Prostate Cancer Screening

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Early Detection & Screening saves lives

Should I Be Screened?

The question of screening is a personal and complex one. It’s important for each man to talk with his doctor about whether prostate cancer screening is right for him.
When Should I Start Screening?

When to start screening is generally based on individual risk, with age 40 being a reasonable time to start screening for those at highest risk (genetic predispositions or strong family histories of prostate cancer at a young age).

For otherwise healthy men at high risk (positive family history), starting at age 40-45 is reasonable.

Guidelines differ for men at average risk. Some recommend an initial PSA and DRE at age 40, and others recommend starting at age 50. In general, all men should create a proactive prostate health plan that is right for them based on their lifestyle and family history.

What are your risk factors?

There are several major factors that influence risk, and unfortunately, some of them cannot be changed. Age: The older you are, the more likely you are to be diagnosed with prostate cancer. Although only 1 in 10,000 men under age 40 will be diagnosed, the rate shoots up to 1 in 38 for ages 40 to 59, and 1 in 14 for ages 60 to 69.
In fact, more than 65% of all prostate cancers are diagnosed in men over the age of 65. The average age at diagnosis of prostate cancer in the United States is 69 years. After that age, the chance of developing prostate cancer becomes more common than any other cancer in men or women.

About the prostate cancer screening

The more you know about the normal development and function of the prostate, where it’s located, and what it’s a ached to, the beer you can understand how prostate cancer develops and impacts a man’s life over time—due either to cancer growth or as a result of treatments.

Normal Anatomy

The normal prostate is a small, squishy gland about the size of a walnut. It sits under the bladder and in front of the rectum.

Normal Physiology

The prostate is not essential for life, but it’s important for reproduction. It seems to supply substances that facilitate fertilization and sperm transit and survival.

Prostate Zones

The prostate is divided into several anatomic regions or zones. Most prostate cancer develops from the peripheral zone near the rectum. That’s why a digital rectal exam (DRE) is a useful screening test.

Prostate Cancer Screening

  •         Transrectal ultrasonography (TRUS)
  •         Computed tomography (CT)
  •         Magnetic resonance imaging (MRI)
  •         MRI: Diffusion-weighted imaging (DAG)
  •         MRI: Perfusion imaging
  •         MR Spectroscopy
  •         Positron emission tomography (PET)


Symptoms to Know

Not everyone experiences symptoms of prostate cancer. Many times, signs of prostate cancer are first detected by a doctor during a routine check-up.
Some men, however, will experience changes in urinary or sexual function that might indicate the presence of prostate cancer. These symptoms include:

  • A need to urinate frequently, especially at night
  • Difficulty starting urination or holding back urine
  • Weak or interrupted flow of urine
  • Painful or burning urination
  • Difficulty in having an erection
  • Painful ejaculation
  • Blood in urine or semen
  • Frequent pain or stiffness in the lower back, hips, or upper thighs

You should consult with the Urology specialist if you experience any of the symptoms.
Because these symptoms can also indicate the presence of other diseases or disorders, such as BPH or prostatitis, men will undergo a thorough work-up to determine the underlying cause.


The ultimate goal is to prevent men from developing prostate cancer. Although significant progress has been made and genetic and environmental risk factors for prostate cancer have been identified, the evidence is not strong enough for conclusive recommendations.
To understand how to prevent prostate cancer, one must first understand what causes it. There are four major factors that influence one’s risk of developing prostate cancer. These are Age, Race, Family History and Where you live. These factors are difficult or impossible to change, however, there are many things that men can do to reduce or delay their risk of developing prostate cancer.

  • Maintain a healthy weight.
  • Minimize the amount of fat intake from red meat and dairy.
  • Watch the amount of calcium intake.
  • Eat more fish.
  • Eat more tomatoes and cruciferous veggies.
  • Avoid smoking for many reasons. Seek medical treatment for stress, high blood pressure or cholesterol and depression.
  • Avoid over-supplementation.
  • Relax more and enjoy life.
  • Engage in early screening and talk with your healthcare provider about your risks.


Multiparametric prostate MRI (mp-MRI)

Multiparametric prostate MR (mp-MRI), which was started to be developed in the 1990s and is now at a very advanced technological level, allows many complex images to be combined with the help of intravenous drugs (intravenous contrast agent). It shows the anatomical structure of the prostate in more detail. It provides the opportunity to examine and report cancerous areas in more detail and detect cancer with an accuracy rate of over 90%. There are 3 different usage techniques:

  1. MR-TRUS fusion biopsy technique

It is sampling from the targeted area by overlapping (fusing) the MR images obtained previously with the help of software and marking cancer foci with rectal ultrasound images. By combining MR and ultrasound images, 3-dimensional virtual prostate tissue is created and biopsy can be taken from the suspect area.

  1. ‘In-Bore’ biopsy technique

It is sampling from the detected area with anesthesia while the patient is in the MR device.

  1. Cognitive fusion biopsy technique

It is the use of suspicious areas previously detected in MR in the biopsy procedure accompanied by standard ultrasound performed from the breech area.

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The secretion organ, which produces secretions for reproductive activities in men, under the bladder, just in front of the rectum, is called the “prostate”. Prostate cancer begins when cells in the prostate gland form tumor structures after abnormal and uncontrolled proliferation. Cancer cells can also settle in other organs or bones.

This type of cancer, which is seen only in men, is usually found after 65 years of age. As the prostate gland also grows with old age, urine flow is somewhat blocked, which can cause pain. This may be due to benign prostate enlargement, or it can be a sign of cancer. This disease, which does not show any symptoms, especially men who have this type of cancer in their family should pay attention to.

Symptoms Containing Suspected Prostate Cancer

  •         Bump or asymmetrical prostate in the prostate gland
  •         Urinary difficulty
  •         Difficulty in starting or stopping urine
  •         Frequent urination, especially at night
  •         Poor urine flow
  •         Urine flow that starts and stops instantly
  •         Pain or burning during urination
  •         Erection difficulty
  •         Pain during ejaculation
  •         Blood in semen and urine

Diagnostic Methods

  • PSA (Prostate-Specific Antigen) Test and Prostate Exam
  • Multiparametric MR
  • Prostate Biopsy
  • MR-Ultrasound Fusion Biopsy


Prostate Cancer Stages

At stage 1, the tumor is only in the prostate. Sometimes it may be too small to be felt during the rectal examination. Gleason score is 6 or less. PSA level is below 10.

In the second stage, the tumor is in the prostate. However, the structure of the tumor has become aggressive. It may be noticeable on finger examination or the tumor grade may be high.

In the third stage, prostate cancer has spread beyond the prostate. It is usually spread over seminal sacs. However, it has not spread to the bones and lymph nodes.

In stage 4, prostate cancer has spread to the bladder, rectum, or tissues other than seminal sacs. There may also be spreading in the lymph nodes and bones around, liver and lung.

Treatment Methods

Depending on how localized the cancer is or how far it has spread, the effect of treatment varies.

  •         Surgery (prostatectomy)
  •         Radiation therapy (brachytherapy, external radiotherapy)
  •         Hormone therapy
  •         Chemotherapy

What is good for the prostate?

  • Vitamin E
  • Garlic, eggs, and seafood containing selenium
  • Zinc-rich nuts, milk, and legumes
  • Fruits and vegetables containing lycopene, such as tomatoes, watermelons, and rosehips
  • Whole grains, fruits, and vegetables can be counted.

See also: Prostate Cancer Awareness

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