• Clinical science

Prostate cancer


Prostate cancer is the second most common cancer in men after skin cancer and the third leading cause of cancer death in men after lung cancer. The risk of developing prostate cancer increases with age. It is more common in African Americans. In early stages, prostate cancer generally causes no symptoms and is typically detected by screening. The preferred diagnostic procedures are digital rectal examination (DRE), PSA testing, and ultrasound-guided transrectal prostate biopsy. Bone metastases are common in advanced prostate cancer and can be diagnosed using a bone scan. Because most patients with prostate cancer are of advanced age, life expectancy and the histological evaluation of a tumor biopsy should be taken into account when planning treatment. Radical prostatectomy and radiotherapy are indicated in young patients. In older patients, “watchful waiting” (i.e., purely symptomatic treatment) and “active surveillance” (i.e., continuous restaging and initiation of curative measures if tumor progresses) are also a treatment option since localized prostate cancer typically has a slower growth rate and a better prognosis compared to other malignancies.


  • Following skin cancer, most common cancer in men
    • Mostly affects elderly men
  • Third leading cause of cancer deaths in American men (after lung cancer)


Epidemiological data refers to the US, unless otherwise specified.


Risk factors

Advanced age is the main risk factor for developing prostate cancer! Sexual activity and benign prostatic hyperplasia (BPH) are not associated with developing prostate cancer.


Clinical features

Early-stage prostate cancer

Advanced-stage prostate cancer




Screening and basic diagnostics

Normal PSA values do not exclude the presence of prostate cancer!

Inflammation, manipulation of the prostate, and other malignant or benign prostate disease causing elevated enzyme levels may lead to false-positive PSA results.

Confirmatory test





Differential diagnoses

The differential diagnoses listed here are not exhaustive.



The treatment plan is based upon the patient's age, life expectancy, medical condition, and preferences. Results of imaging studies, PSA levels, and the Gleason score are taken into consideration when evaluating the different treatment options.

Management of localized disease

Radical prostatectomy involves removal of the vas deferens, resulting in infertility!

Management of disseminated disease

Management of castration-resistant prostate cancer (CRPC)

CRPC is characterized by disease progression (elevated serum PSA levels, progression of pre-existing metastasis, or new metastases) despite ADT (surgical or medical castration).




We list the most important complications. The selection is not exhaustive.