Prostate

PROSTATE CANCER DIAGNOSIS AND TREATMENT

Prostate cancer is the most common cancer in men and is increasing in incidence. A comprehensive integrated localised Prostate Cancer treatment programme is essential to ensure that the treatment an individual patient receives is most appropriate for that person and his disease. We offer a dedicated Prostate Cancer Service supported by specialist Radiological and Pathological services, providing a full range of surgical treatments.

The diagnosis is confirmed with a biopsy taken using a Trans-rectal Ultrasound and now at the London Bridge we are currently doing Transperineal Template biopsies.

TRANSRECTAL ULTRASOUND BIOPSY

Prostatic biopsies are most often carried out under ultrasound guidance. A lubricated sheathed transrectal ultrasound probe is passed into the back passage and the prostate gland examined to identify any obvious abnormalities within the prostate. Local anaesthetic is given and the biopsies of the prostate taken for analyses. This is often an outpatient or day case procedure (if done under a general anaesthetic).

TRANSPERINEAL TEMPLATE BIOPSY

Transperineal Template Biopsy are taken through the perineum (the area between your scrotum and anus) patients do not have rectal bleeding or discomfort, as experienced after trans-rectal biopsies. Taking the biopsies this way through the perineum reduces the risk of sepsis. It allows better sampling of the central and anterior portions of the prostate which are not usually sampled by the trans-rectal biopsy.

RADICAL PROSTATECTOMY

Radical Prostatectomy - Removal of the entire prostate through an incision in your abdomen. This is done if the cancer has not spread from outside the prostate gland. Suitable for men who are younger rather than older.

LAPARSCOPIC PROSTATECTOMY

Laparscopic Prostatectomy - Removal of the prostate through keyhole surgery. This procedure is less invasive than a radical prostatectomy.

HIFU

High Intensity Focused Ultrasound is a form of ultrasound therapy used to treat prostate cancer that has not spread outside of the prostate. The treatment involves inserting an ultrasound probe into your rectum. The probe produces ultrasound waves that pass through the wall of your rectum. The heat destroys the prostate tissue within the specified area. Normally used for smaller prostates.

PROSTATE BRACHYTHERAPY TREATMENT

Brachytherapy is the treatment of prostate cancer by the implantation of radioactive seeds into the prostate. The delivery of intenstital Brachytherapy is now-days carried out with great precision, utilising trans-rectal ultrasound to visualise the prostate and allow the radioactive seeds to be placed under direct supervision. This procedure is now done as a day case, its minimally invasive with little risk of bleeding. The most common symptoms after Brachytherapy are described as irritative symptoms. Almost all patients find that they have to pass urine more frequently. A medicine called an alpha-blocker is prescribed temporally for 3 months to assist the urinary flow that may be slightly weaker than before.

HORMONE TREATMENT

Hormone treatment is given to patients with large tumours in the prostate and it has spread to the lymph nodes or bones. Hormonal treatments are designed to reduce the effects of testosterone, which stimulates prostate cancer growth.

EXTERNAL BEAM RADIOTHERAPY

External Beam Radiotherapy’ is normally given as series of short, daily treatments in the radiotherapy department, using equipment similar to a large x-ray. The treatments are usually given from Monday to Friday, leaving patients to rest at the weekend. Each treatment is called a fraction. Giving the treatment in fractions ensures that less damage is done to normal cells than to cancer cells. The damage to normal cells is mainly temporary, but is the radiotherapy has some side effects. The number of treatments you have depends on several factors, including your general health, the type of cancer being treated and where it is in the body, whether or not you have had, or are going to have surgery, chemotherapy or hormonal therapy as part of your treatment. For these reasons, treatment is individually planned for each patient and even people with the same type of cancer may have different types of radiotherapy treatment.