Prostate carcinoma is the most common cancer in men and one of the most frequent causes of cancer-related deaths in Germany. The incidence of the disease increases with age. Based on 2014 data, around one in nine men in Germany is diagnosed with prostate cancer.
The carcinoma, which is limited to the prostate, usually causes no symptoms and is only rarely diagnosed by symptoms when urinating, but often as part of a screening examination of the prostate. Advanced prostate carcinomas, on the other hand, can cause comparatively frequent symptoms, which are sometimes triggered by metastasis that has already taken place.
At the Department of Urology at Ulm University Hospital, over 500 patients with prostate cancer are treated surgically or medically every year and the entire treatment team, both doctors and nursing staff, specialise in this disease. The clinic has been certified as a prostate cancer centre by the German Cancer Society for many years, as our clinic meets the high quality requirements for the treatment of affected patients at all stages of the disease.
We treat patients with prostate cancer according to the latest scientific findings and guidelines. We are happy to provide you with advice and further treatment planning during our consultation hours if you have been diagnosed with prostate cancer. Our clinic has recently been certified by the German Cancer Society as a second opinion centre for patients with prostate cancer. We are available at short notice for second opinion consultations on the most suitable treatment for the individual patient. To make an appointment, please contact Ms Schmid on 0731-500-58004. All patients treated at our clinic are discussed in our interdisciplinary conference (tumour board) of the Comprehensive Cancer Center Ulm (CCCU) and suitable treatment procedures are recommended.
If surgical removal of the prostate is the treatment of choice, this can be carried out at our clinic using the keyhole technique (laparoscopic and robot-assisted) with the DaVinci® system, which has been established and successfully used for many years. Under the leadership of Clinic Director Prof Bolenz, our team has already performed over 600 operations using the DaVinci system, which means that we have extensive experience with this modern surgical technique. We will be happy to advise you on the possible advantages of the procedure and draw up a treatment plan for you. Take a look here a recent interview with Prof Bolenz about surgical methods for prostate cancer. You can read more answers to frequently asked patient questions in Prof Bolenz's interview here.
We also specialise in the extended clarification of suspected prostate cancer using MRI-TRUS-fused prostate punch biopsy, which is carried out at our clinic using the latest generation of equipment (ARTEMIS®).
If you have more advanced prostate cancer, we can offer the entire spectrum of modern surgical and drug-based tumour therapy, including clinical trial programmes with innovative drugs that have not yet been approved and are generally available.
If the disease recurs after surgery or radiotherapy has already been carried out, a new targeted operation to remove the centre of the disease may be advisable. Such an operation is now possible with the support of the new PSMA-PET imaging. Tumour cells can be specially marked and detected and removed with a probe during the operation (so-called "PSMA-radioguided" surgery).
We maintain close interdisciplinary collaboration with our cooperation partners in the interdisciplinary tumour board of the Comprehensive Cancer Center Ulm (CCCU). These include in particular the Department of Radiotherapy (Prof. Wiegel), Nuclear Medicine (Prof. A. Beer), Oncology (Prof. Döhner and Dr Kull) and Palliative Medicine (Dr Mayer-Steinacker).
Consultation appointments
Phone 0731 500-54777
You can reach us by phone:
Monday to Friday: 7:30 - 14:30
In the early stages, prostate cancer usually goes unnoticed. Fortunately, modern early detection has made it possible to recognise prostate cancer in good time. Depending on the location and extent of the tumour, a wide variety of symptoms can occur later on. The disease can then restrict the quality of life through discomfort when urinating, blood in the urine or pain in the pelvic area.
The decision as to which diagnostic tests are necessary for you depends on the patient's individual risk and the available treatment options. Specialist medical advice is a central component of this. Tests that do not influence the treatment decision can normally be avoided. The determination of the serum PSA value together with the individual history as well as the rectal palpation examination and, if necessary, an ultrasound examination (transrectal ultrasound examination; TRUS) are frequently used for early detection.
Treatment then depends on the type of tumour, the patient's general condition and their personal preference, provided there is a choice between different treatment options.
Our range of treatments includes
- Detailed and individualised consultations
- Comprehensive diagnostics with high-resolution imaging procedures, including fusion biopsy (MRI and TRUS) of the prostate
- Customised treatment concept according to your needs and wishes
- Radical prostate surgery (removal)
- Open surgery
- Laparoscopic robotic-assisted (Da Vinci® X-System)
- Nerve- and tissue-sparing surgical techniques
- Systemic therapy (medication and chemotherapy) for locally advanced and/or metastasised disease:
- Hormone therapy in tablet form
- Intravenous chemotherapy in our interdisciplinary oncological day clinic
- Radionuclide/radioligand therapy (radium-223, lutetium-177-PSMA) in cooperation with nuclear medicine
- Supportive therapy (e.g. bone protection, blood transfusion, nutritional therapy)
- Latest forms of therapy as part of clinical studies
- Close interprofessional collaboration with our cooperation partners
- Radiotherapy clinic
- Clinic for Internal Medicine
- Clinic for Nuclear Medicine
- Social medicine
- Psycho-oncology
- Nutritional counselling
In around 20-30% of patients with prostate cancer, the PSA value rises again after a radical prostatectomy despite an initial apparent cure ("PSA in the zero range"), leading to a recurrence of the disease ("recurrence"). Traditionally, these patients were treated sooner or later with hormone deprivation therapy and possibly radiotherapy. With hormone therapy alone, the disease can usually be controlled for several years, but a cure is not possible.
In the last 10 years, PSMA-PET imaging has set new standards in the localisation of disease relapse. In many cases, it is now possible to provide precise information about the site of tumour regrowth at an early stage. In these cases, we can check whether a new, targeted surgical removal of the recurrence may be able to stop the disease in the longer term or at least delay hormone therapy. After prior radioactive labelling using a so-called "PSMA ligand", lymph node metastases of the prostate carcinoma can be precisely localised and removed intraoperatively using a gamma probe. The non-hazardous radioactive substance binds specifically to the prostate-specific membrane antigen (PSMA). This procedure represents a significant relief and improvement, particularly in the case of very small lymph nodes that are otherwise difficult to locate. The first promising scientific results of this procedure are already available. Whether PSMA-radioguided surgery is a suitable procedure in your case must always be assessed in a preliminary consultation. All patients are also assessed for their suitability for the procedure in the interdisciplinary tumour conference prior to surgery.
For further information on PSMA-radioguided surgery, please contact OA Dr Axel John(Axel.John@uniklinik-ulm.de) and Prof Bolenz during their consultation hours.
Prostate carcinoma is the most common cancer in men over the age of 70 in Germany. If diagnosed at an early stage, a cure is often still possible by means of surgery or radiotherapy. The diagnosis is made by means of a prostate biopsy. In order to increase the accuracy of this biopsy, MRI-ultrasound-fused prostate biopsy has become established in recent years. However, this procedure has also shown that some prostate tumours cannot be detected early, particularly in the so-called transitional zone. With PSMA-PET/MRI, a state-of-the-art procedure has recently become available at our clinic that can visualise specific surface structures on cancer cells for prostate carcinoma. Our hope is that PSMA-PET/MRI in combination with ultrasound-guided prostate biopsy will allow carcinomas to be detected even more accurately and therefore earlier.
The procedure can currently be used in patients who have already undergone a prostate biopsy without tumour detection and who are still suspected of having a tumour, e.g. based on the PSA curve. Whether this was a purely ultrasound-based or a prostate MRI-based fusion biopsy is irrelevant. The PSMA-PET/MRI is scheduled via our clinic's consultation hours and, if appropriate, a PSMA-PET/MRI TRUS (transrectal ultrasound) fusion biopsy of the prostate is then planned as part of the discussion of the findings. The procedure is performed on an outpatient basis under general or local anaesthesia, depending on the patient's wishes. If a tumour is found, the result is discussed in our interdisciplinary tumour conference and a treatment recommendation is made.
For further information on PSMA-PET/MRT TRUS fusion biopsy of the prostate, please contact OA Dr Axel John (Axel.John@uniklinik-ulm.de) and Prof. Dr Christian Bolenz during their consultation hours.
Depending on the risk situation and state of health, there are usually several treatment options for prostate cancer. These include surgery, radiotherapy and, if necessary, drug treatment. Occasionally, there is also the option of so-called active surveillance of prostate cancer, in which the disease is initially monitored regularly and no active treatment is required. We recommend that you give yourself sufficient time to think about your treatment decision and, if you are unsure, seek a second opinion. A decision can only be made on the basis of individual counselling in a confidential consultation with a doctor. The prostate cancer decision aid (you can obtain an access code from your treating urologist) and the pages of the German Society of Urology offer good additional advice. These can help to reduce uncertainty and to better understand the disease and its treatment options.
As part of pre-inpatient preparation, all your questions will be answered in a detailed consultation. You will also be introduced to the anaesthetist at our anaesthesiology clinic. After the operation, you will be hospitalised for approx. 1 week. During your inpatient stay, you will have a discussion with the anaesthetist about any follow-up treatment you may require.
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