Pro­sta­te can­cer

The prostate is a gland. It is located below the bladder and surrounds the uppermost part of the urethra. The prostate produces the prostate-specific antigen (PSA), which is expelled through the urethra with the seminal fluid and semen during ejaculation. Prostate cancer is a malignant tumour disease and originates from the glandular tissue.

Most prostate tumours cause hardly any symptoms for a long time. If the tumour constricts the urethra, problems occur when urinating, for example a weak urinary stream, frequent urge to urinate and pain or other difficulties when urinating. These symptoms can also be caused by benign diseases. They should always be clarified by a doctor.

Some factors can increase the risk of illness:

• Age: Prostate cancer is more common in older men
• The risk of developing prostate cancer is increased if a male relative (father, brother) already has the disease.

Unfortunately, there are still no known ways of preventing prostate cancer and two different examination methods are used for the early detection of prostate cancer: the digital rectal examination and the determination of the PSA level in the blood.

Early detection is controversial among experts. Whether or not a man wants to take advantage of early detection examinations is an individual decision in which the personal situation plays an important role. It is important that this decision is made after comprehensive information about the advantages and disadvantages of early detection of prostate cancer.

During an initial examination, the doctor will determine the PSA level in the blood and palpate the prostate with a finger. The definitive diagnosis of prostate cancer can only be made with an examination of a tissue sample.

To determine whether the tumour has metastasised or not, imaging examinations such as computer tomography (CT) are carried out.

The treatment of prostate cancer is planned individually. It depends on the size of the tumour, the characteristics of the tissue and whether lymph nodes are affected or metastases are present. The man's health situation also plays a role.

The treatment methods for prostate cancer are

• Surgery: Removal of the prostate (prostatectomy) (open or robot-assisted with DaVinci Xi)
• Active surveillance: Patients are monitored closely. Active treatment (e.g. surgery) is only started if the man so wishes or if the tumour continues to grow. This treatment strategy can be used for certain small tumours that are considered low-risk.
• Watchful waiting: This treatment strategy may be chosen for older men. Treatment is only started when the tumour causes symptoms.
• Radiotherapy
• Drug therapies: Chemotherapy, anti-hormonal therapies, targeted drugs