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March 4, 2024Prostate cancer is the most common type of cancer in men. It ranks second in cancer-related deaths. The prostate is a glandular organ in men, approximately the size of a walnut, located under the bladder, producing various secretions for reproductive activities.
Prostate cancer occurs as a result of the abnormal course of some cells that make up the prostate tissue, forming tumor structures. Cancers can develop in only one part of the prostate, or they can develop in more than one part.
This disease, which is usually seen over the age of 65, may not give any symptoms in its early stages. However, if it is not treated, it can grow over time and create pressure on the urinary canal. In such patients, some complaints about urination occur.
In some patients with delayed diagnosis and treatment, cancerous tissues may not be limited to the prostate, but may spread to surrounding tissues.
Prostate Cancer Grades and Stages
Treatment of prostate cancer is planned according to the grade of the tumor and the stage of the tumor.
Tumor Grade
If cancer is detected in the prostate biopsy, the cancerous tissue is evaluated by the pathologist. The most common rating system, the Gleason Scoring System, is used. The results give an idea about the growth rate of the tumor and its differentiation from normal tissue.
A low grade means that the tumor does not differentiate excessively from normal tissues, grows slowly, and has a low risk of spreading. A high degree of risk indicates that the tumor is very different from normal tissues, will likely grow rapidly and may spread to other parts of the body.
Stages of Prostate Cancer
In prostate cancer, staging is done based on how far the tumor has spread in and around the prostate. The following are taken into account when staging.
size of the tumor
Spread of the tumor to tissues inside or around the prostate
Whether the cancer has spread to the lymph nodes
Spread to other parts of the body (metastasis)
stage 1
In the first stage, the tumor is only in the prostate. The tumor is too small to be felt on rectal examination. It does not spread to lymph nodes or spread to other parts of the body. It's low grade.
stage 2
In stage 2, the tumor has progressed into the prostate, but has not spread around it. At this stage, tumor rectal examination or imaging methods (MR) can be detected. It does not spread to lymph nodes or spread to other parts of the body.
stage 3
In the third stage, the tumor has spread beyond the prostate capsule and into tissues such as the seminal vesicle (sperm sac). It does not spread to lymph nodes or spread to other parts of the body.
stage 4
In stage 4, the cancer has spread to other tissues around the prostate. At this stage, there may be spread (metastasis) to the lymph nodes, bones, liver, or lungs.
It is very important to determine the degree of prostate cancer, to apply the appropriate treatment and to follow the course of the disease.
Reasons
The most important risk factors for prostate cancer are age and family history. The incidence of prostate cancer increases with age. Microscopic prostate cancer is detected in 50% of men over the age of 70 and in almost all of those over the age of 90. The disease is not common in individuals younger than 50 years of age. For this reason, prostate cancer screening is recommended for men over 50 for early detection. Studies have shown that approximately 15% of patients have a history of prostate cancer in other family members. Some gene groups responsible for the formation of prostate cancer have been identified. In addition to these, obesity and smoking are among the risk factors identified for prostate cancer.
Symptoms
Localized (limited to the prostate) prostate cancer often develops without any symptoms. Symptoms of prostate cancer include:
burning while urinating
Straining and bleeding in the urine
bleeding in semen
In advanced stages, bone metastases, associated bone pain and sometimes fractures
The treatment of prostate cancer is delayed in individuals who do not have a screening test or who fail their routine controls despite being diagnosed. In these cases, the disease begins to progress.
Diagnostic Methods
Currently, there is no early diagnosis method that can reveal that a healthy man will have prostate cancer.
Increasing age and genetic predisposition are risk factors for prostate cancer. In the light of these risk factors, tests are performed for early diagnosis.
Prostate cancer screening is recommended for men aged 50 years and older without a family history of prostate cancer, while screening for prostate cancer at an earlier age is recommended for those with a family history of prostate cancer.
The methods used for screening are digital rectal examination (for the prostate) and blood test and PSA measurement.