The most common cancer diagnosis in men

The prostate is one of the internal sex organs in men. It lies below the bladder and surrounds the uppermost section of the urethra.

The prostate produces part of the seminal fluid. It also produces the prostate-specific antigen (PSA). The PSA liquefies the seminal fluid.

What are the causes and risk factors?
Some factors can increase the risk of disease: 

• Age: is the most important risk factor for prostate cancer 
• Prostate cancer in the family: if the father has the disease 

Are there ways to prevent prostate cancer?
Unfortunately, there are still no known ways of preventing prostate cancer.

Smoking, alcohol consumption, diet and exercise - i.e. lifestyle - can be influenced. A healthy lifestyle and avoiding certain risks can therefore reduce the risk of developing some types of cancer.

Are there options for early detection of prostate cancer?
Prostate cancer can be detected early with screening tests. If prostate cancer is detected at an early stage of the disease, it can often be treated successfully.

Early detection is controversial among specialists. There is currently no unanimous opinion as to whether and in what form such examinations should be recommended. People at increased risk should discuss the advantages and disadvantages of early detection with their doctor from the age of 40. People whose father has prostate cancer are at increased risk.

Whether or not a man wants to undergo early detection examinations is an individual decision. It is important that this decision is made after comprehensive information about the advantages and disadvantages of early detection of prostate cancer.

What symptoms and ailments can indicate prostate cancer?
Prostate cancer usually grows slowly. It is therefore common for prostate cancer to remain at an early stage of the disease for years without causing any symptoms or complaints.

A benign enlargement of the prostate, prostate inflammation or prostate cancer can cause the following complaints and symptoms:  

• Difficulty urinating  
• Frequent urination  
• Pain when urinating  
• Blood in the urine 
• Bloody or painful ejaculation

You should have these symptoms checked out by your doctor. 

How is prostate cancer diagnosed?
If prostate cancer is suspected, various tests are carried out. In some cases, not all of the tests described here will be carried out: 

• Physical examination: Palpation of the prostate  
• Determination of the prostate-specific antigen (PSA) in the blood  
• Magnetic resonance imaging (MRI)  
• Removal of tissue from the prostate (prostate biopsy) 
• Computed tomography (CT) 
• Positron emission computed tomography (PET-CT)

How is prostate cancer treated?
The treatment options for prostate cancer are (links are in German): 

• Active Surveillance: The cancer is monitored and checked regularly. Active treatment is only carried out if the growth of the tumour progresses or if treatment is desired.  
• Watchful waiting: The focus here is on maintaining quality of life, not treating the prostate cancer. If there are no symptoms, no checks such as PSA tests are carried out.  
• Surgery: Removal of the prostate 
• Radiotherapy: External radiotherapy, internal radiotherapy (brachytherapy), radionuclide treatment, lutetium-PSMA treatment 
• Drug therapies: Anti-hormonal therapies, chemotherapy  
• As part of clinical trials: targeted therapy, high-intensity focussed ultrasound (HIFU) 

These treatments are used individually or in combination. If they are combined, this can be done simultaneously or consecutively.