Prostate cancer is a type of cancer that progresses slowly, shows late symptoms, but often spreads when it gives symptoms. Treatment becomes more complicated in cancers that have spread. However, treatment is easier in prostate cancers that are detected in the early stages before they spread to surrounding lymph nodes or other organs and tissues.
Early detection of prostate cancer is an important advantage. For this purpose, various scanning programs can be applied.
Prostate Cancer Screenings:
Two different methods can be used for screening in the early diagnosis of prostate cancer. Screening programs can be life-saving, especially for people over the age of 40 and with risk factors or a family history. However, it should be known that both screening tests will give false positive or false negative results. It is useful to follow the disease in a person with a negative screening test and risk factors.
- PSA level follow-up: PSA value is checked in the blood. The value, which is at most 2.5 ng/ml between the ages of 40-50, increases over time, increasing to 3.5 ng/ml at the age of 60 and 4.5 ng/ml at the age of 70.
Apart from prostate cancer, PSA values may also increase due to benign prostatic hyperplasia, inflammation of the prostate, after biopsy, after rectal examination, and urinary tract infections. It is not sufficient for the diagnosis of prostate cancer alone. However, it is useful for suspecting and applying other diagnostic methods.
- Digital rectal examination: It is the examination of the prostate by entering the rectum with a finger. It gives information about prostate size and shape. In suspected cases, other diagnostic methods are applied.
Prostate Cancer Diagnostic Methods:
For the diagnosis of prostate cancer, first of all, an appropriate anamnesis and examination, and if necessary, a digital rectal examination are required. If a suspicion of cancer arises in these, other tests are started. These:
- PSA measurement: PSA value is checked in the blood. At values below 4 ng/ml, the suspicion of cancer is weak. Values between 4-10 ng/ml are considered borderline values. The risk is 25%. Further investigation is required. Values above 10 ng/ml have a 50% chance of prostate cancer. PSA value can also be used in the follow-up of the treatment, in the follow-up of recurrence in patients who have been diagnosed and treated for prostate cancer before. It is also used in prostate cancer staging.
- Ultrasound: With transrectal ultrasound applied from the rectum, prostate structure, shape, size and mass lesions can be detected.
- Magnetic Resonance (MR): It gives clearer information about prostate tissue, size, presence of mass.
- Prostate Biopsy: Up to 12 fine needle aspiration biopsy samples are taken from the prostate tissue with instruments entered through the rectum. The process takes about 10 minutes. There are usually no complications in the procedure performed by the specialist. But sometimes rectal bleeding, bleeding in the urine may occur. Since it is entered through the rectum, preventive antibiotic treatment is applied. The patient is also asked to follow up the fever after the biopsy. Fever may indicate possible post-operative infection. Biopsy can sometimes be performed with imaging procedures such as MRI and ultrasound. In this way, biopsy is taken from the prostate by targeting tumor cells, not randomly. Thus, false negativity is prevented and the correct diagnosis is made. The biopsy procedure can also be performed transperineally by entering through the scrotum.