Prostate Cancer

What is the prostate?

The prostate is a small gland in men. It sits below the bladder and around the tube that carries urine out of the body (the urethra). Its main job is to make some of the fluid in semen.

What is prostate cancer?

Prostate cancer is when cells in the prostate start to grow in a way that they should not. It is one of the most common cancers in Australian men.

Prostate cancer is not all the same. Some types grow very slowly and may never cause a problem in a person's lifetime. Others grow faster and need treatment. That is why each person needs to be looked at on their own.

How do doctors find prostate cancer?

Doctors use a few different tests. They are usually used together, not on their own.

• PSA blood test. PSA is a protein made by the prostate. A higher level can be a sign that something needs checking. A high PSA does not always mean cancer.
• Digital rectal exam (DRE). The doctor gently feels the prostate through the back passage to check its size and shape.
• MRI scan. A special scan called a multiparametric MRI gives a detailed picture of the prostate.
• Biopsy. If the tests above suggest a problem, small samples of the prostate may be taken and looked at under a microscope. At Urology NSW the preferred method is a transperineal biopsy, which has a very low risk of infection.

Plain English versions of diagnosis and treatment options are also available.

What treatments are there?

There are several options. The right one depends on the type of cancer, your age, your general health, and what matters most to you.

• Active surveillance. Closely watching a slow-growing cancer with regular tests, instead of treating it straight away.
• Surgery (prostatectomy). Removing the prostate. This can be done by open surgery, keyhole (laparoscopic) surgery, or robot-assisted surgery.
• Radiotherapy. Using carefully aimed radiation to treat the cancer. This can be from outside the body (external beam) or by placing tiny radioactive seeds in the prostate.
• Hormone treatment. Medicines that lower the male hormones the cancer needs to grow.
• Focal treatments. Treating only the part of the prostate that has cancer, for example using NanoKnife.

Some people will have more than one treatment, sometimes one after the other.

About Dr Kooner and the practice

Dr Raji Kooner is a urologist. He started the robotic prostate surgery program in NSW and has now performed over 3,000 robotic procedures. He can offer open, keyhole or robotic surgery, so the surgical option can be chosen to suit the person.

Choosing a treatment is a big decision. Dr Kooner usually spends time over more than one appointment to go through the options with you and your family.