Prostate cancer
Diagnosis & treatment in Vienna

What is prostate cancer?

Prostate cancer is the most common cancer in men in Austria, diagnosed in several thousand men every year. It arises in the prostate gland, usually in the outer zone, and in many cases grows slowly.

The spectrum ranges from tumours that need no treatment for years to aggressive forms that must be treated promptly. Telling these apart is the core of good advice – it decides whether watching, operating or radiotherapy is the right path.

Early prostate cancer usually causes no symptoms. A weak stream, frequent urination or blood in the urine or semen typically appear only with advanced tumours – or have a benign cause such as an enlarged prostate.

More about the enlarged prostate

Diagnosis: from PSA to biopsy

The starting point is usually a raised PSA or an abnormal digital rectal examination. A single elevated value does not mean cancer – inflammation, an enlarged prostate or physical activity can raise it too. That is why the value is repeated and interpreted as a trend.

If suspicion remains, a multiparametric MRI of the prostate follows. It shows whether and where a suspicious area lies (PI-RADS classification). A biopsy is only needed when the MRI or your risk profile justifies it – today as a targeted MRI fusion biopsy, in which the MRI images are overlaid live on the ultrasound.

PSA measurement and trend, further markers if needed Digital rectal examination and prostate ultrasound Multiparametric MRI (PI-RADS classification) MRI-targeted fusion biopsy If cancer is confirmed: risk grouping (ISUP grade, PSA, stage), PSMA PET/CT where indicated

Treatment options for prostate cancer

01.
Active surveillance

Low-risk tumours often need no immediate treatment. The cancer is monitored closely with regular PSA tests, MRI and repeat biopsies, and treated only if it changes. Continence and erectile function are preserved without compromising the chance of cure.

02.
Robot-assisted radical prostatectomy

For localised cancer of intermediate or high risk, complete removal of the prostate is the standard. I perform it minimally invasively with the da Vinci system, using nerve-sparing technique wherever the tumour allows.

More about robotic prostatectomy
03.
Radiotherapy

External beam radiotherapy or brachytherapy are equivalent alternatives to surgery, often combined with a time-limited course of hormone therapy. Which option suits you better depends on the tumour, your age, other conditions and your priorities – I discuss both openly with you.

04.
Drug therapy

For advanced or metastatic prostate cancer, hormone therapy, newer anti-androgens, chemotherapy and targeted approaches such as PSMA radioligand therapy are available. Treatment is coordinated in a multidisciplinary tumour board.

Frequently asked questions

Is prostate cancer curable?

Yes, in most cases. If the tumour is found while still confined to the prostate, the chance of cure with surgery or radiotherapy is very high. Even advanced disease can today often be controlled for many years.

Does every prostate cancer need immediate treatment?

No. Low-risk tumours can be safely followed under active surveillance. Avoiding over-treatment matters as much as treating aggressive tumours in time.

How long until surgery?

Prostate cancer is not an emergency. A few weeks between biopsy and surgery are sensible so that the tissue recovers and planning is complete – without any effect on prognosis.

Is a second opinion worthwhile?

With a new diagnosis, almost always. I review your results and MRI images and explain which options are in line with the guidelines.

About second opinions
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