Visit the NHS website for general information about prostate cancer. The information below is about the care, treatment and diagnosis we use.
A range of specialists may be involved in your care, including:
- urology surgeons
- specialist oncologists - doctors who treat cancer
- pathologists - doctors who specialise in identifying different types of cells using a microscope
- radiologists - doctors who specialise in x-ray tests/scans.
These are supported by our expert clinical nurse specialists.
All cases are discussed at a weekly multidisciplinary meeting. Patients are reviewed in a dedicated prostate clinic, where their treatments can be individually tailored and our expert team can help them decide on the best treatment for them.
Prostate cancer clinic
Every Tuesday morning at Guy's we hold a clinic for men with prostate cancer. Before the clinic starts, urologists, oncologists, radiologists and specialist nurses look at your scans and histology (tissue samples) and come up with an individual management plan for each patient.
When your seen in clinic, you'll have the benefit of everyone’s expertise, not just of the person you're seeing. All complex cases are discussed at a weekly specialist meeting involving surgical teams from other hospitals.
We try to book any additional scans that are needed on the same day as the prostate cancer clinic, although this is sometimes not appropriate.
We regularly give second opinions to patients from around the country to try and help them understand the disease they have and offer treatments that may not be available to them locally.
Benign prostate conditions
The most common problem we see is men with enlarged prostates that are making it difficult for them to pass urine. While we offer conventional treatments such as transurethral resection of the prostate (TURP), we also offer laser treatment using the Holmium laser. This has been shown to be as effective as TURP and is particularly suitable for men with larger prostates. Additionally, it can avoid the need for open surgery.
Diagnosis and treatment
Patients are initially investigated in the one-stop clinic where they have blood tests, flow rate tests, urine tests and will be offered a prostate biopsy either on the day or the following week. They may also be booked for an MRI scan to look at the tissue surrounding the prostate and a bone scan to check if any cancer has spread to the bones.
We use the most modern techniques for diagnosis and treatment:
Transperineal (template) biopsy
This technique has shown promising results. We now offer this routinely to certain patients to help them decide on the best form of treatment. Biopsies are taken through the transperineal route (the skin between the anus and scrotum) rather than through the rectum (back passage).
We are pleased to be able to offer this new and exciting technique, which involves specialised computer-aided ultrasound equipment to look for areas of cancer within the prostate.
Men with low risk disease may avoid curative treatment by undergoing a programme of PSA monitoring and repeat biopsies at one to two years. All the other treatment options are still available if there are any signs of progression or the patient opts for cure at a later date.
This is surgical removal of the whole prostate. We usually perform this using keyhole (laparoscopic) surgery, with the aid of the Da Vinci Robot.
This day case treatment involves implanting radioactive seeds into the prostate. The dynamic technique we use allows patients with large prostates and those who have previously had surgery to their prostate (such as TURP) to be treated.
Conformal external beam radiotherapy
X-rays are aimed at the prostate from the outside. This may be used in combination with brachytherapy to treat intermediate and high risk disease.
Hormone therapy and chemotherapy for advanced disease
Prostate cancer is hormone dependant, ie it grows using the male hormone testosterone. If testosterone is not produced or cannot reach the prostate cancer cells, then the cancer will stop growing and shrink. Medication which does this is called hormone deprivation therapy (or hormone therapy). This can be done with tablets (which stop the cancer cells using testosterone) or by injections (which stop the body making testosterone) or a combination of the two. This is not a cure but a way of managing the cancer, even if it has spread to other parts of the body. Hormone therapy may also be used in combination with radiotherapy in prostate cancer which is still confined to the prosate.
Chemotherapy is used when prostate cancer has spread to other parts of the body. Chemotherapy drugs are medicines which kill rapidly dividing cells such as cancer cells. If it is felt that this may be a suitable treatment for you, you will be referred to the oncology team who are specialists in chemotherapy
Prostate cancer support
For more information and support, see the: