Facing Prostate Cancer

Prostate cancer, one of the most common cancers in men, often progresses silently because it does not cause symptoms in the early stages. While some patients seek medical attention due to symptoms such as difficulty urinating or blood in the urine, others visit their doctor solely because of an elevatedPSAlevel. This situation is a source of anxiety for many men: “Could I have prostate cancer?”

Prof. Dr. Volkan İzolsays the following on this subject:

“Prostate cancer is completely curable when detected early. The key is to make the right diagnosis at the right time and choose the treatment that’s right for the individual.”

In this article:

  • Causes of prostate cancer,
  • PSA and PSA levels,
  • Diagnostic methods, particularlyMRI-guided fusion biopsy,
  • Modernminimally invasivetreatmentsfor prostate tumors,
  • A detailed explanation of laparoscopic surgeryandrobotic surgery,
  • Treatment options,costs,side effects, andthe discharge process
    will be discussed step by step.

Causes and Risk Factors of Prostate Cancer

There is no single cause of prostate cancer, but certain risk factors have been identified:

  • Age:The prevalence increases significantly in people over 50.
  • Family History:If a father or brother has prostate cancer, the risk increases 2 to 3 times.
  • BRCA1/BRCA2 Mutation:The risk is higher in families with a history of breast or ovarian cancer.
  • Lifestyle:A diet high in red meat and low in fiber; obesity and physical inactivity.
  • Hormonal Effects:The effect of testosterone on prostate cell growth.

Understanding these factors makes it easier to decide on early screening, especially for men in the high-risk group.

PSA and PSA Levels

PSA (Prostate-Specific Antigen) is a protein secreted by the prostate gland. It is measured through a blood test, and its levels rise in prostate diseases, particularlyprostate cancer.

  • 0–2.5 ng/mL:Generally considered normal.
  • PSA levels should be evaluated based on the patient's age and medical history.

Looking at PSA levels alone is not sufficient. Additional parameters, such as PSA density, PSA velocity, and the free-to-total PSA ratio, are also evaluated.

Diagnostic Methods

Digital Rectal Examination

It is a simple but still valid method. The presence of firmness and nodules is detected.

Multiparametric MRI

It creates a detailed map of the prostate and classifies suspicious lesions according to the PI-RADS score.

MRI-Guided Fusion Biopsy

The difference from a conventional biopsy is that MRI images are combined with ultrasound to ensure that samples are taken only from suspicious areas.

  • Fewer samples
  • Higher cancer detection rate
  • Preventing Unnecessary Repeat Biopsies

Prof. Dr. Volkan İzol is one of the urology professors who frequently uses MRI-guided fusion biopsy:

“Thanks to MR fusion biopsy, we are able to achieve much more targeted and accurate results in the diagnosis of prostate cancer.”

Treatment Options

Treatment options for prostate cancer vary depending on the stage and aggressiveness of the tumor:

  • Active Surveillance:Regular PSA and MRI monitoring in low-risk patients.
  • Radiotherapy:External beam radiation therapy or brachytherapy.
  • Focal Treatments:Methods such as HIFU and cryotherapy are used in selected cases.
  • Surgical Treatment:Radical prostatectomy is now most commonly performed asa minimally invasive procedure for prostate cancer.

 

Treatment for Prostate Tumors

Today, open surgery has given way to minimally invasive techniques.

  • Laparoscopic surgery
  • Robotic surgery

These two methods result in less blood loss, a shorter hospital stay, and a faster recovery.

Laparoscopic Surgery

Laparoscopic surgery involves removing the prostate using a camera and long instruments inserted through 4–5 small incisions in the abdomen.

  • Less pain
  • Shorter hospital stays
  • A smaller scar

Although it yielded successful results, it has largely been replaced by robotic surgery due to technical challenges.

Robotic Surgery – A Detailed Explanation

Robotic surgery is an advanced form of laparoscopy. It is performed using the da Vinci Robot.

How to Do It?

  • Five or six small incisions are made in the abdomen.
  • Robotic arms are installed.
  • The surgeon performs the surgery from the console, guided by 3D and magnified images.

Advantages:

  • Excellent View:Even the finest blood vessels are visible at 10x magnification.
  • Nerve Protection:The nerves responsible for erections are protected more effectively.
  • Less Bleeding:The need for transfusions is minimal.
  • Faster Discharge:Most patients return home within 24–48 hours.
  • Better Continence:Bladder control returns more quickly.

Prof. Dr. Volkan İzol has extensive clinical experience in robotic surgery:

“Robotic surgery allows us to safely remove cancer while preserving the patient’s quality of life. Its most significant advantage is the very high success rate in nerve preservation.”

Cost

The cost of treating an intra-prostatic tumorvaries depending on the technology used:

  • Laparoscopic surgery is relatively less expensive.
  • Robotic surgery is more expensive, but it is preferred because it leads to good functional outcomes in the long term.

Side Effects

  • Temporary or permanent urinary incontinence
  • Erectile dysfunction is one of the most common and feared side effects.

Your surgeon’s experience is the most important factor in keeping these side effects to a minimum. Robotic surgery minimizes these side effects.

Discharge and Recovery Process

  • Discharge within 1–2 days
  • The catheter is removed in 5–7 days
  • Full recovery in 2–3 weeks
  • The scar is minimal, and there is very little pain

Frequently Asked Questions

  • How will my sex life be affected?
    Thanks to the nerve-sparing technique used in robotic surgery, erectile function returns more quickly.
  • How long does urinary incontinence last?
    Most patients become completely dry within 3–6 months.
  • Is the cost difference worth it?
    Given the functional outcomes and short recovery time, most patients prefer robotic surgery.

Prof. Dr. Volkan İzol’s Approach

Prof. Dr. Volkan İzol, one of the pioneers of modern urology in Adana, actively performs both laparoscopic and robotic surgery for the treatment of prostate tumors and, after confirming the diagnosis with MRI-guided fusion biopsy, provides his patients with personalized treatment plans.

Conclusion

Prostate cancer is a disease that can be completely cured when diagnosed early.
RegularPSAscreenings, targeted diagnosis usingMRI fusion biopsy, and precise treatment viarobotic surgerygive patients the chance to not only overcome cancer but also maintain their quality of life.