Prostate Cancer

Fear of Prostate Cancer


Elevated PSA levels are often a sign of prostate cancer.

Many men with prostate cancer experience no symptoms whatsoever, especially during the early stage of the disease. This is why PSA testing and early detection are so important. Early detection can greatly increase the chances of successful treatment.

At Risk Groups

There are a number of risk factors associated with prostate cancer that deserve mention. Here, specific symptoms play a subordinate role because men with prostate cancer often experience no symptoms, especially in the early stages of the disease:

  • Middle-aged men
  • Men with elevated or fluctuating PSA levels
  • Men with a certain family history (e.g. those whose fathers had prostate cancer)
  • Men whose PSA levels do not decrease after the administration of antibiotics
  • Men whose prostate glands are enlarged (with and without signs of urinary dysfunction)
  • Men with pain in the area of the pelvis


 Prostate Cancer Symptoms


Although the cause of prostate cancer is still unknown, it is known that some men have a higher risk of contracting the disease.

Prostate cancer seldom causes pain or other symptoms in its early stages. This is because it usually develops in the peripheral zone of the prostate gland. It is not until the cancer has reached an advanced stage that men begin to notice some of the common symptoms such as urinary dysfunction, which results from a compressed urethra or urinary bladder.

Prostate Cancer and PSA Level

Blood tests to determine a patient’s PSA level are important because elevated or rising PSA levels are an indication of prostate cancer. Your doctor will therefore be interested in determining what your PSA level is and how the level develops over the course of an extended period of time. If testing shows an abnormal PSA level, then it will be essential to find out what the cause is, even if you have experienced no other symptoms.

MRI of the Prostate at the ALTA Klinik

We use MRI to examine the prostate glands of our patients and to determine whether any disorders are present.

MRI allows your doctor to visualize any areas of prostate tissue that have undergone change, to determine the precise location and extent of any tumors that are present, to determine whether capsular penetration has taken place and whether any existing cancer has spread to the lymph nodes or bones.

Thanks to the superior resolution and quality of the images it generates – significantly better than that offered by ultrasound – MRI enables us to detect even the smallest of tissue lesions. Moreover, the MRI procedure used at our clinic does not involve the use of a rectal coil or any other form of rectal intervention.

(-> MRI of the Prostate)

Conventional Methods of Examination in Cases of Suspected Cancer

We do not carry out the following conventional examinations because they simply do not provide a reliable means of diagnosing prostate cancer:

  • Digital rectal examination
  • Transrectal ultrasound
  • Elastography

The results of these examinations are only reliable when they are carried out under ideal conditions. In other words, any tumors that are not large enough and not in the right location (e.g. on the side of the prostate nearest the lower intestine) will not be detected, and the prostate itself will have to be its normal size and not enlarged. In contrast, none of these factors present a problem when it comes to the reliability of the MRI procedure that we use.

How is prostate cancer diagnosed?

Prostate cancer is conclusively diagnosed by removing a tissue sample (biopsy) from the prostate gland and examining it in a laboratory. However, this procedure is only necessary if the MRI examination indicates the presence of conspicuous tissue structures. If such structures are present, we use an MRI-guided biopsy procedure to go directly to the area in question and remove the tissue sample precisely from this area.

(-> Prostate Biopsy)

Any tissue samples that are removed are analyzed by a pathologist. If the tissue analysis shows the presence of a malignant tumor, the pathologist will proceed to categorize the tumor based on the Gleason grading system. The resulting Gleason score, which is used to specify the tumor’s potential to grow at an aggressive rate or to spread beyond the prostate, is then used to guide treatment.

Gleason Score

The Gleason score reflects the degree to which the structure of the tissue in a malignant tumor varies from normal tissue. The Gleason score may range from 2 to 10, with a score of 2 indicating a slow-growing tumor and a score of 10 indicating a fast-growing, aggressive tumor.


In addition to evaluating a malignant tumor’s potential to grow at an aggressive rate and to spread beyond the prostate (Gleason score), it may be necessary to determine whether it has already done so – in other words, to determine whether the cancerous growth has penetrated the prostate capsule or spread beyond the prostate to other organs or tissue such as the seminal vesicle, neighboring lymph nodes or bones (metastasis).

MRI has introduced a range of new treatment options for those who have been diagnosed with prostate cancer. The precise visualization of a prostate tumor can be used as a basis for removing the tumor surgically (male lumpectomy) instead of removing the whole gland or a significant part of it. The advantage of such organ-preserving treatment is that it significantly reduces the risk of major side effects such as incontinence and impotence.

The prostate MRI we use at our clinic is a basis for enhancing the established forms of organ-preserving prostate treatment. However, decisions concerning organ-preserving treatment are essentially based on the position and extent of the cancer in the prostate gland as well as the estimated degree of its malignancy.

Using a focal approach and treating only the zone in which the tumor is located will leave the unaffected prostate tissue intact. The nerves and blood vessels in the healthy tissue will be spared and side effects such as incontinence and impotence can usually be avoided.

However, if a prostate tumor is already so advanced or aggressive (Gleason score of 8 to 9) that it is not possible to treat it focally, the information provided by the MRI scans can be used to support the subsequent prostate surgery. Equipped with exact specifications concerning the location of the tumor, the surgeon who performs the prostatectomy (partial or complete removal of the prostate gland) may be able to avoid damaging the nerve on the unaffected side. This nerve-preserving surgery can help to minimize side effects such as impotence and incontinence.

In some cases, it will be necessary to remove the entire prostate without sparing the nerves. This form of surgical intervention is usually accompanied by radiation therapy, anti-hormonal therapy or chemotherapy.

Interestingly enough, there are also cases of prostate cancer (small-volume, low-risk tumors) that do not call for surgical intervention. In such cases, your doctor may advise no more than a regimen of active surveillance. For more information, please refer to:

(-> Active Surveillance for Prostate Cancer)

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Partnerklinik der Charite
Pathologie Partner


Alfred-Bozi-Str. 3
33602 Bielefeld
Tel: +49 521 260 555 44
Fax: +49 521 260 555 14

Reinhardtstr. 23-27
10117 Berlin
Tel: +49 30 814 501 8118
Fax: +49 30 814 501 8119

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ALTA Klinik
Neuenkirchener Straße 97
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