After the first evaluation in patients who have complaints about the prostate or for routine control, an opinion is obtained after digital rectal examination and blood tests. At this stage, especially when interpreting the PSA test, it is decided whether the patient is in the risk group for malignant disease according to the age of the patient, according to the previous PSA values, the size of the prostate and the free PSA value.
It is questioned whether there are factors that may cause temporary increases in patients with high PSA values for age. Long-term bicycle rides, sexual intercourse, urinary tract infections are among these factors.
According to the physical examination and PSA results, the suspicion of prostate cancer can be eliminated and these patients are called for intermittent controls. The 'gray zone' patients in the middle can be re-examined in the near future or the presence of a suspicious lesion can be revealed by taking an MRI of the prostate. In patients with strong suspicion according to rectal examination and PSA test or with suspicious lesions in MRI, the character of the tissue is investigated by taking a piece of the prostate (biopsy). Biopsy can be performed directly with the standard biopsy procedure or with fusion biopsy for the target lesions in prostate MR.
In addition to prostate biopsy, prostate tissues removed by surgery are usually sent for pathological examination. According to the results of this examination, it can be understood that the prostate is benign or malignant.