Prostate cancer and prostate conditions:
– Prostate cancer:
Prostate cancer is the most common cancer in men, accounting for 30% of all new cancer diagnoses and over 13% of all male cancer deaths in Australia. Prostate cancer behaves variably, and factors such as age, grade, volume and extent of disease all play a vital role in determining the best treatment plan.
Some prostate cancers are considered low risk and observation through a surveillance protocol can be safely used to optimise quality of life whilst ensuring the cancer remains indolent. Other more aggressive cancers may require surgery or radiotherapy. Since a variety of treatment options exist, it is crucial to tailor an individualised plan to each patient to best serve their needs.
– PSA testing:
This blood test is used as a screening tool to detect prostate cancer. There are a number of reasons why your PSA may be elevated. Kapil will guide you through the meaning of this result and discuss in detail the merits of further investigations such as an MRI or prostate biopsy.
MRI of the prostate is a valuable tool in the diagnosis of prostate cancer. It provides valuable information regarding suspicious areas within the prostate, along with spread of cancer beyond the prostate. An MRI is usually requested by your urologist if there is a high index of suspicion for underlying prostate cancer.
– Transperineal Prostate Biopsy:
A transperineal prostate biopsy is performed as a day case under general anaesthetic. A needle is passed through the skin between the scrotum and the anus (perineum) to sample MRI reported areas of the prostate as well as all other aspects of the gland in a systematic way.
– Active Surveillance:
If there is a small area of low-grade cancer, Kapil will discuss with you the suitability of regularly monitoring your disease with a protocol that is safe and maximises your quality of life. Active surveillance allows the maintenance of sexual function and continence whilst avoiding potential overtreatment. Treatment for your cancer can therefore be securely delayed as long as possible.
– Robotic radical prostatectomy:
In larger volume or more aggressive cancer, treatment by surgery or radiotherapy is recommended. Kapil has trained in performing robotic radical prostatectomy at the Martini Clinic, the highest volume prostate cancer centre in the world. The centre performs over 2500 prostate surgeries per year and leads the world in its robotic technique, the mainstay for prostate cancer surgery. The surgery removes the entire prostate gland, along with the pelvic lymph nodes if required, and joins the bladder back up to the urethra. The gold standard is to remove the entire cancer whilst preserving closely running nerves that supply erections and ensuring satisfactory long-term urinary continence.