In most cases, ‘prostate cancer’ is diagnosed suddenly one day without any symptoms, but then abnormal findings are discovered in a blood test. The pace of progress is not fast until it progresses to a certain extent.
However, prostate cancer has the characteristic of easily metastasizing to bone. Cancer cells remaining in the prostate do not cause any subjective symptoms, but once they metastasize to the bone, the pain is so severe that it cannot be tolerated unless narcotic painkillers are taken continuously, and the metastasized bone area becomes weak and prone to fractures. If it metastasizes to the spine, serious irreversible complications such as paralysis of the lower body may occur.
Additionally, as prostate cancer progresses, the urethra through which urine is discharged may be completely blocked, causing the urine stream to become thinner, resulting in a complete inability to urinate, or suffering from persistent hematuria. Prompt diagnosis and treatment are required. Let’s learn about the diagnosis and treatment of prostate cancer with the help of Kim Jeong-jun (photo), professor of urology at Incheon St. Mary’s Hospital, Catholic University of Korea.
◇Prostate cancer increases 2.5 times over 10 years… If you have a family history, get regular checkups once a year starting at age 40.
The prostate is a reproductive organ found only in men. It is located below the bladder and surrounds the urethra, which drains urine. Involved in urination and reproductive functions. It weighs 15-20g, is 4cm long, and is 2cm wide, making it the size of a ‘walnut’. The fluid secreted from the prostate serves as nutrients for sperm and prevents infection in the urethra.
The number of prostate cancer patients in Korea is increasing rapidly every year. According to the Health Insurance Review and Assessment Service, the number of people who visited hospitals for prostate cancer last year (2023) was 134,504, an increase of about 2.5 times compared to 52,910 in 2013, 10 years ago. The elderly population is increasing significantly, and lifestyle patterns, including eating habits, are becoming westernized, which is pointed out as the cause. Prostate cancer has long been the number one cancer in men in the United States and Europe. In Korea, it is still ranked second after lung cancer, but considering the recent increase, it is expected that it will soon rank at the top of the incidence rate.
The cause of the occurrence has not yet been clearly identified. However, some causes that increase the risk include old age, family history, obesity, and high-fat diet.
Kim Jeong-jun, a professor of urology at Incheon St. Mary’s Hospital of the Catholic University of Korea, said, “About 10% of prostate cancer patients have a family history, and if a father or brother has prostate cancer, the probability of developing the disease is known to be three times higher than that of the general public.” “Starting from the age of 40, if you are over 50 years old, it is recommended to get a regular checkup once a year,” he advised.
◇Check for cancer using a prostate cancer marker (PSA) test… General robotic surgery treatment for localized prostate cancer
For prostate cancer, regular follow-up is important. It is relatively easy to check for suspected cancer with a prostate cancer marker (PSA) test. If the PSA result is above the normal level, the presence of cancer is confirmed through prostate MRI (magnetic resonance imaging) or prostate ultrasound. You can also perform a ‘targeted biopsy’ in which a prostate MRI is first performed and only the parts suspected of having cancer are biopsied.
Treatment methods vary depending on the stage of progression, but robotic surgery (robotic-assisted prostatectomy) is common for localized prostate cancer. Currently, more than 90% of prostate cancer surgeries in Korea are performed using robotic surgery. Recently, the side effects of surgery have decreased significantly due to the expansion of robotic surgery, and surgery is becoming the most appropriate primary treatment for most patients.
In addition, as the scope of reimbursement for new drugs for the treatment of metastatic prostate cancer has expanded significantly since last year, domestic metastatic prostate cancer patients who previously thought there was little hope can now receive good treatment within the institutional system without burden of cost.
Kim Jeong-jun, professor of urology at Incheon St. Mary’s Hospital of the Catholic University of Korea, said, “Many new treatments for prostate cancer are emerging and have their own advantages, but considering that nothing is as important in cancer treatment as the patient’s life expectancy, the importance of surgery as a primary treatment cannot be emphasized enough. “It is not excessive,” he said. “If surgery is performed as primary treatment, the possibility of a complete cure through the surgery itself is high at around 70%, and even if a complete cure is not achieved through surgery, approximately 40% of such patients will need salvage radiation therapy in the future.” There is one more chance for a complete cure. However, it is important to decide on a treatment plan after thorough consultation with a specialist from various angles.”
◇There is no definite prevention method, but the incidence of high-fat diet and obesity increases, and normal weight must be maintained.
Various studies have been conducted on selenium and green tea as a way to prevent prostate cancer, but none have yet shown a clear preventive effect. However, it is generally known that a high-fat diet or obesity increases the risk of prostate cancer. It is best to maintain a normal weight. Also, be sure to eat plenty of beans and tomatoes on a daily basis, as they have positive reports on the prevention of prostate cancer, benign prostatic hyperplasia, and prostatitis.
According to the ‘2017 Status of Prostate Cancer Incidence in Koreans’ published by the Korean Urological Association, the Korean Society of Urological Oncology, and the Korea Urological Foundation, the incidence of prostate cancer is higher in patients with chronic diseases such as diabetes, hypertension, and dyslipidemia than in normal men, and the abdominal circumference Men with abdominal obesity measuring more than 90 cm also had a 1.32 times higher incidence rate than men with normal weight. You need to improve your lifestyle habits and take special care such as regular checkups if you are in a high-risk group.
Kim Jeong-jun, a professor of urology at Incheon St. Mary’s Hospital of the Catholic University of Korea, said, “There is no treatment that shows results better than surgical treatment for prostate cancer that has not yet spread to other organs, and although there is a problem that sexual function may decrease after some surgeries, it is the longest period of life for patients. “There is no treatment as effective as surgery in terms of guaranteeing health,” he said. “If you are diagnosed with prostate cancer, it would be wiser to think about which medical staff you can trust to perform your surgery rather than worrying about whether or not to undergo surgery.” emphasized.
