At the Prostate Cancer Center, we offer a comprehensive range of services for the diagnosis, treatment and follow-up care of prostate cancer. Depending on the time of diagnosis and the extent of the tumor, as well as patient-specific factors such as age and previous illnesses, prostate tumors are treated with surgery, system therapy, anti-hormonal therapy or radiation therapy. Sometimes a combination of these treatments is also necessary.
In patients whose prostate carcinoma is small, grows very slowly, has a low histological differentiation grade (Gleason Score) and does not cause any symptoms, the tumor is often only monitored regularly (clinical controls, PSA value determination, renewed biopsy in the course). No specific treatment is given. This active monitoring is called “active surveillance” (watch and wait).
In a so-called prostatectomy, the entire prostate gland is surgically removed. There are various surgical techniques for this, including the “keyhole technique”. In this technique, the operation is performed endoscopically, i.e. through several small incisions and with the help of thin special instruments. Robotics (Da Vinci surgery) is often used for this purpose.
This treatment is not a standard procedure and is being tested in clinical trials. In this form of treatment, the part of the prostate affected by cancer cells is specifically heated so that the tumor cells are killed. This is done, for example, with focused (targeted) ultrasound waves (abbreviated HIFU internationally). Another focal therapy method works with fine light guides that are specifically inserted into the cancerous tissue of the prostate. Laser light is passed through the thin fibers, activating a drug injected into the blood. The drug develops its destructive effect specifically where the laser light comes into contact with the tissue.
In this method, high-energy radiation is directed at the prostate tumor to kill tumor cells. This form of treatment is also called radiation therapy or radiotherapy. It is equivalent to surgery and may be given instead, or it may be used after surgery as so-called adjuvant or salvage therapy later in the course.
Prostate cancer can only grow if testosterone is produced in the body. The goal of hormonal therapy is to suppress testosterone production. This can be done surgically by removing both testicles (site of formation of testosterone, this method is irreversible) or medicinally (reversible, testosterone forms again after therapy is stopped). These are injections applied every 4 weeks, every 3 months or every 6 months.
A tablet therapy used in combination with anti-hormonal therapy to treat metastatic prostate tumor that must be taken daily on an ongoing basis (abiraterone, enzalutamide, apalutamide, or darolutamide). All drugs do not differ in their efficacy but in their side effect profile. The doctor will decide with you which drug to use.
As with other types of cancer, chemotherapy (cytostatic drugs) for prostate tumors is intended to cause the cytostatic drugs to prevent the cancer cells from dividing. This can slow or stop the growth of prostate cancer. Chemotherapy is given in addition to anti-hormonal therapy in the metastatic stage. There are the drugs docetaxel and cabazitaxel , which can be given.
In some patients, the tumor cells have a specific change in the gene called BRCA mutation. Patients with metastatic disease who have this change can receive tablet therapy with so-called PARP inhibitors (drug olaparib).
This is a novel form of treatment for patients with a metastatic tumor. It involves a radioactive substance that is transported to the tumor cell via a carrier and thus specifically kills the tumor cell. The therapy is currently being used in clinical trials at the USZ. It has not yet been approved as a standard therapy in Switzerland.
Vice President of Prostate Cancer Centre
Director CCCZ Outreach and Education, Comprehensive Cancer Center Zurich
Medical Director, Department of Radiation Oncology
Medical Co-Director a.i.
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Klinik für Urologie
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