Dann ist es wichtig, Zugang zu umfassenden und detaillierten Informationen über Ihre Krankheit und alle verfügbaren Behandlungsmöglichkeiten zu haben. In diesem Abschnitt geben wir Ihnen einen Überblick darüber, was Sie oder ein Familienmitglied wissen sollten, damit Sie auf das Gespräch mit Ihrem Arzt gut vorbereitet sind. Wenn Sie über Ihre Optionen gut informiert sind, können Sie Entscheidungen beruhigt angehen.
Viele Männer mit Prostatakrebs haben keine Symptome. Daher entwickelt sich Prostatakrebs in den frühen Stadien typischerweise unbemerkt; in der Regel hat der Patient keine Beschwerden. Anzeichen und Symptome treten erst in späteren Stadien auf.
Um festzustellen, ob ein Patient Prostatakrebs hat, wenden Ärzte verschiedene diagnostische Verfahren an. Die häufigsten Tests ist untenstehend aufgelistet.
Die vielfältigen diagnostischen Verfahren zeigen wie aggressiv der Krebs ist, wie groß er ist, ob er sich in das umliegende Gewebe ausgebreitet hat, und beurteilen den Gesamtzustand des Patienten. Verschiedene Untersuchungen müssen unter Umständen mehrfach durchgeführt werden, um ein möglichst genaues Bild zu erhalten.
Prostataspezifisches Antigen (PSA) ist ein Protein, das vom Prostatagewebe produziert wird. Die in Ihrem Blut gemessene PSA-Menge steigt normalerweise mit dem Alter und der Prostatagröße an, aber ungewöhnlich hohe Werte können auf die Notwendigkeit zusätzlicher Tests hinweisen1.
The Digital Rectal Exam (DRE) test is performed by the Urologist who will use their gloved index finger to feel your prostate through the rectal wall to assess the size, shape and stiffness of your prostate1.
The Magnetic Resonance Imaging device will use magnets to generate an image of your prostate and surroundings. From this image, the doctor may be able to find regions suspicious for cancer1.
Under imaging guidance (typically ultrasound), a small needle is used to collect a small amount of tissue from the prostate for further examination1.
Prostatakrebs wird als eine Veränderung des Gewebes beschrieben. Die Prognose hängt davon ab, wie weit sich der Krebs zum Zeitpunkt der Diagnose ausgebreitet hat. Der Krebs kann durch mehr oder weniger aggressives Wachstum gekennzeichnet sein. Ärzte verwenden eine Klassifikationsmethode namens „Staging“, um das lokale Ausmaß und die Hinweise auf die Ausbreitung von Krebs zusammenzufassen.
Die meisten Prostatakrebserkrankungen werden in einem frühen Stadium diagnostiziert, in dem der Krebs auf die Prostata beschränkt ist, d. h. lokal in der Prostata wächst. Daher wird es als lokalisierter Krebs bezeichnet. In späteren Stadien kann es sich außerhalb der Prostata ausbreiten, was als lokal fortgeschrittener Krebs bezeichnet wird, oder sogar in andere Organe metastasieren. Es kann sich über die Prostata hinaus ausbreiten durch:
Um eine geeignete Behandlung zu empfehlen, ordnen Ärzte den Prostatakrebs des Patienten einem Stadium zu. Das Staging richtet sich nach dem Ausmaß des Krebses, danach, ob Lymphknoten betroffen sind und ob sich der Krebs bereits auf andere Organe ausgebreitet hat2.
Eine gesunde Prostata.
Der Krebs ist bei einer digitalen rektalen Untersuchung nicht zu tasten und kann mit bildgebenden Verfahren nicht gesehen werden2.
Der Krebs ist auf die Prostata beschränkt – lokalisierter Prostatakrebs2.
Der Krebs hat die Kapsel durchbrochen – lokal fortgeschrittener Prostatakrebs2.
Der Krebs wächst in benachbarteten Organen2.
Die Wahl der richtigen Behandlung ist nicht immer eine einfache Entscheidung.
Das Verständnis für die Vorteile und Risiken, die mit den verfügbaren Optionen verbunden sind, ist unerlässlich, damit Sie die bestmögliche Entscheidung treffen können.
Im Folgenden sind einige der am häufigsten verwendeten Behandlungen aufgeführt.
Um weitere Informationen zu erhalten, sprechen Sie immer mit Ihrem Arzt über Ihre Diagnose und darüber, was für Ihre Gesundheit und Ihren Lebensstil am besten ist.
Viele Männer mit Prostatakrebs müssen nicht sofort behandelt werden, da ihr Krebs langsam wächst und ein geringes Ausbreitungsrisiko besteht2.
Stattdessen wird diesen Männern eine aktive engmaschige Überwachung ihres Krebses angeboten, mit wiederholten PSA-, DRE- und Biopsietests. Eine Behandlung wird empfohlen, wenn es Anzeichen dafür gibt, dass der Krebs fortschreitet4.
The TULSA Procedure is a less invasive option. It is a customizable, predictable, incision-free and radiation-free ablation of a surgeon defined region of the prostate. It is performed in combination with real-time MR Imaging, transurethral thermal ultrasound and a closed-loop temperature feedback control.
Radical prostatectomy is a surgical procedure (performed robotically or not) that removes the entire prostate gland. If the cancer has spread to surrounding lymph nodes, they too are removed.
Common side effects faced by patients after undergoing prostatectomy include erectile dysfunction and urinary incontinence4.
External beam radiation therapy (EBRT) uses high-energy x-ray beams from outside of the body to ablate cancer cells. Brachytherapy (internal radiation therapy) involves placing radioactive material inside or beside the cancer to ablate cancer cells5. Although both healthy and cancerous cells are damaged by radiation therapy, the goal is to destroy as few healthy cells as possible.
Common side effects faced by patients after undergoing radiation therapy include erectile dysfunction and gastrointestinal toxicity4.
1. National Cancer Institute. (2011, August). Understanding Prostate Changes. Aufgerufen: Aufgerufen: http://www.cancer.gov/types/prostate/understanding-prostate-changes/prostate-booklet.pdf
2. American Cancer Society. (2015, March 12). Prostate Cancer. Atlanta, GA: American Cancer Society. Aufgerufen: http://www.cancer.org/acs/groups/cid/documents/webcontent/003134-pdf.pdf
3.Rukstalis, D. B. (2002). treatment options after failure of radiation therapy—a review. Reviews in urology, 4(Suppl 2), S12. Aufgerufen Aufgerufen: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1477547/
4.National Cancer Institute. (2019, June 12). Prostate Cancer. National Cancer Institute. Aufgerufen: https://www.cancer.gov/types/prostate/patient/prostate-treatment-pdq
5.Radiologyinfo.org (2019, May 01). Brachytherapy RadiologyInfo.org for Patients.
Aufgerufen: https://www.radiologyinfo.org/en/info.cfm?pg=brachy
64 years old
“By far, the TULSA Procedure had the lowest risk of any treatment out there. To me, there was no question. If you are a candidate for the TULSA Procedure, please consider it.”
My wife and I hadn’t seen a doctor in many years, so in 2019, we decided to get physicals. I found out that my PSA was elevated. After another PSA test with elevated results, I was referred to a urologist.
In between that time, I came across an article on-line about a new procedure for prostate cancer called the TULSA Procedure. When I read the article, I didn’t know that I definitely had prostate issues. I always knew it was a possibility, but for some reason, that article stuck with me.
After another PSA test with elevated results, a positive prostate biopsy, and genetic testing confirming a more aggressive type of cancer, my physician recommended treatment and referred me to a surgeon. I started researching what my options were knowing I had to do something.
I decided I had to get more information to determine if the TULSA Procedure was a viable option. I started researching and looked at some of the TULSA Procedure studies. What I was able to determine was that for short term side effects, there really is no comparison between the TULSA Procedure and other treatment options.
I was hesitant about having surgery because anything can happen when you start cutting into the body. My brother also had prostate cancer and ended up getting surgery (twice) and radiation. He experienced issues afterwards and said to avoid surgery if at all possible. I also talked to a few other people I knew that had had prostate cancer, and all of them said to avoid surgery. From a relationship standpoint, my wife just said that she didn’t care what I did, she just wanted me to be around.
After meeting with a surgeon, my wife and I decided that was not the way I wanted to go. For me, surgery was going to be more expensive than other options, and I would have probably needed radiation on top of that. I’m looking at quality of life and surgery is risking your quality of life. I’m only 63. I don’t want to have a bag for the rest of my life. With the TULSA Procedure, it was likely that I would not need radiation, there was less risk of side effects which meant a better quality of life afterwards.
I had to get a new Urologist to proceed in the direction that I wanted. You have to make your own decisions about what you want to do to yourself, and you cannot be afraid to make difficult decisions. After conversations with my Urologist and their surgeon and their lack of knowledge or interest about new developments for the treatment of prostate cancer, my wife and I knew we had to make a change.
It is important to remember that Doctors are not God and they only know what they have learned or been exposed to. If they are not listening to you or you don’t think they are giving you the best advice for your condition, you have to have the courage to make the best decision for yourself.“
I also looked at HIFU, and from my understanding, it works like a pencil eraser, delivering treatment line-by-line so one of the problems is that it could miss some cancerous tissue. I was concerned about getting rectal or bladder damage from the heat. With the TULSA Procedure, the device rotates in a cooling tube and has 10 rotating transducer elements delivering the treatment with direct MRI feedback to ensure the tissue is heated to the proper temperature to kill the cancerous tissue but not too high to damage any non-cancerous tissue. So, to me, there’s no comparison between these two treatments either.
I can’t say enough about Dr. Dora’s team at the Mayo Clinic in Jacksonville. He, his nurses, the technicians, and the other staff were amazing. Because there are three different doctors in the room – the urologist, radiologist, and anesthesiologist, you’re getting three different perspectives on what the treatment should be.
As far as the actual procedure versus an operation, there is no comparison. In general, there is no recovery. I didn’t have any pain. If it wasn’t for the catheter, I would not have known anything was done. If I had had surgery, it would have taken a lot longer to recover with more pain.
You have to make your own decision and be informed. Being informed means that you know the possible treatment options available and you understand their benefits and risks. As a patient going through this procedure, I can say that this was the best decision I could have made to treat this problem. And I did not go into it blindly. I knew there were risks, but I looked at the risks of all potential treatments. By far, the TULSA Procedure had the lowest risk of any treatment out there. To me, there was no question. If you are a candidate for the TULSA Procedure, please consider it.
There are things I talk about now that I never thought I’d be talking about – like urinary issues and ED issues. I know that a lot of men don’t want to talk about prostate issues or the possible side effects of prostate treatment, but it’s important. If you were to ask me two years ago, if I would be talking openly about my prostate issues and experience, I would say no. Now, I won’t stop talking about it.
I hope information about this procedure gets out to Urologists and to their patients. I am glad I had the choice.
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