Prof. Dr. Ali Ulvi Önder, Head of the Department of Urology at University Hospital, pointed out that prostate cancer, 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 risk of cancer increases 5.1 times for people with prostate cancer in 2 first-degree relatives.
Prostate cancer, which is one of the most common types of cancer faced by men in the world and in our country, can be caused by genetic reasons as well as environmental effects. Prof. Dr. Ali Ulvi Önder, Head of the Department of Urology at Near East University Hospital, said that the risk of developing the same disease increases 2.2 times in a person whose father has prostate cancer, 3.4 times in those whose siblings have the same disease and 5.1 times in those whose 2 first-degree relatives have the same disease.
Excess consumption of unsaturated fats increases the risk of developing prostate cancer
“Prostate cancer is the most common cancer among men,” says Prof. Dr. Ali Ulvi Önder, ”One of the important risk factors is fat consumption. Excessive consumption of unsaturated fats and obesity increase the risk of developing both prostate cancer and malignant cancer.” He also says that while smoking, red meat and animal fat consumption increase the risk of prostate cancer, lycopene (tomatoes, other red vegetables and fruits), selenium (cereals, fish, meat-poultry, eggs, dairy products), omega-3 fatty acids (fish), vitamin D and E have a reducing effect on the risk of prostate cancer.
Problems with urination may be a sign of prostate cancer
Prof. Dr. Ali Ulvi Önder says that prostate cancer causes complaints such as difficulty urinating, burning during urination, frequent urination, nighttime urination, urinary incontinence, bifurcation, and difficulty holding urine, depending on the degree of obstruction in the urinary tract. In addition, in the presence of advanced or metastatic prostate cancer, pain can also be observed, especially in the lumbar bones, depending on the area of the disease.
The 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 finger rectal examination of the prostate (DRE-DigitalRectal 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
Since prostate cancer is the most common type of cancer among men and its risk increases with increasing age, it is extremely important for men to have periodic controls after a certain age.
Imaging methods are used for staging
Prof. Dr. Ali Ulvi Önder said, “Today, the standard practice in prostate biopsy is to perform a biopsy with the help of rectal ultrasound (TRUS - transrectal ultrasound). In this application, the prostate is visualized with ultrasound and the biopsy procedure is performed systematically with the help of a special needle and gun. In general, a total of 8-12 biopsies are taken and sent to the laboratory for pathological examination. Biopsy is performed without anesthesia or preferably under local anesthesia. If prostate cancer is diagnosed as a result of the biopsy, the stage of the disease is determined in order to decide on treatment. Various imaging methods such as computed tomography or MRI, whole body bone scintigraphy or PET are used for staging.”
Prof. Dr. Ali Ulvi Önder said, “As with all cancer diseases, the treatment of prostate cancer is based on the stage of the disease. We can roughly divide the stage of prostate cancer into 3 main groups. Organ limited disease, locally advanced stage and advanced stage. Prostate cancer treatment decision depends on factors such as the stage of the disease, biopsy data, patient's health status and patient age.”
Standard treatment options according to stages; follow-up, active follow-up, radiotherapy, 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 monitored without any treatment. In general, active follow-up is applied in older patients with low progression potential. In patients with low progression potential, low PSA value and cancer detected in 1 or at most 2 parts of the biopsy, a biopsy is performed again after a certain period of time. In more advanced cases, radiation therapy is applied. This treatment aims 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 together with the seminal vesicle and the last part of the seminal duct. It is very different from surgery for BPH. It can be performed open or closed. Closed surgery is laparoscopic and has two options: standard or robot-assisted laparoscopic prostatectomy. Radiotherapy, open surgery, standard laparoscopic and robot-assisted laparoscopic prostatectomy treatments have oncologic outcomes.
Stating that the treatment options in locally advanced disease are surgery and radiotherapy, Prof. Dr. Ali Ulvi Önder said, “Radiotherapy and surgery applications are the same as in organ-limited disease, but since the risk of recurrence is high, it may be necessary to apply combined treatments at this stage. Hormonal treatment with or before radiotherapy, hormonal treatment before and/or after surgery, or radiotherapy after surgery may be treatment options.” Prof. Dr. Önder said, “The standard treatment option in advanced stage disease is hormonal therapy. Hormonal therapy is a medication administered in the form of injections or pills that inhibit the effect of the male hormone testosterone, thus preventing the development of normal and cancer cells of the prostate. They do not have serious side effects like systemic chemotherapy.” Prof. Dr. Ali Ulvi Önder finally said that all diagnosis and staging methods as well as all treatment options for prostate cancer are successfully applied at the Near East University Hospital.
