Near East University Hospital, Head of the Department of Urology Prof. Dr. Ali Ulvi Önder pointed out that prostate cancer, which is the most common type of cancer among men, is not due to a single cause and that there are various risk factors in the development of cancer. prof. Dr. Önder stated that the cancer risk of people with prostate cancer in 2 of their first-degree relatives increased by 5,1 times.
Prostate cancer, which is one of the most common types of cancer encountered by men in the world and in our country, can occur due to genetic reasons as well as environmental effects. Near East University Hospital, Head of the Department of Urology Prof. Dr. Ali Ulvi Önder said that the risk of catching the same disease is 2,2 times in a person whose father has prostate cancer, 3,4 times in those with a sibling, and 2 times in those with 5,1 first-degree relatives.
Excessive consumption of unsaturated fats increases the risk of developing prostate cancer.
Saying that prostate cancer is the most common cancer among men, Prof. Dr. Ali Ulvi Önder, “One of the important risk factors is oil consumption. Excess consumption of unsaturated fats and obesity increase the risk of developing both prostate cancer and malignant cancer. In addition, smoking, red meat and animal fat consumption increase the risk of prostate cancer, while lycopene (tomatoes, other red vegetables and fruits), selenium (cereal, fish, meat-poultry, eggs, dairy products), omega-3 fatty acids (fish) says that vitamins D and E have a reducing effect on the risk of prostate cancer.
Trouble urinating may indicate prostate cancer
prof. Dr. Ali Ulvi Önder says that, depending on the degree of obstruction in the urinary tract, prostate cancer causes complaints such as difficulty urinating, burning during urination, frequent urination, getting up to urinate at night, urinary incontinence, bifurcation, and difficulty in keeping urine. In addition, in the presence of advanced or metastatic prostate cancer, pain can be seen, especially in the lower back bones, depending on the region of the disease.
Definitive diagnosis of prostate cancer can be made by prostate biopsy.
Explaining that the definitive diagnosis of prostate cancer is made by pathological examination of the tissue obtained from prostate biopsy, Prof. Dr. Önder said, "The most important determinants for the biopsy decision are the digital rectal examination of the prostate (DRE-Digital Rectal Examination) and the PSA (Prostate Specific Antigen) test in the blood."
People with a family history of prostate cancer should have a PSA test from the age of 40, and those who do not, from the age of 50.
Since prostate cancer is the most common type of cancer among men and the risk of its occurrence increases with age, it is extremely important for men to have periodic check-ups after a certain age. prof. Dr. Önder said, “People with a family history of prostate cancer are recommended to be checked with PSA test and DRE starting from the age of 40, and those who do not, starting from the age of 50. This is a simple and inexpensive form of cancer screening. Even if the patient has no complaints, he may have cancer in his prostate.
Imaging methods are used for staging…
prof. Dr. Ali Ulvi Önder, “Today, the standard practice in prostate biopsy is rectal biopsy with the help of ultrasound (TRUS – transrectal ultrasound). In this application, the prostate is visualized with ultrasound and the biopsy procedure is systematically performed with the help of a special needle and gun. Generally, a total of 8-12 biopsies are taken and sent to the laboratory for pathological examination. The biopsy procedure is performed without anesthesia or preferably under local anesthesia. If prostate cancer is diagnosed as a result of biopsy, the stage of the disease is determined in order to make a treatment decision. Various imaging modalities such as computed tomography or MRI, whole body bone scintigraphy or PET are used for staging.
prof. Dr. Ali Ulvi Önder “As with all cancer diseases, the treatment of prostate cancer is done according to the stage of the disease. We can roughly divide the stage of prostate cancer into 3 main groups. Organ-confined disease, locally advanced stage and advanced stage. The decision to treat prostate cancer depends on factors such as the stage of the disease, the biopsy data, the patient's health status, and the patient's age.
Standard treatment options according to stages; monitoring, active monitoring, radiation therapy, surgery…
Prof. Dr. Ali Ulvi Önder also gave detailed information about the standard treatment options that can be applied according to the stages of the disease. In cases where the cancer is limited to the organ, the patient is followed up without any treatment. In general, active surveillance is applied to patients with low progression potential and older patients. A re-biopsy is performed after a certain period of time in patients with low progression potential, low PSA value and cancer detected in 1 or at most 2 parts in the biopsy. In more advanced cases, Radiation Therapy is applied. In this treatment, it is aimed to neutralize the tumor by placing radioactive nuclei outside or inside the prostate. One of the options is surgical intervention. Prostate cancer surgery is the removal of the entire prostate with the semen sac and the last part of the semen duct. It is a very different application from the surgery performed for BPH. It can be made open or closed. Closed surgery is a laparoscopic method and has two options: standard or robot-assisted laparoscopic prostatectomy. Radiotherapy, open surgery, standard laparoscopic and robot-assisted laparoscopic prostatectomy treatments have oncological consequences.
Stating that the treatment options for locally advanced disease are surgery and radiotherapy, Prof. Dr. Ali Ulvi Önder said, “Radiotherapy and surgical applications are similar to the organ-limited disease, but because the risk of recurrence of the disease is high, it may be necessary to apply combined treatments at this stage. Hormonal therapy with or before radiotherapy, hormonal therapy before and / or after surgery, or post-surgery radiotherapy treatment options may be available, ”he said. Prof. Dr. Önder “The standard treatment option in advanced stage disease is hormonal therapy. Hormonal treatments are drugs that prevent the action of the male hormone testosterone, thus preventing the development of normal and cancer cells in the prostate, and are administered in the form of needles or pills. "There are no serious side effects like systemic chemotherapy," he said.
Prof. Dr. Finally, Ali Ulvi Önder said that besides all diagnostic and staging methods related to prostate cancer, all treatment options are successfully applied at Near East University Hospital.