ABSTRACT

Prostate cancer is a disease with increasing incidence that can be fully cured thanks to the innovations in diagnosis and treatment when detected in local stage. It is the second most common cancer in men after lung cancer. Prostate cancer usually gives late symptoms because it is a slow-growing disease. Most of the early-stage prostate cancers are asymptomatic as the disease develops from peripheral zone and in the form of multifocal small foci. The presence of symptoms can often indicate local, advanced and/or metastatic disease. Obstructive and irritative voiding symptoms are often associated with benign prostatic hyperplasia. For early diagnosis and screening purposes, it is strongly recommended that prostate-specific antigen (PSA) testing be conducted on Afro-American and men with family history at age of 45 years, and on those without risk - at age 50 and over. Transrectal ultrasonography-guided biopsy, digital rectal examination (DRE), PSA, and multiparametric magnetic resonance imaging (mpMRI) are methods used to diagnose prostate cancer. Patients with a serum PSA level of 2.5-10 ng/mL have only 30% positivity of prostate cancer in their biopsies. Therefore, new methods have been introduced to increase the reliability of the PSA test. These are race-specific PSA, PSA density, annual PSA increase (PSA velocities), free-PSA, prostate cancer antigen 3, and combined use of these parameters. Ultrasonography-guided biopsy is the gold standard for diagnosis. PSA elevation, abnormal DRE findings, and suspicious imaging results (mpMRI) are indications for biopsy.