ABSTRACT

Prostate cancer is not always a disease that requires immediate treatment. In this article, I discuss in detail how treatment decisions for prostate cancer are made and which patients can be monitored.

If you’ve been diagnosed with prostate cancer, is the first question that comes to mind: “Should I have surgery right away?”

In this article, as Prof. Dr. Volkan İzol, I will explain whether treatment for prostate cancer is always necessary, which patients can be monitored, and what the correct approach is.

 

What Is Prostate Cancer?

Prostate cancer is a cancer that develops in the prostate gland and is one of the most common cancers in men.

Features:

  • It may move slowly
  • Some species can be aggressive
  • It may not show any symptoms in the early stages

👉 Key point:
Not all prostate cancers behave the same way.

Why Does It Happen?

Although the exact cause is unknown, there are risk factors:

  • Advanced age
  • Family history
  • Genetic predisposition
  • Obesity
  • Hormonal factors

👉 However, these factors do not determine the aggressiveness of the disease.

What Are the Symptoms?

Most patients do not show any symptoms.

Advanced stage:

  • Urinary problems
  • Blood in the urine
  • Bone pain

👉 If no screening is performed, it may be detected too late.

 

 

How Is the Diagnosis Made?

🔹 Diagnostic process:

  • PSA test
  • Rectal examination
  • Mp MRI
  • Prostate biopsy

👉 The most important step after diagnosis: risk stratification

Which Patients Should Be Treated?

Not all prostate cancers are treated.

🔴 Those who need treatment:

  • Moderate-risk tumors
  • High-risk tumors
  • A rapidly progressing disease

🟢 Patients who can be monitored:

  • Low-risk prostate cancer
  • Patients with low and stable PSA levels
  • Older adults

👉 This approach is called “active monitoring.”

Treatment Options

🔹 1. Active Monitoring

  • Regular PSA
  • MRI and biopsy follow-up

👉 Goal: to avoid unnecessary treatment

🔹 2. Surgical Treatment

  • Radical prostatectomy

👉 Robotic surgery is at the forefront today.

🔹 3. Radiation Therapy

  • Alternative treatment

🔹 4. Systemic Treatment

  • Hormone therapy
  • Chemotherapy

My Approach in My Clinical Practice

In my clinical practice, as Prof. Dr. Volkan İzol, I do not treat every patient diagnosed with prostate cancer the same way.

In particular:

  • In low-risk patients
  • In people with low PSA levels
  • In individuals with a limited life expectancy

I prefer the active monitoring approach.

👉 In my clinical practice, I’ve observed that preventing unnecessary surgeries is particularly important for patients’ quality of life.

However:

  • In aggressive tumors
  • In young patients

I am planning to undergo early treatment using robotic surgery.

 

 

IMPORTANT MESSAGES

  • Not all cases of prostate cancer require treatment
  • Low-risk patients can be monitored
  • Early diagnosis increases treatment options
  • The decision regarding treatment is specific to each patient
  • Unnecessary treatment should be avoided

CONCLUSION + CTA

Prostate cancer treatment should be tailored to each individual.

As Prof. Dr. Volkan İzol, my recommendation is that patients who have received a diagnosis should seek an expert evaluation before making any hasty decisions.

Remember, the right patient must be managed with the right treatment.

For a detailed evaluation, please contact Prof. Dr. Volkan İzol.

Short Answer

Prostate cancer does not always require treatment. In low-risk patients, regular monitoring can be performed using active surveillance. However, treatment is necessary for moderate- and high-risk prostate cancer.

❓ FREQUENTLY ASKED QUESTIONS

❓ Does every case of prostate cancer require surgery?

No. Low-risk prostate cancers can be monitored through active surveillance. Surgery is not necessary for every patient.

❓ What is active monitoring?

Active surveillance is the practice of monitoring the disease in patients with low-risk prostate cancer through regular PSA tests, MRIs, and biopsies, rather than treating it.

❓ Which cases of prostate cancer should be treated?

Moderate- and high-risk prostate cancers, rapidly progressing tumors, and younger patients should generally be treated.

❓ What happens if prostate cancer is left untreated?

Low-risk cancers may not progress for a long time. However, in aggressive cancers, the disease can progress and spread if left untreated.

❓ Is robotic surgery suitable for everyone?

No. Robotic surgery is preferred for suitable patients. The choice of treatment is determined on a case-by-case basis.

❓ Does an elevated PSA level require treatment?

No. An elevated PSA level alone does not require treatment. A diagnosis and risk assessment should be performed.

❓ Is active monitoring safe?

Yes. When the right patients are selected, active surveillance is a safe and effective approach.