Facts about prostate cancer and bladder problems: from examination to treatment

What tests are needed to detect prostate cancer early?

From the age of 50, urologists recommend a prostate screening test to detect malignant prostate changes early and treat them accordingly. In some cases (for example, in families with a history of the condition), this examination is recommended from the age of 45. In addition to a detailed discussion, a urinalysis, physical examination and ultrasound, the so-called PSA level in the blood is determined. An elevated prostate-specific antigen (PSA) level can give the doctor an initial indication of whether there is currently an abnormal process in the prostate area. However, the PSA level alone does not allow a distinction to be made as to what kind of process is involved. Further examinations are carried out to provide a more precise differentiation. The urologist performs a digital rectal examination, whereby he feels through the rectum for any abnormalities in the prostate, such as enlargement, hardening, etc. If there is any suspicion of the presence of prostate cancer, imaging techniques such as magnetic resonance imaging (MRI) of the prostate will be arranged to precisely detect suspicious areas in the organ and to take targeted samples in a further step. Depending on the results, your doctor will then discuss and plan the necessary treatment steps with you.

What are the chances of recovery with early detection of prostate cancer?

Prostate cancer that is detected early and is localised (i.e. confined to the prostate gland) without any spread has a good chance of recovery with a good overall prognosis. Of those affected, around 90% are still alive after five years.

What treatment options are available for men with bladder problems caused by an enlarged prostate?

The further therapeutic approach depends on how severe the symptoms are subjectively and objectively, and to what extent other organs are already affected. A fundamental distinction is made between a conservative (without surgical intervention) and surgical procedure.

The conservative approach includes easy-to-implement behavioural measures, such as changing drinking behaviour, adjusting toilet visits, avoiding alcohol and coffee, a drug therapy and regular follow-up visits to the urologist to monitor whether the medication is working, what the current bladder emptying situation is, whether new symptoms have arisen, so that timely action can be taken to adjust and optimise the treatment process.

Surgical treatment involves reducing the prostate tissue, and various surgical procedures have already been established. Discuss with your urologist which surgical option is best for you.

Is there a difference in the treatment of benign prostate enlargement and malignant tumours?

The differences lie in the various treatment objectives. The primary objective in the treatment of malignant tumours is to eliminate the tumour. However, depending on how advanced the tumour is at the time of diagnosis, this is not always possible, so that stopping/slowing further tumour and metastases growth and avoiding/limiting their spread in the body determine the choice of treatment.

Benign prostate enlargement is treated if it causes symptoms. Not every enlargement of the prostate gland requires treatment. If treatment is necessary, the primary goal is to restore satisfactory micturition and to minimise the risk of consequential damage.