Diagnosis and treatment: How is prostate cancer usually detected?

Revered consultant urological surgeon Mr Zeb Khan details how a diagnosis of prostate cancer is established and also explains how patients and specialists decide the next steps in treatment in this informative article.

How is prostate cancer usually detected and diagnosed?

Unfortunately, there are no early warning signs of prostate cancer and therefore, it is usually picked up by PSA (prostate specific antigen) screening.

If results from this screening show high levels of PSA or the prostate examination appears to be suspicious, we perform an MRI scan to either confirm or rule out prostate cancer. If the results of the MRI scan are also suspicious and PSA levels are high, then we proceed with a prostate biopsy, which is the final diagnostic test.

How is prostate cancer treated?

Treatment for prostate cancer largely depends on the stage of the disease. If the prostate cancer is low grade and the patient has relatively low PSA levels, we can adopt a ‘wait and see’ approach, which is called active surveillance or active monitoring.

However, for young patients with a life expectancy of more than fifteen years who prefer to undergo treatment, there are a number of options including surgery, brachytherapy or hormonal radiotherapy with the aim to eradicate the disease.

How often do men suffering from prostate cancer need to have their prostate removed?

Overall, the rate of men who undergo surgery to remove the prostate, known as a prostatectomy, is between five and ten per cent but patient preference is a key factor.

If the patient’s preference is surgery, we have to consider several factors, including their fitness for anaesthesia, their age and whether their cancer is locally confined to the prostate or if they have locally advanced prostate cancer. According to all of these factors and also depending on their level of PSA and number of positive biopsies, we may offer the patient surgery or they may opt for brachytherapy with the aim to eradicate the disease.

Additionally, some patients may be suitable for treatment using high-intensity focal ultrasound (HIFU) however, this is only available at University Hospital London, not locally.

If you are seeking treatment for prostate cancer and wish to schedule a consultation with Mr Khan, you can do so by visiting his Top Doctors profile.