About this disease
What it is about
Prostate cancer can develop through the malignant degeneration and proliferation of prostate cells. Risk factors include age and a hereditary predisposition, i.e. prostate cancer in the family. Whether early detection examinations make sense should be discussed individually with the family doctor or with specialists in urology. After a clinical examination, the PSA value (prostate-specific antigen) can be measured in the blood - a method that is currently still being discussed among experts with regard to the optimal timing.
Prostate carcinomas are mostly adenocarcinomas. Other small-cell, so-called squamous or mucinous carcinomas are very rare. With the help of tissue samples, the aggressiveness of the disease can be assessed on the basis of differentiation characteristics of the tissue (Gleason score, ISUP grading, Ki-67). The growth of the cells is subject to the influence of the male sex hormone testosterone, therefore the medicinal lowering of the hormone can sometimes be part of the therapy.
Symptoms and consequences
Prostate carcinomas often grow slowly and initially cause no to few symptoms. Complaints such as difficulty urinating, more frequent urination, burning, blood in the urine or painful ejaculation should be clarified. Often, other causes such as benign prostate enlargement can also be behind it. In advanced stages, metastases can form in the lymph nodes or bones, which can subsequently lead to pain or fractures, usually in the spine or pelvic bones.
What we do for you
Examination and diagnosis
If abnormalities are detected during rectal palpation or PSA analysis in the blood, an ultrasound examination and magnetic resonance imaging (MRI) follow. This allows the spread of the disease in the prostate or beyond its borders to be assessed. It is also important to perform a targeted tissue sampling. If advanced cancer is suspected, a computed tomography (CT) scan or a PSMA-PET-CT scan can be used to look for distant metastases. Important concomitant diseases should be clarified before starting therapy.
Treatment is determined in our interdisciplinary tumor case discussion, the so-called tumor board. In the early stages, active surveillance with close monitoring may be an option. If the tumor can be localized, surgery with radical removal, known as prostatectomy, or radiotherapy may be considered. Among the drug treatment options, various anti-hormonal therapies and chemotherapy are available. These can also be used after previous surgery or radiotherapy.