Is a high PSA level ‘prostate cancer’ unconditionally? [건강톡톡]

The number of prostate cancer patients in Korea is increasing rapidly. According to data from the Health Insurance Review and Assessment Service, the number of prostate cancer patients in Korea increased from 75,000 in 2017 to 110,000 in 2021, an increase of about 45% in 4 years. We studied in detail with a specialist in urology at Haidaq about the tests needed to diagnose prostate cancer, which ranks first among male cancers, and the treatment methods after confirmation.

The number of prostate cancer patients in Korea is increasing rapidlyㅣSource: Getty Image Bank
Q. What is prostate cancer?
Normal cells divide and grow on their own, complete their functions, and die. However, if there is a problem with these functions, cells can grow rapidly without dying and spread to nearby tissues or other parts of the body, threatening life. This is called a malignant tumor, and when such a malignant tumor develops in the prostate, it is called prostate cancer. Prostate cancer occurs mainly in people in their 70s or older, but recently it is also common in people in their 40s and 50s.
– Hydak Kyongho Ryu Urology Counseling Doctor (Goldman Urology Clinic)

Q. It’s hard to urinate these days. Is it prostate cancer?
Prostate cancer usually has no symptoms in its early stages. This is because it grows slowly compared to other cancers. Even if the size of the tumor increases to some extent, it does not cause problems such as difficulty urinating, inflammation of the bladder, and hematuria, as long as the urethra or the surrounding tissues are not compressed. Symptoms such as urinary frequency, nocturnal polyuria, dysuria, and a feeling of residual urine may appear only when the cancer is significantly advanced, and sometimes hemostatic fluid may occur. When cancer develops and metastasizes, it usually metastasizes to the bone, and in this case, the pain is severe.
– Professor Yoon Jang-ho, counseling physician, Department of Urology, Haidak (Wonkwang University Sanbon Hospital)

Q. My PSA level was high What does this mean?
PSA (Prostate Specific Antigen) is a type of tumor marker test, also known as prostate specific antigen. Although it is most commonly used as a type of prostate cancer screening test, it is also high in various related diseases such as prostatitis and hypertrophy, and depending on the degree of elevation, related diseases can be classified and suspected to some extent.

Benign diseases such as inflammation or hypertrophy usually show a value of less than 2, and a value of 2 or more requires regular careful observation. You can perform detailed inspections such as inspections.
– Director Lee Woo-seung, consulting physician, Department of Urology, Haidak (Eurojin Urology Clinic, Wonju Branch)

Q. What additional tests are carried out if prostate cancer is suspected?
Prostate cancer screening methods include a prostate PSA level blood test, a prostate biopsy, and a pelvic MRI. If the PSA blood level is confirmed to be high, a direct examination is required to confirm the diagnosis. The cutoff value of the prostate value for which a prostate biopsy should be performed can vary depending on age and circumstances, so a doctor’s judgment is required. If cancer tissue is found in a biopsy, an MRI scan is required for staging, and a bone scan is carried out to confirm bone metastases. Bone scans are performed because bone metastases are more common in prostate cancer than in other sites.
– Director Lee Woo-seung, consulting physician, Department of Urology, Haidak (Eurojin Urology Clinic, Wonju Branch)

Q. Is it necessary to have an operation to get a cure?
The general principles of treatment are: In the case of stage 1-2 carcinoma confined to the prostate on imaging tests for staging, radical prostatectomy is performed and follow-up is performed without additional treatment. If it is a stage 3 or 4 cancer with distant metastases to the bone, lungs, liver, brain, kidneys, etc., systemic treatment is performed without surgery for curative purposes. It is common to receive testosterone suppression treatment at first, followed by chemotherapy. Testosterone, the male hormone, causes prostate cancer to grow, so hormone blockade treatment is a common treatment for distant metastases.
– Director Lee Woo-seung, consulting physician, Department of Urology, Haidak (Eurojin Urology Clinic, Wonju Branch)

* This article has been reproduced from a Haidak expert answer.

Support = Haidak Counseling Doctor Ryu Gyeong-ho (Urology Specialist Goldman Urology Clinic), Haidak Counseling Doctor Yoon Jang-ho (Urology Specialist Wonkwang University Sanbon Hospital), Haidak Counseling Doctor Lee Woo-seung (Urology Specialist Eurojin Wonju Urology Clinic)

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