Prostate cancer is the most common cancer, accounting for almost 25 percent of all cancers. At just under 12 percent, the second most common cause of cancer death among men in Germany. It mainly affects older men, in the age group between early 50s and mid 70s. In Germany there is a statutory cancer screening program, the services of which are financed by health insurance companies. Men 45 years of age and older have the option of having their prostate palpated and their external genitalia examined once a year.
In early stage prostate cancer there are no typical symptoms. Problems with urination, which indicate a change in the prostate, are almost always caused by a benign enlargement of the prostate, which has nothing to do with cancer.
Prostate cancer typically only causes symptoms when it is more advanced. Then cancer can also become the cause of problems with urination, for example, an increased urge to urinate or a weaker urinary stream. In some cases, blood in the urine or seminal fluid may also indicate prostate cancer. If the cancer is very advanced, it can spread to other parts of the body, such as the bones, through the bloodstream or lymphatics, which can also cause bone pain. So far, the causes for the development of prostate cancer are. The factors influencing the course essentially unknown. However, age is considered the main risk factor. A family history of prostate cancer increases the risk of developing prostate cancer twofold. The male sex hormones (testosterones) also play a role in the development and progression of prostate cancer, without which it would not develop.
The treatment considered for men affected by prostate cancer depends on numerous factors, including the aggressiveness, size, and stage of the tumor. In addition, the age of the man also plays. Its general health status a role in the choice of approach.
High-risk prostate cancer In cases of advanced cancer (high-risk prostate cancer), the prostate is often irradiated. This can be done externally (external radiation therapy) or internally (internal radiation therapy, brachytherapy). You can find more information about this in the portal gesundheitsinformation.en:
In addition to radiation, surgery, hormone therapy, and/or chemotherapy are treatment options for advanced prostate cancer. Men who want to find out more can find an overview of the options, prospects and the consequences and side effects of the individual treatments on the information portal of the Cancer Information Service.
However, patients should be aware of other procedures before choosing the right treatment for them in each case. Information from the Internet can therefore not replace medical advice, at most supplement it.
Low-risk prostate cancer
Watchful Waiting If the carcinoma is small and not aggressive (low-risk prostate cancer), other treatment alternatives may be considered. On the one hand, this is the medical observation of the cancer ("watchful waiting"). As long as the cancer is not growing, this does not require therapeutic intervention. If the tumor changes, the resulting symptoms may be treated, but the tumor is not irradiated or surgically removed. This strategy is particularly suitable for older men who may have other medical conditions. For them, the risks and burdens of surgery or radiation therapy may outweigh the potential benefits of these treatments.
Active Surveillance On the other hand, active surveillance can be considered for low-risk prostate cancer. With this strategy, too, the cancer is initially only observed. Background is that a small, non-aggressive carcinoma usually grows very slowly or not at all. In many cases, there is no progression of the disease even years after initial diagnosis. The prostate is checked at regular intervals. Therapeutic treatment is given only if the tumor enlarges. This approach can have the advantage of sparing a man the side effects of radiation therapy or surgery as long as the cancer does not cause symptoms and does not change.
Basically, for men with low-risk prostate cancer, there is no a priori right or wrong therapy decision. Which treatment strategy is chosen, in addition to the factors of age and general health, is also a matter of personal consideration for the patient: For one person, it is more important to avoid possible side effects such as impotence or incontinence, while another wants to be as sure as possible that the cancer has been removed and accepts possible side effects in return.