If symptoms of a prostate disease appear or there is a suspicion of prostate carcinoma, before prescribing treatment for prostate cancer in Germany, the doctor prescribes the necessary studies. With their help, he can find out whether it is really a malignant tumor. And if found, studies provide information about how far the disease has gone.

Transrectal ultrasound

The next diagnostic method is transrectal ultrasound (TRUS). In this case, the doctor receives a visible image of the prostate and surrounding tissues on the screen using an ultrasound probe inserted through the anus into the rectum. If there is a tumor, then in some cases it is also visible on the monitor. In some cases, transrectal ultrasound can determine whether the tumor has spread beyond the prostate and has grown into nearby seminal vesicles. An ultrasound examination of the kidneys is used to determine whether the outflow of urine from the kidneys is impaired due to cancer. Ultrasound can be repeated frequently as the patient is not exposed to damaging radiation exposure. An ultrasound of the prostate is painless.

Taking a tissue sample (biopsy)

A biopsy can reliably show whether prostate cancer is present or not. In this study, under ultrasound guidance, multiple tissue samples from the prostate are taken through the large intestine with a thin needle. The resulting tissue is examined under a microscope by a specially trained pathologist for cancer cells (histological examination). After a few days, the result is ready. A biopsy is a non-hazardous study. There is no danger of tumor cells spreading throughout the body. Tissue sampling can be performed without anesthesia under local anesthesia. The patient is not required to be admitted to the hospital. Microscopic examination of tissue samples gives an answer in a few days whether there is prostate carcinoma or not. A pathologist can also determine how aggressive the malignant tumor is and prescribe treatment for prostate cancer in Germany at one of our clinics.

Criteria for the appointment of tissue sampling (biopsy) as part of early diagnosis:

PSA value from 4 ng / ml or more.

  •  Cancer-Suspicious Findings on Digital Rectal Examination
  • Noticeable increase in PSA value (without changing the method of its determination)
  •  Before performing a prostate biopsy, the patient should be explained the benefits, risks and consequences of this study.

Magnetic resonance imaging (MRI)

MRI is currently considered the best imaging modality for tumor detection, including prostate cancer. If carcinoma of the prostate is suspected, MRI can be used to localize suspicious areas for a tumor. But an MRI cannot replace a biopsy. However, it provides useful information about the volume of the prostate and the location of suspicious areas before a biopsy is taken.

Skeletal bone scintigraphy

With the help of scintigraphy of the bones of the skeleton, it is possible to determine whether the tumor has affected the bones. To do this, a small amount of radioactive material, especially intensively accumulating in the affected bones, is introduced into the bloodstream. A camera that registers radioactive radiation identifies suspicious areas in which metastases could form.

X-ray examination

X-ray examination of the urinary tract with contrast material, the so-called excretory urography, can show whether the ureters, bladder or urethra are also affected. Today, this examination is carried out only in exceptional cases, for example, with a suspicious ultrasound result. In an advanced case of prostate carcinoma, chest x-rays can be used to determine whether lung metastases have formed.

Laboratory research

A blood test before starting treatment for prostate cancer in Germany provides information about the general condition of the patient, the function of individual organs, and the stage of the disease. So, for example, an increase in the concentration of alkaline phosphatase and calcium levels may indicate the presence of bone metastases. Information about how much the tumor has already spread is given in a limited amount by the PSA test. There is a relationship between the height of the PSA level in the blood, the size of the tumor and possible metastases: with a PSA value of less than 10 ng / ml, the tumor is more often limited to the prostate itself and does not grow beyond the boundaries of the organ. With PSA values of more than 10 ng/ml, the probability that the tumor has already spread beyond the boundaries of the organ is high. In these cases, the risk of having daughter tumors in the lymph nodes, bones, or lungs is high.

Professor, Doctor of Medical Sciences
Head of Urology Clinic
Professor, Doctor of Medical Sciences
Head of Urology Clinic