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Urology

Prostate Cancer

Prostate cancer develops when cells in the prostate gland begin to grow uncontrollably. Most prostate cancers grow slowly, but some types are aggressive and can spread rapidly.

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ℹWhat is Prostate Cancer?

The prostate is a walnut-sized exocrine gland located below the bladder. Its primary function is to produce the fluid that nourishes and transports sperm. The urethra, which carries urine and semen, passes through the center of the prostate.

Prostate cancer results from genetic alterations in normal glandular cells, transforming them into malignant cells. The most important risk factor is age; it is rare under 50 but increases rapidly with advancing age. Genetic predisposition (2-3 fold increased risk in first-degree relatives) and a diet rich in animal fats are other significant factors.

Common Symptoms

Difficulty Urinating
Difficulty initiating urination, intermittent stream, and decreased flow rate.
Frequent Urination
Especially nocturia (frequent nighttime urination) and sensation of incomplete bladder emptying.
Blood in Urine or Semen
Hematuria or hematospermia.
Advanced Stage Symptoms
Bone pain due to widespread skeletal metastases, weight loss, and fatigue.

Diagnosis Methods

PSA Test
Measurement of prostate-specific antigen in the blood. Elevated levels do not always indicate cancer.
Digital Rectal Examination (DRE)
Manual assessment of prostate consistency and surface.
Multiparametric Prostate MRI (mpMRI)
Highly sensitive imaging modality for localizing cancer within the prostate.
TRUS Biopsy with MRI-Fusion
Combining MRI images with ultrasonography to obtain targeted tissue samples from suspicious foci.

Causes

Age
The most important risk factor. Rare under 50, incidence rises rapidly with advancing age.
Genetics and Family History
Risk is 2-3 times higher in men with first-degree relatives diagnosed with prostate cancer.
Dietary Habits
A diet rich in animal fats and obesity are thought to increase the risk.

Treatments

Active Surveillance
Close monitoring with PSA, mpMRI, and biopsy instead of immediate treatment for low-risk cancers.
Robotic Radical Prostatectomy
Complete removal of the prostate using robotic surgery. Nerve-sparing, continence-preserving with rapid recovery.
Radiotherapy
Focused high-dose radiation therapy with IMRT, SBRT (CyberKnife), and IGRT.
Focal Therapies
HIFU (High-Intensity Focused Ultrasound) and cryotherapy to ablate only the cancerous focus.
Hormone Therapy
Testosterone suppression with LHRH analogs, anti-androgens (Enzalutamide, Apalutamide), CYP17 inhibitors (Abiraterone).
Lu-177 PSMA Therapy
Nuclear therapy using radioactive Lutetium-177 targeting the PSMA protein to destroy cancer cell DNA.
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