Prostate Cancer


Have you been diagnosed with prostate cancer recently?

If so, it is important for you to have access to comprehensive, in-depth information about your disease and all the treatment options available. In this section, we will give you an overview of what you or a family member should know, in order to help you feel well-prepared for when you speak with your doctor. Knowing your options may help you approach decisions with peace of mind.


What is Prostate Cancer?

Normally, our body carefully controls the growth of all cells. New cells take the places of old dying cells. When cells start to grow in an uncontrolled way then cancer can develop. Often men with prostate cancer do not show any symptoms or signs right from the start as it either growth slowly or hardly at all. Some prostate cancer whatsoever grows fast and will need treatment and monitoring in order to avoid it spreading further outside the prostate.¹⁰

Symptoms

Many men that have prostate cancer have no symptoms. Therefore, it can be said that prostate cancer typically develops unnoticed in the early stages; there are usually no complaints from the patient. Signs and symptoms only occur at later stages.
  • Trouble in passing urine and emptying the bladder completely
  • Sudden urgent need to urinate, especially at night
  • Burning sensation or pain while passing urine
  • Presence of seminal fluid or blood in the urine
  • Continuous pain in the back, hip or pelvic area
  • Signs of anemia
  • Pain during ejaculation, and a weak or interrupted flow of sperm
  • Erectile dysfunction
  • Unexplained weight loss¹¹

Diagnosis

Doctors use various diagnostic procedures to determine whether a patient has prostate cancer. The most common tests are listed below. The aim of the multiple diagnostic procedures is to find out how aggressive the tumour is, how large it is, whether it has spread into the surrounding tissue and to assess the patient’s overall condition. To get the most detailed picture possible, various examinations may need to be carried out several times.
 
Prostate Specific Antigen (PSA) is a protein made by prostate tissue. The amount of PSA measured in your blood increases normally with age and prostate size, but abnormally high levels may indicate the need for additional testing.
This test is performed by the Urologist who will use their gloved index finger to feel your prostate through the rectal wall to assess the size, shape and stiffness of your prostate.
The Magnetic Resonance Imaging device will use magnets to generate an image of your prostate and surroundings. From this image the doctor may be able to find regions suspicious for cancer.
Under imaging guidance (typically ultrasound), a small needle is used to collect a small amount of tissue from the prostate for further examination.¹²

Classification: Stage & Category

Prostate cancer is described as a change in the tissue, the prognosis depends on how far the cancer has spread at the time of diagnosis. It can be characterised by ‘more’ or ‘less’ aggressive growth. Doctors use a method of classification called ‘staging’ to summarize the local extent and evidence of spread of the cancer.
If diagnosed at an early stage, the tumour is mostly limited to the prostate, meaning it grows locally within the prostate. Therefore it’s referred to as localised cancer. In later stages, it can extend outside the prostate, which is referred to as locally advanced cancer. It can spread beyond the prostate by:

- Growing into neighbouring tissues
- Spreading through the lymphatic system (lymph nodes and lymph vessels)
- Traveling to distant tissues through the blood

In order to being able to recommend an appropriate treatment, doctors assign a stage to each patient’s prostate cancer. Staging is based on the extent of the tumour, whether lymph nodes are affected and whether the tumour has already spread to other organs.

Prostate-Cancer-Stages-timeline-01-1024x268

Stage T1

The tumour cannot be felt in a digital rectal examination, and cannot be seen using imaging techniques
Prostate-Cancer-Stages-02

Stage T2

The tumour is limited to the prostate — localised prostate cancer
Prostate-Cancer-Stages-03

Stage T3

The tumour has broken through the capsule — locally advanced prostate cancer
Prostate-Cancer-Stages-04

Stage T4

The tumour is growing in surrounding organs
The “N” category describes whether the tumour has affected the nearby lymph nodes, and the “M” category indicates whether metastases are present. Doctors assign a stage of cancer by combining the T, N, M classifications and PSA levels.

Treatment

Many men that have prostate cancer have no symptoms. Therefore, it can be said that prostate cancer typically develops unnoticed in the early stages; there are usually no complaints from the patient. Signs and symptoms only occur at later stages.

Conventional Treatment Options

  • Surgery
    -Open & laparoscopic Prostatectomy
    -Robotic Prostatectomy
  • Radiation therapy
  • Brachytherapy
    (Brachytherapy is an outpatient procedure, where a needle is inserted through the perineum and radioactive seeds are implanted into the prostate.¹³)
  • Active surveillance/ watchful waiting

Alternative Treatment Options

  • High intensity focused ultrasound (HIFU) – (Ablation)
  • Cryotherapy
  • TULSA (Ablation)

Looking for a
Treatment Centre?


There are several hospitals that are offering a TULSA in Europe.
Find out out more about each centre following the link.


Treatment Centres
¹⁰ iData Research Report (2016): European Market Report Suite for Urological Devices, pp 163.
¹¹ https://prostatecanceruk.org/prostate-information/about-prostate-cancer/prostate-cancer-symptoms, May 20.
¹² Prostate Cancer UK, https://prostatecanceruk.org, May 29, 2019
¹³ iData Research Report (2016): European Market Report Suite for Urological Devices, pp 163.