Prostate cancer

Prof. Dr. Cemil Uygur, Director of Urooncology Center, Anadolu Medical Center

Out of 100 newly diagnosed cancer in men, 15 are prostate cancer.  Prostate cancer is the second most common cancer in men and the third most common cancer-related death after lung and colorectal cancer. One of every 39 men dies from prostate cancer.

Men over 50 years of age; have frequent urination, decreased urine flow, erectile dysfunction, blood in urine or semen are at risk of prostate cancer.

What are the symptoms of prostate cancer?

It does not have specific symptoms. Generally, complaints that occur in the late period are increased urinary frequency, weakness in urine flow, inability to urinate, discontinuous urination, pain in urination and burning in urination. If the disease is metastasized to the bones, bone pain may occur, especially in the back, hip, legs and ribs.

What scans are being performed for the diagnosis of prostate cancer?

It consists of a manual examination with prostate control and a PSA examination in the blood. PSA is normally fully secreted into sperm but begins to pass into the bloodstream after the 40s. This may lead to the growth of the prostate, inflammation, advanced age or the presence of cancerous tissue in the shell. If the results of these examinations are considered to be a risk, prostate biopsy will be done and the research is completed. After cancer possibility eliminated, patient's urinary complaints are evaluated for often and severity.

What is the MR-TRUS fusion diagnostic method?

In classical biopsy method, biopsy samples are taken from standard regions with Trans-rectal ultrasound. Combining advanced MR images with real-time ultrasound images, the MR-TRUS Fusion method creates a three-dimensional map of the prostate and biopsy needle is directed directly to the focus of cancer with help of the robot. The rate of cancer in patients with high PSA level is 25-30%. Classical biopsy can diagnose 70-75% of existing cancers. The diagnosis rate of MR-TRUS Fusion biopsy is above 95%. In addition, since MR-TRUS Fusion biopsy is targeted, it is less likely to have infective complications because the number of taken samples will be less. MR-TRUS Fusion biopsy increases the rate of diagnosis of clinically important cancers especially in patients with persistent PSA elevation and recurrent prostate biopsies with no tumor.

What's new in the surgical treatment of prostate cancer?

New advanced surgical and radiotherapy techniques, molecular methods and targeted agents increase the treatment options used in cancer. Robotic surgery is one of the most successful applications in the treatment of prostate cancer.

Robotic surgery offers great advantages in the treatment of prostate cancer. While a large incision is required for traditional prostate surgeries, a small incision is made in the abdominal cavity by robotic surgery. In this surgical method, 12-fold enlarged and three-dimensional image is provided with micro tools that can move in many directions. In robotic radical prostatectomy operations, the operation area can be enlarged thanks to three-dimensional cameras. This way, cancerous prostate tissue can be seen clearly and removed sensitively in robotic prostatectomy and the bleeding can be stopped earlier. It should be noted that the robotic surgery system is not completely dependent on the robot. The surgical experience of the surgeon who undergoes surgery is also very important for radical prostatectomy.

Do sexual and urinary problems disappear with robotic surgery?

If the patient's age is smaller than 60 and bilateral nerve-sparing technique is applied, it is not necessary to take medication after radical prostatectomy with robotic surgery technique. The rate of performing sexual function after robotic surgery is 80-90% and the probability of keeping urine as normal is 96-98%. With the advantage of robotic surgery, surgical performance is increased in nerve preservation and protection of urinary retention muscles. Thus, the nerve and vascular bundle responsible for sexuality can be better protected. This is especially important for patients who want their sexual life to continue.

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