What is prostate cancer?
No clear symptoms
These signs may indicate prostate cancer
Diagnosis: from palpation examination to bone scintigraphy
- Palpation examination: The doctor palpates the prostate through the rectum with a finger in order to assess its size, solidness and surface.
- A blood test shows the doctor the level of concentration of the prostate-specific antigen (PSA). The PSA is formed in the prostate. An increased PSA level can indicate prostate cancer.
- During a magnetic resonance imaging, patients lie down in a magnetic resonance tomography device for about 30 minutes. During the examination, which is called multi-parametric magnetic resonance imaging (mpMRI), the most aggressive tumor centers are identified. That way, the urologist can see whether there really is a malignant prostate cancer or just an inflammation.
- Sampling of tissue (biopsy) shows whether there is cancer tissue in the prostate. Usually, 10 to 12 tissue samples are taken and then examined for cancer cells under the microscope.
- If the doctor is sure that a patient has prostate cancer, further examinations can show how far the disease has advanced. By means of a trans-rectal ultrasound (TRUS), the examining urologist can see if the tumor has already penetrated the connective tissue capsule or if it has already grown into the seminal vesicles. For this examination, the doctor introduces an ultrasonic probe into the rectum. The ultrasonic probe provides precise images of the prostate, the seminal vesicles and its environment.
- Has the tumor already affected the bones? This can be determined by means of a bone scintigraphy. For this examination, small amounts of radioactive substance are injected into the blood stream which gathers especially in diseased bone. A camera can locate the radioactive radiation and thus the suspected metastatic areas.
This is how many men are treated for prostate cancer in German clinics
Therapies: Local tumor vs. tumor with metastases
Urologists distinguish between three stages of disease: locally limited prostate cancer, advanced prostate cancer and prostate cancer with metastases.
Locally limited prostate cancer
If the tumor is limited to the prostate and has not formed any metastases yet, doctors speak in terms of a locally limited prostate cancer. For this form, the chances of recovery are very good. Either surgery is recommended for the complete removal of the tumor, or a radiotherapy where the tumors irradiated by means of a linear accelerator. In the case of small tumors or older patients, tumor growth can also only be observed. Doctors call this procedure “active surveillance”.
Advanced prostate cancer
If the tumor has penetrated the connective tissue capsule of the prostate and has spread for example in the rectum or the seminal vesicle, doctors speak in terms of advanced prostate cancer. Such tumors can be treated either by means of a surgery or by a combination of irradiation and hormone therapy.
Prostate cancer with metastases
If the tumor has spread even further and has affected for example the lymph nodules or other organs, doctors speak of prostate cancer with metastases. In this case, surgery or local irradiation are no longer sufficient as forms of therapy. Now, measures have to be taken which target all tumor cells in the body. Doctors prescribe medicine that influences hormone levels. Often, they also arrange chemotherapy.
Treatment costs in Germany
The treatment of prostate cancer varies from patient to patient, thus it is impossible to say which costs will occur. It is possible that only a small tumor has to be removed from the prostate and no further measures are necessary afterwards. In this case, the expenses remain comparably low. If the tumor has spread, more complex and costlier therapies have to be applied.
In principle, foreign patients pay the same prices as German patients, because the bill complies to statutory cost catalogues. If individual services like treatment by a head physician or single room are added, prices increase. For patients from abroad explicitly, travel expenses, costs for translation and accommodation accrue.
Suppose that a patient has been diagnosed with local prostate cancer that has not spread yet. The patient is 65 years old and physically fit for his age. A doctor advises him to have surgery, because there is a high chance that he will recover well. The patient agrees. In this case, his treatment in a clinic would cost approximately 8,694 euros and he would spend 8 days in the hospital. He would be charged according to the flat-rate payment M01B which is the flat-rate that is most frequently used for prostate cancer in Germany. These costs and the days of stay are average values.
Cost allocation for the treatment of prostate cancer in the clinic
However, only the costs that accrue during the time in the hospital are included here. The follow-up examination and the preliminary medical examination are calculated separately and differ on a case-by-case basis.
If you are interested in a treatment in Germany and have questions, do not hesitate to contact us. We gladly recommend you a suitable contact person.