Diagnostics - Introduction

Early precaution

More than 70 percent of prostate carcinomas can be detected and cured at an early stage by means of targeted preventive examinations. Once a year, every man over the age of 40 should have a cancer screening examination performed by an urologist. The highest level of safety in diagnosing prostate carcinoma at an early stage is currently provided by the combination of the two:

Control of the PSA value in the blood (PSA: prostate specific antigen) Touch examination of the prostate gland Ultrasound examination with a high-resolution colour duplex ultrasound device of the latest generation (colour duplex sonography)

Reliable diagnosis of prostate cancer

If prostate cancer is suspected in the preventive examinations, a biopsy is required to secure the patient. The tissue of the prostate gland is examined for the presence of tumor cells. On the basis of the pathological findings (biopsy), the PSA value and the palpation findings, a precise prognosis can be made with regard to the local limitation of the cancer to the prostate. 

If the biopsy does not provide tumor detection, but if the PSA level continues to rise, further examinations with modern imaging methods are advisable. In addition to colour duplex ultrasound, the West German Prostate Center uses real-time elastography and/or multiparametric 3-Tesla magnetic resonance tomography.

Classification of the tumor stage

If prostate cancer is actually diagnosed, the aggressiveness and spread of the tumour must be precisely determined. Only then can the optimal therapy recommendation be made with the best possible chances of recovery. The WPZ offers various methods for the exact classification of the tumour stage:

PSA-Test

In addition to palpation and ultrasound examinations, the PSA test has been available for the early detection of prostate carcinoma for more than 25 years.

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Elastography

Elastography combines ultrasound images of the tissue with a colored representation of the blood flow in the vessels.

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3-Tesla MRI

Functional magnetic resonance tomography (fMRI, magnetic resonance imaging) with a 3-tesla tomograph is currently the most accurate method for visualizing prostate cancer.

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Prostate Biopsy

Prostate biopsy is the removal of tissue from the prostate gland for examination by a pathologist under the microscope.

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MRI-guided Prostate Biopsy

The West German Prostate Center iuses the most modern imaging method available today and combines it for prostate biopsy.

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Gleason-Score

The malignancy of the prostate carcinoma depends not only on the type and extent of the tumour but also on the extent to which the cells of the tumour tissue differ from the healthy prostate cells. The Gleason score is a measure of the extent and degree of tissue alteration.

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TNM Classification

The TNM classification describes the size and extent of the tumor as well as the spread of cancer cells in other organs.

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Bone Scan

Bone scintigraphy (also known as skeletal scintigraphy) is a special nuclear medicine examination method in which the accumulation of a previously administered radioactive drug in the bone is measured.

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PSMA-PET/CT

PSMA imaging with a newly developed slightly radioactive marker for PET (positron emission tomography) detects tumour centres and metastases even more precisely than conventional choline PET/CT, which is still standard in many hospitals.

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