Modern Treatment of Prostate Cancer

Prostate cancer is often diagnosed at an early stage as part of a preventive check-up and can then be cured in many cases. As long as prostate cancer is diagnosed in the early stages and has not yet formed metastases (secondary tumors), there is a high probability that it can be cured, e.g. by complete surgical removal. But the therapeutic spectrum includes many possibilities from active monitoring to multimodal concepts.

Symptoms

Prostate cancer usually grows slowly and does not cause pain or other typical symptoms in the early stages. Normally, the tumor initially only grows locally, i.e. within the prostate. Possible symptoms of prostate cancer include pain and difficulty urinating, blood in the urine or semen, or pain when ejaculating.

Diagnosis

In addition to the clinical examination and the PSA test (laboratory test), the prostate is examined using a multiparametric MR. If prostate cancer is suspected after an MRI, the diagnosis must still be confirmed by a prostate biopsy (analysis of tissue sample) in order to determine the risk factors for the therapy decision.

A relatively new procedure - the prostate fusion biopsy - provides very reliable results. The MRI and ultrasound images are superimposed to make prostate carcinomas visible that are difficult to detect by ultrasound alone. Not only does this method provide more accurate results, it also helps to avoid repeat biopsies. On the basis of the histopathological examination of the tissue sample the staging and classification of the tumor is determined.

Treatment

A large number of therapy options are available for prostate cancer treatment, which are chosen depending on the stage of the carcinoma, the age or life expectancy of the patient and his personal wishes. Every step of the therapy is discussed and coordinated in detail with the patient. In many cases, surgery alone can be the solution. In some cases, active observation is sufficient.

In the case of primary radiation therapy, concomitant hormone therapy is often necessary. Follow-up radiation after an operation is necessary in up to 20-30% of cases in order to achieve healing. Other forms of therapy such as classic hormone therapy, new hormone therapy and chemotherapy have long been “palliative” measures to slow down tumor growth and, if possible, to make the disease, which can no longer be cured, become chronic. Today, however, the new hormone therapies are already being used as curative therapy approaches in combination with radiation or surgery.

Prostatectomy

If a surgical intervention (prostatectomy – prostate removal) is necessary, the surgeon’s experience, precision and the best possible minimally invasive therapies are required. Many of my patients come to me because I am known for the excellent performance of radical prostatectomy (removal of the prostate). I have performed this minimally invasive procedure well over 1000 times.

I have specialized in the large function-preserving and minimally invasive methods. My operational expertise now includes more than 5000 operations, especially in the field of uro-oncology.

Prevention is always better than cure...

Yes, the earlier prostate cancer is detected, the easier it is to treat. However, many of those affected only become aware of the malignant tumor when it is already more advanced, as it does not show any symptoms in the early stages. Therefore, men should regularly visit the urologist for check-ups. Even with advanced tumors, there are excellent treatment options, often in the sense of multimodal concepts.


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