Prof. Dr. Ljupcho Lekovski, who is a surgeon urologist at Acibadem Sistina Hospital, highlights the recent findings on prostate cancer (risk factors, symptoms, treatment)

Prostate cancer develops in the gland called the prostate. It’s the size of asweet chestnut and it’s located just below the bladder. This gland produces part of the fluids in the semen. After skin cancer, this type of cancer is the most common among men. Prostate cancer develops slowly, without making serious disruptions. However, there are types of prostate cancer that areaggressive and spread quickly.



Symptoms might not appear in the early phase of the disease. As the disease progresses, the first symptoms such as frequent urination, especially during the night, difficulties in starting or stopping to urinate, weak urinary discharge, feeling of pain and burning sensation when urinating or blood in the urine or semen appear.

Risk factors

The prostate cancer has risk factors which we can control and one of them is nutrition. Excessive consumption of fatty foods and red meat increases the levels of hormones. On the other hand, the age and family history are risk factors we can’t control.

Myths about prostate cancer

There are many myths related to prostate cancer. It has been proved that frequent sexual activity doesn’t increase the risk of prostate cancer, nor the increased prostate leads to cancer.

DRE and PSA screening

The main risk factor for prostate cancer is the age. The risk is greater if one or more family members have had prostate cancer. One of the most important preventive check ups to be made by every man over 50 is prostate examination, which consists of an ultrasound and rectal examination of the prostate. An integral part of this male package is determination of PSA in the blood. This is a kind of tumor marker that can detect presence of prostate cancer at a very early stage. These check ups should be implemented starting from 45 years oldfor men with family history of prostate cancer, as well as for smokers. Elevated PSA level may indicate an increased risk of cancer. Increased values ​​of PSA don’t indicate prostate cancer. This tumor marker canhave elevated values in the blood and in prostate inflammation.

Biopsy is also one of the diagnostic methods. It is performed using a needle with which samples are taken from the prostate tissue. The tissue samples are examined under a microscope. The biopsy is the best way to detect cancer and its stage.

Prostate cancer imaging

Some patients need further examinations on whether the cancer has spread around the prostate. These examinations include ultrasound, CT tomography, magnetic resonance imaging, PET scan and bone scan.

Prostate cancer stages

Prostate cancer can have four stages, from the moment when it’s in its initial stage and is located in the prostate, to the moment when it metastasizes to the lymph nodes, nearby organs or tissues (rectum and bladder) or more remote organs, such as bones and lungs.

Prostate cancer survival rate

"The good side" of this disease is that it usually develops slowly and 9 of 10 cases are detected at an early stage. The ones that are not diagnosedwith cancer at the time until it hasn’t extended to other organs, i.e. when it is localized only in the prostate, the survival rate is 100%, while in those whose cancer has spread to the remote organs is 28%.


The treatment of prostate cancer is surgical, called radical prostatectomy, which can be performed in a classical manner, laparoscopically or with robotic surgery.

Hormonal therapy may reduce the growth of cancer cells. These medicines or hormones block testosterone production and other male hormones called androgens. The side effects of these drugs are sweating, breast growth, obesity and impotence.

Chemotherapy and radiotherapy are part of the treatments. Radiation therapy at Acibadem Sistina is conducted with the most powerful accelerator - TRILOGY.

Erectile dysfunction

Erectile dysfunction doesn’toccurs in every patient, it can occur in cases where the cancer is advanced. In the treatment of erectile dysfunction, penile prostheses are recommended which represent a permanent solution to this problem.

Healthy nutrition is the best prevention of this type of cancer.

Five or more vegetable meals a dayare recommended, as well as whole grain instead of white bread, reduced intake of fatty foods and processed meat, reduced intake of alcoholic beverages.

Read more about prostate cancer for further information.


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