Whether patients opt for conventional methods such as radiotherapy or a radical prostatectomy (RP), or for newer methods such as TULSA (which carries a lower risk of side effects), patients will undergo regular check-ups following their treatment to ensure that any relapses are detected at an early stage. Follow-up care begins no later than twelve weeks after the treatment. According to the German Cancer Society, 93 percent of all prostate cancer patients are still alive after five years . If new tumours develop following treatment, they may be a local recurrence at the surgical site or they may be a metastases in other parts of the body.
During follow-up examinations, the main thing bring tested is the patient’s PSA level. If the patients PSA level is found to be elevated, a digital examination is performed. Follow-up care also includes providing physical, psychological and social support for the patient, particularly if they are suffering from side effects, such as urinary incontinence or impotence which are are mainly caused by conventional methods such as radiotherapy or radical prostatectomy. Studies into the use of the TULSA method show that patients who receive this treatment tend to be less affected by typical side effects. In the first and second year after therapy, follow-up examinations are usually scheduled every three months. In the third and fourth year, the check-ups take place every six months. If the patient has not suffered a relapse after four years, check-ups are scheduled annually.
Patients who are affected by side-effects such as incontinence and impotence following therapy often find these side-effects difficult to cope with, and as a result they may suffer considerably even when the side effects are temporary. When such side-effects occur with a patient, follow-up care should go beyond just the medical treatment of these side effects, but also on the psychological problems that may be associated with them. Active relaxation, physical activity, visiting a support group and talking to others who are affected can help patients in managing the disease and its consequences.
 German Cancer Society: Patientenratgeber Prostatakrebs (Patient advice booklet for prostate cancer). 2nd, updated version, Berlin, September 2014, page 15.
Ultrasound and biopsy are considered reliable methods of diagnosing prostate cancer in men. Newer diagnostic techniques using magnetic resonance imaging (MRI) obtain even more precise images of the area under examination. The standard diagnostic procedure is ultrasound-guided biopsy. MR Imaging techniques are then used when further examination is required. The purpose of the MRI is to determine the size of the tumour and its exact location, whether the lymph nodes are also affected, and whether the cancer has metastasized to the bones or other organs.
Prostate carcinoma is mostly diagnosed by ultrasound and biopsy. In some cases, however, the biopsy does not reveal any abnormalities, even if the PSA level in the patient’s blood continues to rise, which suggests the presence of prostate cancer. This is an indication for doctors to use more sophisticated imaging techniques such as multiparametric MRI. This is a special form of magnetic resonance imaging that provides more precise images of the tissue. In some cases, this examination can also help to assess whether surgery is an option or not.
MRI uses a magnetic field that influences the hydrogen atoms in the body. This produces signals that the MRI can use to create an image of the inside of the patient’s body. A multiparametric MRI is also used before treatment with TULSA to ablate the prostate; this MRI creates several sequences, which provide an even more accurate image of the prostate and adjacent organs and structures. A contrast medium is also administered to the patient. When diagnosing suspected prostate cancer, the device produces a score; depending on this value, a tumour can be classified as highly likely (score 5) or highly unlikely (score 2). An MRI makes it easy to distinguish between cancerous tissue and healthy tissue.