Prostate cancer

Prevention of Prostate Cancer

Can we catch prostate cancer at an early stage?

Yes, with the  help of a PSA blood  test, we are able to catch prostate cancer at an early stage, when it can not  be demonstrated by any other method. The main benefit is that the tumor is caught early, can be treated effectively and in many cases can be completely cured.

Prostate cancer is a disease in which malignant (cancer) cells form in the tissues of the prostate.

The prostate is a gland in the male reproductive system located just below the bladder (the organ that collects and empties urine) and in front of the rectum (the lower part of the intestine). It is about the size of a walnut and surrounds part of the urethra (the tube that empties urine from the bladder). The prostate gland makes fluid that is part of the semen.

 Anatomy of the  male reproductive and urinary systems; drawing shows front and side views of ureters, lymph nodes, rectum, bladder, prostate gland, vas deferens,  penis, testicles, urethra, seminal vesicle, and ejaculatory duct.

Prostate cancer is found mainly in older men. As men age, the prostate may get bigger and block the urethra or bladder. This may cause trouble urinating or sexual problems. The condition is called benign prostatic hyperplasia (BPH), and although it is not cancer, surgery may be needed to fix it. Thesymptoms of benign prostatic hyperplasia or of other problems in the prostate may be similar to symptoms of a prostate cancer.

Two-panel drawing shows normal male reproductive and urinary anatomy and benign prostatic hyperplasia (BPH). Panel on the left shows the normal prostate and flow of urine from the bladder through the urethra. Panel on the right shows an enlarged prostate pressing on the bladder and urethra, blocking the flow of urine. 

Normal prostate and benign prostatic hyperplasia (BPH). A normal prostate does not block the flow of urine from the bladder. An enlarged prostate presses on the bladder and urethra and blocks the flow of urine.

Tests that examine the prostate and blood are used to detect (find) and diagnose prostate cancer.

The following tests and procedures may be used:

Digital rectal exam (DRE): An exam of the rectum. The doctor or nurse inserts a lubricated, gloved finger into the rectum and feels the prostate through the rectal wall for lumps or abnormalareas.

Digital rectal exam; drawing shows a side view of the male reproductive and urinary anatomy, including the prostate, rectum, and bladder; also shows a gloved and lubricated finger inserted into the rectum to feel the prostate. 

Prostate-specific antigen (PSA) test: A test that measures the level of PSA in the blood. PSA is a substance procured by the prostate that may be found in an increased amount in the blood of men who have prostate cancer. PSA levels may also be high in men who have an infection orinflammation of the prostate or BPH (an enlarged, but noncancerous, prostate).

Transrectal ultrasound: A procedure in which a probe that is about the size of a finger is inserted into the rectum to check the prostate. The probe is used to bounce high-energy sound waves (ultrasound) off internal tissues or organs and make echoes. The echoes form a picture of body tissues called a sonogram. Transrectal ultrasound may be used during a biopsy procedure.

 

 

How to decide for the best treatment modality after prostate cancer diagnosis?

Have you been diagnosed with a prostate cancer? Did your doctor suggest more treatment options and you don´t know what procedure to decide for? Would you like to discuss your decision with an expert?

In most cases, prostate cancer is detected at the localized stage. It is a situation where we assume that the tumor is limited to the prostate and has not produced any metastasis. What is important? If the tumor is only in the prostate, the disease can be cured.

Today, we have more treatment options in such cases. The definitive choice depends on many factors. Factors that we consider include: a specific result of histological examination (degree of tumor malignancy, number of positive samples in biopsy, etc.), your PSA range, size of the tumor (rectal investigation or magnetic resonance imaging), but also your age and other diseases. Your preferences may also play an important role in decision-making.

Basically, there are three basic options today:

  • Surgical treatment: complete removal of the prostate and often removal of lymph nodes – this procedure is called radical prostatectomy. Radical prostatectomy can be performed in different ways. It can be performed as open surgery, laparoscopically or the most modern way – using an operating robot.
  • Prostate irradiation by external emitter or by applying radioactive particles directly into the prostate (so-called brachytherapy). External irradiation can be done by photon or proton radiation therapy.
  • In certain cases the disease can be just monitored for some time. This approach is considered with the most favorable findings, when the tumor is still small and less active. The patient may then be monitored for a certain period of time following a strict schedule (regular PSA check-ups, magnetic resonance imaging, sometimes repetition of biopsy) and start the active treatment (surgery or irradiation) only when the tumor begins to grow and becomes active. We call this procedure active surveillance.

 

In case you cannot decide which procedure to choose, you can book an appointment at our clinic to consult your case. Our experts with many years of experience will be willing to pay attention, will explain everything to you and help you decide.