Diagnosed?
Today, there is no early diagnostic method that can definitively show that a healthy man will develop prostate cancer. The methods used for screening purposes are digital rectal examination ((DRE) and PSA measurement through a blood test.
PSA Test and Prostate Examination in the Diagnosis of Cancer
With the PSA (prostate-specific antigen) test performed using a blood sample, prostate cancer may be detected at an earlier stage. Early diagnosis of prostate cancer is important in terms of increasing treatment options.
PSA levels may be elevated not only due to cancer but also due to benign prostatic hyperplasia – BPH (prostate enlargement), prostatitis (prostate inflammation), sexual intercourse, biopsy, rectal prostate examination, urinary tract infection, urological interventions (e.g., catheterization), and after surgeries.
For this reason, a high PSA level does not necessarily mean cancer, just as a low PSA level may be insufficient to rule out cancer.
Therefore, in the screening and diagnosis of prostate cancer, the PSA test can be supported by prostate examination. As a result of these examinations, some additional tests may be performed for the diagnosis of prostate cancer in patients suspected of having prostate cancer.
Multiparametric MRI
It is an imaging method that can support the diagnosis in patients with suspected prostate cancer. Cancerous cells and tissues have a different appearance from healthy tissues due to certain characteristics such as increased cell density and blood supply.
In this way, they can be visualized with multiparametric MRI. In addition, with multiparametric MRI, it can be determined whether the tumor has extended beyond the prostate capsule and possible lymph node metastases can be detected. These MRI images can also be used as a guide during prostate biopsy.
Prostate Biopsy
The procedure of taking a tissue or cell sample from any part of the body for examination under a microscope and performing various tests is called a biopsy.
In prostate biopsy, samples are taken from different regions of the prostate. In standard prostate biopsy, systematic biopsy samples are obtained from the prostate with the help of a special device placed in the rectum under local anesthesia. Later, pathological examinations are performed to determine whether there are cancerous cells in these tissues.
With the development of technology, new biopsy methods have been developed, and thus diagnostic accuracy rates have been increased. Prostate biopsy is used to diagnose prostate cancer and to determine whether the tumor has a rapid and aggressive course.
What Are the Causes of Prostate Cancer?
The most important risk factors in prostate cancer are age and family history. The incidence of prostate cancer increases with advancing age.
Microscopic prostate cancer is detected in 50% of men over the age of 70 and in almost all men over the age of 90.
The disease is not commonly seen in individuals younger than 50 years of age. Therefore, for early diagnosis, annual prostate cancer screening is recommended for men over the age of 50.
For those with a family history of prostate cancer in first-degree relatives, annual prostate cancer screening is recommended after the age of 40.
Symptoms of Prostate Cancer
Prostate cancer occurs as a result of some cells that make up the prostate tissue showing abnormal progression and forming tumor structures. Cancers may develop in only one part of the prostate or in multiple parts.
Localized (confined to the prostate) prostate cancer can often develop without causing any symptoms.
Observable symptoms of prostate cancer are as follows:
- Frequent need to urinate, especially at night
- Difficulty starting urination
- Dribbling, intermittent urination
- Feeling pain, burning, or discomfort during sexual intercourse and at the time of ejaculation
- Decreased ejaculate volume after sexual intercourse
- Presence of blood in urine or semen
- Difficulty during erection
Prostate Cancer Treatment Methods
After prostate cancer is detected, treatment is planned by taking into account disease-related factors (stage, extent) and patient-related factors (general condition, age, comorbidities).
Treatment options include surgery, chemotherapy, radiotherapy, hormonal therapy, or different combinations of these.
If the disease is diagnosed at an early stage, close monitoring without applying any treatment for a period of time may be recommended. The most common and effective treatment option is surgery and usually involves complete removal of the prostate (radical prostatectomy).
If prostate cancer is at an early stage, monitoring may be recommended instead of immediate treatment. The surgical option 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 the complete removal of the prostate. Again, in the early stage, prostate radiation therapy (radiotherapy) is also an important treatment option in suitable patients. The type of treatment is determined by taking into account the patient’s conditions and general health status.
