Prostate Cancer

With an annual incidence of 200/100,000 men in western Europe, prostate cancer is one of the most common malignant tumours in men over the age of 70, alongside tumours of the skin. A further increase in the incidence is expected in the coming years, which means that this disease represents a challenge for the healthcare system.

As a result of this prognosis, precise diagnostics and a therapy individually adapted to the patient cannot be avoided. In recent years, various risk factors have been repeatedly discussed that could be partly responsible for the development of prostate cancer, such as diet, excessive alcohol consumption, chronic inflammation or UV radiation. However, only the familial risk has been scientifically proven with certainty.

How is prostate cancer detected?

In addition to the palpation of the prostate, the diagnosis also includes the determination of the PSA value from the blood, although the value of this test is highly controversial.

The PSA value can be influenced by various circumstances and factors, including inflammation, cycling or ejaculation up to 24 hours before the blood sample is taken, the prostate volume, etc., which is why a single value is not yet meaningful. For this reason, if the PSA value is elevated once, the test should be repeated in 4-6 weeks to rule out any influences from the factors mentioned.

If the PSA value remains elevated, the next step should be to take a tissue sample from the prostate for further diagnosis. The most common method is ultrasound-guided punch biopsy of the prostate, in which the sample is taken through an access via the rectum.

Mrt Fused Prostate Biospy

The biopsy can be supported by a prior MRI examination of the prostate, as an MRI-fused prostate biopsy contributes to improved diagnostics. According to current data, it leads to a significantly higher detection rate (approx. 70%) compared to conventional biopsy (40%), which means that aggressive and poorly differentiated carcinomas can also be detected more frequently.

Before considering a prostate biopsy, the “European Guidelines for Prostate Cancer” recommend an MRI examination of the prostate. It can therefore be summarized that this new method offers superior possibilities with regard to the clarification of a possible prostate carcinoma and determines the necessity of a biopsy.

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