1-WHAT IS THE PROSTATE? WHERE TO FIND IT? WHAT DOES IT DO?
The prostate is a gland (organ) located in the lower abdomen, just below the bladder, just in front of the anus (rectum) area in ALL MEN. The prostate is located in a HIDDEN area that is not easily accessible. For this reason, their diseases may have an insidious course.
Both the urinary tract and the semen tract pass through the prostate. During ejaculation in men, the prostate contracts and sends seminal fluid towards the penis. Its function here is to protect the sperm. Just as the salivary glands produce fluids that aid digestion, the Prostate is a gland that produces special substances in the seminal fluid related to reproduction and sperm maturation.
The Prostate is located on a VERY INTENSIVE JUNCTION where the urine, intestines and sexual organs are located. For this reason, a possible problem in the prostate gland may affect many systems and cause different complaints. In addition to the most common urinary complaints, it can also cause sexual dysfunctions such as premature ejaculation and erectile dysfunction, or other problems such as constipation and hernia.
The example of walnut is generally used to describe the prostate gland. Although it is similar in shape and size, its hard shell and contents do not resemble the prostate at all. It is more similar to plum with its soft texture and spongy structure. Although it is normally the size of a plum, it can grow in the 40s and reach the size of a tangerine or even an orange.
2- DO YOUNG PEOPLE HAVE PROSTATE?
Prostate is present in EVERY MAN, starting from the womb. is available. In pre-puberty boys, the prostate gland is insignificant and weighs about 3-6 grams. With the increase in male hormones during puberty, the prostate gland grows, reaches a weight of 20 grams and begins to secrete seminal fluid together with the seminal vesicle. This fluid is produced to protect sperm cells as they travel towards the female reproductive tract. The prostate, which remains the same size until the mid-40s, then begins to grow again. The most common problem at young ages is inflammation of the prostate gland called PROSTATITIS. Benign prostatic hyperplasia (BPH) and cancer are very rare at these ages.
3-WHAT ARE THE MOST COMMON DISEASES OF THE PROSTATE?
The most common diseases of the prostate are BPH (benign prostatic hyperplasia). ), Prostate cancer and Prostatitis(pro staphitis). All three diseases can cause urinary complaints such as night urination, frequent urination, burning sensation in urination, and inability to void completely. Rarely, it may cause ejaculation problems or bleeding. While BPH (benign prostate hyperplasia) and prostate cancer are seen in the group over the age of 40, prostatitis is the disease of younger men.
4-WHAT ARE THE DIFFERENCES BETWEEN PROSTATE CANCER AND BENEFITED PROSTATE ENLARGEMENT?
BPH. (benign prostate enlargement) is a condition that occurs in every man with age. If it extends into the urinary canal (urethra) in the inner part of the prostate, it causes difficulty in urination and causes prostate complaints, which are known to the public.
Prostate cancer is insidious because it mostly originates from the shell part of the prostate. It may not cause complaints such as benign prostate enlargement. Therefore, it is necessary to have a checkup every year after the age of 40. If not diagnosed early, it can be fatal. Especially people with a family history of prostate cancer should be more careful. The risk can increase up to 7 times.
5-WHAT ARE THE SYMPTOMS THAT SHOW THAT A PERSON HAS PROSTATE DISEASE?
Since the urinary tract passes through the middle, frequent urination at night, frequent urination, burning sensation during urination, complete It may cause urinary complaints such as inability to void.
The main complaints may be urination at night, frequent urination, burning sensation in urination, incomplete voiding and feeling of urine remaining inside, interrupted urination, painful/bleeding ejaculation-semen discharge. However, it can cause intestinal problems such as constipation and inguinal hernia. But especially prostate cancer MAY NOT MAKE ANY COMPLAINTS. At this point, annual routine control is very important.
6-HOW ARE PROSTATE DISEASES DIAGNOSED?
Routine prostate control is performed by urine analysis, PSA (prostate-specific antigen in the blood) and finger examination. Ultrasound, blood tests and voiding tests may also be added if necessary. Of course, this check should be done by a specialist physician. Cancer screening techniques developed in recent years should be applied by a specialist physician and early diagnosis of prostate cancer should be ensured.
7. WHAT IS PSA (BLOOD ANALYSIS) FOR PROSTATE CHECKUP?
With the blood test performed during prostate checks, patients are diagnosed with prostate cancer due to high PSA (Prostate specific antigen) and/or abnormality in the examination. Biopsy may be recommended. The purpose here is to determine whether there is cancer or not. However, high PSA does not always mean cancer. In fact, it mostly indicates causes other than cancer.
Possibilities of cancer according to PSA range:
PSA 2.5-4 ng/ml: 20% cancer, 80% infection and prostate enlargement, etc.
PSA 4-10 ng/ml: 25-30% cancer, 70-75% infection and prostate enlargement etc.
PSA >10 ng/ml: 40-50% cancer, % 50-60 infections and prostate enlargement etc.
As can be seen, PSA elevation does not actually indicate cancer in most patients. Therefore, the decision to biopsy should be taken very carefully. Other parameters other than PSA (free PSA, PSA rate, prostate volume, etc.) should be taken into consideration. It is necessary to do all of these under the supervision of a physician specialized in this field.
8- HOW SHOULD PROSTATE BIOPSIS BE?
Prostate biopsy, which is used in the diagnosis of prostate cancer, is frequently performed today. This procedure, which has very serious side effects such as blood in the urine and semen, infection and sepsis, should be done very carefully. So what should the ideal biopsy be like?
A. Although it can be performed with local anesthesia, it can be recommended to be performed with sedation-narcosis due to pain and psychological perception.
B. Ultrasound-MRI-guided prostate biopsy At least 10-12 cores (pieces) should be made, this number should be increased according to the size of the prostate.
C. Since it is a rectal procedure, hygiene rules should be taken into consideration.
D.Pathological. Evaluation should be done in a center where there is a physician specialized in this field
E. The patient should be informed about the possible consequences of the procedure and its preparation.
9- WHY DOES PROSTATE CANCER OCCUR?
Reason Although it is not known exactly, hormones, genetics (inherited from the family) and environmental factors are thought to be the causes of this disease. Since it does not appear before puberty, the hormones secreted after puberty and the presence of hormones (such as estrogen) used in the treatment of this cancer show that hormones are effective on this disease. It has been determined that the risk of disease is also increased in first-degree relatives of people with prostate cancer. Therefore, genetic factors are also held responsible for prostate cancer. It is more common in black Americans and those of African origin. It is seen with age and occurs at an earlier age. The reason for this situation is not yet known. Studies are still continuing to find the genes that cause prostate cancer. The higher incidence of prostate cancer in certain geographical places suggests that environmental factors also play a role. It is especially common in Scandinavian countries. It is less common in Japan and some Asian countries. The risk of disease did not increase as a result of migration from these regions to risky areas, but it was observed to increase in the next generation. This shows the importance of environmental impact. It is thought that eating foods with high animal fat content increases the risk of disease.
10-HOW SHOULD PROSTATE CANCER TREATMENT BE DONE?
Early diagnosis saves lives!
Prostate cancer treatment It is very important in many respects. Of course, the first goal is to eliminate cancer. However, choosing the most appropriate treatment that will prevent urinary incontinence and continue sexual life are important points to consider in terms of quality of life.
While almost complete treatment-cure is possible in cancers caught early, this is not possible in metastatic cancers. For this reason, it is vital for every man after the age of 50 to have annual check-ups with PSA (blood test) and examination, even if he has no complaints.
What treatments can be applied in early stage prostate cancer?
1. Active monitoring
2. Surgery: Radical prostatectomy (Open, laparoscopic or robotic)
3. Radiotherapy (Ray therapy) and brachytherapy
4. Focal treatments: Cryotherapy, HIFU
Active monitoring can be applied in centers experienced in this field in very small and low-grade tumors detected very early. It is applied at a rate of up to 30% in the USA. It requires very careful monitoring.
Among these treatments, the most successful in terms of cancer control is surgery. However, in good centers there is a risk of urinary incontinence up to 5%. Impairment of sexual functions is seen in 30-50% despite the protection of the nerves. Although radiation therapy has results similar to surgery in terms of cancer control, sexual function and urinary problems may still occur. In recent years, instead of removing or irradiating the entire prostate, treatment of only the tumor area (focal treatment) has been on the agenda and appropriate treatment has been performed. It is a form of treatment that may be suitable in hospitals and experienced centers and has much fewer side effects, but its long-term results are not yet known.
As a result; There are successful treatment alternatives for prostate cancer. A TUMOR-FREE, LONG AND HEALTHY LIFE IS POSSIBLE. The most important point is that a PATIENT-SPECIFIC treatment should be performed in an experienced center and with an experienced physician.
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