Cancers

What Cause Prostate Cancer? Symptoms and Treatment

Prostate is the most common type of cancer in men today. In a general screening, we can find prostate cancer in more than half of men over the age of 70. However, it does not always require treatment; According to studies, very low-risk patients can be followed without treatment with regular PSA control and biopsies performed at regular intervals. In treated patients, the chance of cure is particularly high if it is caught in the early period, and the survival time is quite high if it is caught in the late period. It is also possible to prevent it from occurring with some precautions…

What is Prostate?

The prostate is a gland located close to the urinary bladder in male individuals. This gland secretes a white colored liquid which has a basic structure. This liquid forms a part of the semen and neutralizes the acidic environment in the vaginal environment. This causes sperm to live longer. The prostate is located at the exit of the urinary bladder and surrounds the urethra, that is, the urinary canal. It also prevents urinary incontinence by narrowing the mouth of the bladder.

Prostate Gland Function

The main function of the prostate gland is to support the ejaculation of semen during sexual intercourse by secreting fluid. In fact, the prostate, which is not a part of the excretory system, affects this system due to its location. The prostate, which surrounds the upper part of the urinary canal, may enlarge and swell in the following processes, making it difficult to urinate.

What is Prostate Cancer?

A video will be added titled What is Prostate Cancer and How to Identify it?

One of the most common types of cancer in men is prostate cancer. The prostate gland is an organ located under the bladder, about the size of a walnut, and is an organ in men that secretes for reproductive functions. Prostate cancer, on the other hand, occurs as a result of the production of tumor structures by some cells that make up the prostate organ in abnormal conditions. Cancerous cells can result from changes in normal cells. Cancerous cells can occur in only a certain part of the prostate, or they can occur in more than one part of the prostate.

This type of cancer, which is generally seen over the age of 65, may not have any symptoms in the early stage. If this disease is not treated, it can grow in the later stages and create pressure on the urinary canal. In such advances, complaints about urination may occur in individuals.

In some cases that are late in the diagnosis and treatment process, cancer cells may not remain in the prostate, but may spread to the surrounding tissues and organs. Therefore, early diagnosis directly affects the effectiveness of the treatment process.

What are the Symptoms of Prostate Cancer? How Is It Diagnosed?

Symptoms of prostate cancer, which usually develops without showing any symptoms, may include burning when urinating, bleeding and difficulty in urination, bleeding in the semen, and bone pain in advanced cases. Prostate cancer is most often diagnosed during screening. Since there is no specific finding of prostate cancer, even if patients present with any complaint, it may be confused with an infection or a benign enlargement. In the presence of PSA value in the blood and suspicious nodules during examination and imaging, it is not possible to make a definitive diagnosis other than biopsy.

  • Burning while urinating
  • Strain and bleeding in the urine
  • Bleeding in semen
  • In advanced stages, bone metastases, related bone pains and sometimes fractures

Prostate Cancer Risk Factors

There are also many studies showing that familial and genetic factors are important in prostate cancers. According to statistics, the risk of developing prostate cancer in an individual whose father has prostate cancer is 2 times higher than that of the normal population, 3 times if his sibling has prostate cancer, and almost 5 times for those whose father and sibling have prostate cancer.

How is Prostate Cancer Diagnosed?

There is no early diagnosis method for prostate cancer that does not show many symptoms at an early stage. Among the methods used for screening are rectal examination and blood PSA test. Early diagnosis can be made by looking at the prostate specific antigen in the blood PSA test. Multiparametric magnetic resonance imaging can be used in suspected patients. By gaining knowledge about the tumor and spreading to places such as lymph nodes, it can also be detected by this imaging method. Inferences can be made by analyzing the sample taken from the body by performing a biopsy. With this process, the characteristics of cancerous cells and appropriate treatment options are determined.

Which Diseases Can Be Confused with Prostate Cancer?

Some of the diseases confused with prostate cancer are inflammation of the prostate and benign enlargement of the prostate. Inflammation from these diseases is known as prostatitis in the medical literature. It is an inflammatory condition that occurs in the prostate gland. Enlargement of the prostate gland is also called benign prostatic enlargement, but it will be explained in detail in the following sections of our article.

Early Diagnosis of Prostate Cancer

Men over 50, please do not neglect the PSA test. If you have prostate cancer in your family, you can get PSA test a little earlier. Prostate Specific Antigen (PSA) is an enzyme released by the prostate that allows sperm to liquefy. Its elevation in the blood is important in the diagnosis of prostate cancer, but it is not only specific to prostate cancer, it can also be secreted in benign tumors of the prostate and inflammations.

In recent years, more specific PCA3 genetic testing in prostate cancer has been studied. It is based on the investigation of cancer-specific mRNA structure in the epithelial cells of the prostate shed into urine. It is much more original than PSA and will probably have more usage region than PSA in the near future.

Our knowledge about the diagnosis and treatment of cancer is increasing day by day, moreover, it is possible not to get cancer with small changes in lifestyle and simple precautions. Even in cases where we cannot escape from cancer, if we do not run away from ourselves and increase our awareness, there will be no obstacle for a healthy life.

At What Ages Does Prostate Cancer Occur?

Prostate cancer, which is the most common type of cancer in men, can become worse at later ages. The incidence of contracting over the age of 50 also increases. However, it is rarely seen in young men. In this cancer, which can be diagnosed early, from the age of 50, if there is prostate cancer in the family history, regular examinations should be made from the age of 40.

Prostate Cancer Stages

We prefer to divide prostate cancer into risk groups rather than staging. Many classifications are used for this. However, we traditionally use the D’Amico classification. According to this classification;

Low-risk prostate cancer: T1-T2a stage and Gleason score ≤6 and PSA≤10

Intermediate risk prostate cancer: T2b stage and/or Gleason score =7 and/or 10< PSA ≤20

High-risk prostate cancer: stage ≥T2c or Gleason score 8–10 or PSA >20

What is PSA and Gleason Score?

PSA is unlocked as prostate specific antigen. It is a protein made by prostate cells. The measurement of the level of PSA in the blood is used effectively in the diagnosis of cancer and in determining the treatment after diagnosis.

The Gleason score gives an idea about the rate of spread and reproduction of cancerous cells. An increase in the score indicates that the cancer has a more aggressive nature.

The decision to treat prostate cancer is made depending on the patient’s general health status, risk group and expectations in terms of quality of life.

Tumor Grade

If cancerous cells are found in the sample taken for diagnosis, that is, at the biopsy stage, this tissue gets evaluated and analyzed. At this point, a scale called the Gleason Scoring System is most frequently used as a rating system. From the results, information is provided about the rate of progression of the tumor and how it differs from normal tissue.

Low grade tumors do not differentiate much from normal tissues and grow slowly. The risk of spread is also low. The higher the grade, the more different a structure emerges from normal tissues. In general, high-grade tumors spread more rapidly and to different regions.

What is Benign Prostate Enlargement?

Benign prostatic hyperplasia, also called benign prostatic hyperplasia, is the enlargement of the prostate gland located in the upper part of the bladder and urinary tract. The prognosis of this hyperplasia, which generally reduces the quality of life, is benign, which is not life-threatening. Although the exact cause of its occurrence is not known, the presence of a disease in the first-degree relative increases the probability of developing this disease.

            This enlargement of the prostate narrows the urinary canal, making it difficult for urinary excretion to occur. The patients have to contract their bladder more to pass urine. Over time, they begin to be unable to fully discharge their urine. This disease, which reduces the quality of life, is more common at later ages. It is also treated for quality loss.

How Is Prostate Cancer Treated?

After the diagnosis of prostate cancer, the treatment process is determined according to the characteristics of the tumor and the patient’s condition. This type of cancer can be treated with methods such as surgery, radiotherapy, and hormone therapy. Today, with the increase in screening tests, it can be diagnosed at an early stage. However, surgical method is preferred in early stage, that is, locally located cancers. The types of treatment used in prostate cancer are listed below.

1.     Nanoknife

Special electrodes are positioned around the tumor with the help of ultrasound, and a high dose of short-term electricity is given. It is aimed to kill cancerous cells by creating an electromagnetic field. After the procedure, curative treatments can be planned against the risk of cancer recurrence.

2.     Surgical Treatment in Prostate Cancer – Radical Prostatectomy

It is the surgical removal of the prostate in prostate cancer with a low spread. The name of the operation is called radical prostatectomy operation. It is essential that the nerves and important structures are not damaged during the procedure.

  1. Radiotherapy: Non-Surgical Solution for Prostate Cancer

Radiotherapy, also known as radiation therapy, is the treatment of cancerous cells with the aim of killing them with radiation. The main purpose here is to destroy cancer cells and prevent their proliferation by keeping the damage of normal tissue at minimal levels. It is a local treatment method similar to surgery. It shows its effect and side effects in the region where it is applied locally.

Contrary to the belief in the surgical method in the treatment phase of prostate cancer, with the increase in technological developments, radiotherapy can be safely performed at every level of the disease. Radiotherapy with up-to-date technologies and experienced people has given results as effective as traditional methods in relieving discomfort. In addition to this, the protection of living comfort is also ensured. While sexual functions are largely preserved after radiotherapy, urinary incontinence is extremely low.

There are no series directly comparing surgery and radiotherapy in the treatment of prostate cancer. However, in retrospective evaluations, we see that both treatment modalities are equal in terms of cancer control. Only the side effect profiles differ.

Traditionally, we used to divide radiotherapy into fractions, that is, sessions, but parallel to the developments in radiotherapy devices, we are doing treatments with fewer sessions (hypofractionated) or radiosurgery, so it is possible to end the treatment in a few sessions by performing radiosurgery. With these treatments, results equal to fractionated radiotherapy can be obtained in terms of side-effect profile and response to treatment.

When you are diagnosed with prostate cancer, you must consult a Urologist and a Radiation Oncologist before making a treatment decision. Since prostate cancer is a disease that can be largely cured and at least a long-term survival can be achieved, your quality of life during and after treatment is as important as being treated. For this reason, you should talk to your doctor not only about the treatment but also the post-treatment process and choose the most appropriate treatment method for your expectation. Doctors may only offer the treatment of their own department as the only option due to their belief in their own discipline, but it should be investigated that they can also be used for non-surgical solutions to prostate cancer.

Note: For more detailed information on this subject, you can review our article titled Radiotherapy Treatment in Prostate Cancer.

4.     Chemo-Hormonotherapy

In advanced stages of prostate cancer, cancerous cells are not limited to the prostate, but may spread to surrounding and distant tissues and organs. At this point, since surgical methods will not be very effective, drug treatments and home radiotherapy are preferred. Since the tissue of the prostate organ is sensitive to testosterone, which is called the male hormone, antiandrogen drugs can be used as drugs that prevent the effect of this hormone. This treatment is called hormone therapy. Chemotherapy can be applied in patients who do not respond to or are resistant to this treatment.

Chemotherapy is the treatment by giving drugs to the body. In general, it can be seen as a reason for preference in patients at advanced stage since chemotherapy is given to the circulation and circulates throughout the body.

Targeted drugs developed against prostate cancer in recent years may have successful results in cases that do not respond to first-line treatments. While increasing the effectiveness of the treatments applied, additional measures that will reduce the side effects must be investigated and you should consult your responsible physician or an Oncology Specialist (Radiation Oncologist / Medical Oncologist). You can get help in this regard from our clinic. We do not find it appropriate for you to receive help from doctors and healthcare professionals who are not oncology specialists during cancer treatments.

5.     HIFU Method

HIFU, abbreviation of High Intensity Focused Ultrasound which is a treatment method used today without surgical intervention, HIFU minimizes the side effects that may occur by cleaning only the diseased region. It is generally preferred in the early stages of cancer, small and non-invasive cancers. With the help of a probe from the anus. high-power ultrasound waves are sent to the cancerous region and cancerous cells are damaged. In this way, healthy tissues in the environment are also protected.

Is Prostate Cancer Surgery Necessary?

Contrary to the popular belief that only surgical methods are used in the treatment of prostate cancer, radiotherapy can be safely given at any stage of the disease.

Moreover, when it comes to the quality of life after both treatments, radiotherapy is much more effective in terms of life comfort. Depending on whether hormone therapy is used together with radiotherapy or whether there is a loss of function; While the preservation of sexual functions after radiotherapy is 60-80%, the rate of urinary incontinence is extremely low (1-3%).

In recent years, the most remarkable development in the treatment of prostate cancer is the wider application of stereotactic body radiotherapy and hypofractionated treatments. Traditionally, radiotherapy is given in sessions. In patients with prostate cancer, the treatment is givn for approximately 8 weeks, 35-40 sessions. In hypofractionated treatments or SBRT, a higher dose can be given in fewer sessions and in each session. The important thing here is to focus more precisely on the tumor. The growing knowledge about this method is that it is much less toxic than conventional methods.

Although hypofractionated treatments require precise aiming accuracy, this is possible with newly developed treatment devices. The new system devices allow us to make millimetric calculations and can affect the tumor at very high doses. This is beneficial not only with its shorter duration but also with its high hit rate in the battle against the tumor. This precise hit advantage: This happens thanks to high-level imaging systems developed to confirm the location of the tumor before or during the delivery of beams to the tumor. No matter what stage of your life, when you are diagnosed with prostate cancer, do not panic so much that you ignore your comfort of life. Consult your Urology doctor and then your Radiation Oncology doctor for the most appropriate treatment for your disease. The radiotherapy you will receive with new technologies and experienced hands will provide equal results with traditional methods in controlling the disease, while protecting your quality of life. Take care of your life so that we can help you more.

Does Prostate Cancer Kill?

Prostate cancer is a disease that can be followed without treatment in a disease with very low risk factors. It is a highly treatable disease for low and medium risk groups, and long-term survival can be achieved when caught in the metastatic period. For this reason, when you are diagnosed with prostate cancer, you should also question how your quality of life will be during and after the treatments.

What Is Good For Prostate Cancer?

As with all types of cancer, no smoking and doing sports are highly protective. In addition to animal foods, it is important to stay away from solid fats such as margarine and polyunsaturated fatty acids.

Among the preventive measures are the consumption of tea and coffee due to the antioxidants they contain, increasing the consumption of red vegetables and fruits, especially tomatoes, due to their richness in lycopene, the fact that our foods are rich in folate and consuming soy.

Nutrition has a reducing effect on the risk of cancer. Consumption of foods containing substances such as vitamin E, selenium and zinc provides a good protection mechanism against prostate cancer. In addition to nutrition, exercising regularly and maintaining a healthy weight are other factors.

Some foods that may be good for prostate cancer are listed below.

  • Selenium-rich garlic, eggs and seafood
  • Legumes, nuts and dairy products containing zinc
  • Foods such as rosehip, watermelon, tomato that contain the antioxidant substance called lycopene
  • Fruits and vegetables and whole grains

Lycopene is an antioxidant substance and can slow down cell division with a mechanism that prevents damage to the cell. However, it has been proven that selenium has a reducing effect on the risk of prostate cancer, especially in people who use tobacco products. Zinc, on the other hand, affects cell cycles, which are effective in DNA repair.

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