Prostate disease always carries the risk of cancer and is particularly prevalent at an advanced age. Early diagnosis is just as important as starting treatment as soon as possible. Here you can find out what prostate diagnostics involve and when which examinations are carried out. If you are diagnosed, your doctor will inform you of the most suitable treatment procedure for you.
The male prostate gland is one of the sex glands. It shows changes in almost 50 percent of all men around the age of 50. These are either benign or malignant and, in the latter case, represent cancer. The benign disease is referred to in medicine as benign prostatic hyperplasia (BPH = benign enlargement of the prostate).
Prostate diagnostics are used to ensure that malignant findings are detected as early as possible. The purpose of prostate diagnostics is to detect a disease promptly using various examination procedures. Health insurance companies recommend early diagnosis as part of statutory prostate cancer screening from the age of 45. They cover the costs of a palpation examination of the genitals and inguinal lymph nodes.
Specialists in prostate diagnostics are specialists in urology (urologists) and radiology (radiologists). These specialists often work in medical fields such as radiotherapy/radiation oncology and uro-radiology.
Palpation alone is not considered sufficiently conclusive to detect a tumor. You also have the option of having a PSA test (PSA = prostate-specific antigen) carried out by your doctor. This allows an elevated value to be detected as part of a laboratory test and is a service that you have to pay for yourself. As an elevated PSA level in the blood can also have harmless causes, such as inflammation, the test is considered controversial.
The aim of prostate diagnostics is primarily the early detection and treatment of prostate diseases. The focus here is on prostate carcinoma(prostate cancer), whose chances of recovery are greatest when the cancer is still very small and localized. A tumor of the prostate initially causes no symptoms for a long time. Early detection as part of cancer screening is the only chance of starting treatment early.
If you notice symptoms, these are almost the same for benign and malignant diseases and only indicate a tumor in around ten percent of those affected. Possible symptoms include painful ejaculation, an increased urge to urinate or blood in the urine. A key factor in the risk of malignant findings is age. Having a father or brother with the disease also doubles the risk of such a finding.
The course of prostate diagnostics depends largely on your findings. The first step is a physical examination. Your doctor will perform a (digital rectal) palpation of the rectum. At a separate appointment or before the palpation, he or she will take a blood sample to determine the PSA value as part of a prostate cancer screening. Only if these two methods reveal a well-founded suspicion of cancer will further examinations be carried out.
In the next step, your doctor will suggest an MRI (magnetic resonance imaging) examination. This imaging procedure provides more precise information about whether your findings are a tumor, an inflammatory process or a harmless enlargement. If the suspicion of cancer is confirmed, a subsequent prostate biopsy (removal of tissue from the prostate) will provide the final findings. Computed tomography(CT) can be used to detect metastases in the bones or lymph nodes.
If prostate cancer is confirmed, further diagnostic methods are available that provide information about the size and degree of malignancy of the tumor. These include transrectal ultrasound (TRUS) in particular. During this ultrasound examination, your doctor checks whether and to what extent the cancer has penetrated the capsule surrounding the prostate. Elastography is also used to detect additional suspicious hardening.
If the findings show that your cancer is limited to the prostate, further treatment will be individually tailored to your disease. The treatment spectrum for prostate cancer includes at a glance
Your doctor will use radiotherapy or chemotherapy either to shrink the tumor before surgery or afterwards to prevent it from growing again.
Your doctor may also prescribe complex pain therapy in the further course of treatment. In the area of aftercare, positron emission tomography(PET) is often used to monitor the progress of prostate cancer. This procedure uses radioactive markers to visualize metabolic processes. Any tumor remnants and new malignant changes can thus be clearly identified.
After treatment, there is a possibility of temporary or, more rarely, permanent incontinence. Sexuality is also likely to be limited at first, although this is usually temporary erectile dysfunction that is not permanent. As studies have established a link between the incidence of prostate cancer and smoking, it is helpful to give up smoking.
The treatment risks associated with surgery range from urinary incontinence, erectile dysfunction and dry seminal discharges to pain and inflammation in the area of the operation. All of these are medically treatable. In the case of a radical prostatectomy (complete removal of the prostate), your doctor will probably recommend an outpatient or inpatient rehabilitation program to support your further recovery.
The prognosis depends on the stage of the disease at the time of diagnosis. If the disease is diagnosed early and has not yet metastasized to other organs, the chances of recovery are extremely good. The general life expectancy for this form of cancer is considered to be very good. The so-called five-year survival rate is around 87-92 percent.
Prostate diagnostics offers various procedures for the early detection of prostate cancer. Treatment depends on the individual findings and a customized therapy by a specialist, a urology specialist. With appropriate early detection, prostate cancer is one of the most treatable cancers in men.
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