Prostate cancer diagnostics

Prostate Cancer is the most common cancer in men. In its early stages, there may not be any clinical symptoms, a raised prostate specific antigen (PSA) blood test may be required for your doctor to diagnose this condition. Symptoms may only become apparent when the cancer has progressed to a higher stage.

The growth of prostate cancer can block the flow of urine from the bladder causing poor urine flow, difficulty in starting urination, an increased urge to urinate, straining when urinating and a feeling that your bladder has not been emptied completely.

These symptoms can also occur with more common condition of benign prostatic hyperplasia (BPH). If the prostate cancer is at a more advanced stage then it can affect the nearby organs (locally advanced prostate cancer) or spread to other distant organs (metastasis).

At the Royal Free PPU our expert Urology consultants and private clinic allow us to provide a rapid and efficient service for Prostate Cancer diagnostics with the full support of the latest equipment and clinical expertise available.

There are a number of assessment services available to our patients, to fully assist with this diagnosis you may be required to have more than one of these tests depending on your symptoms.

We offer the following prostate cancer diagnostics to our patients

• Multiparametric prostate MRI (mpMRI) – This involves a standard MRI scan of the prostate and the pelvis combined with three more specialised sequences including contrast enhancement. Our expert radiologists review and interpret these MRI scans and the report is issued in 1-2 hours.
• TRUS biopsy of prostate – This examination involves taking tissue samples from the prostate gland to look for cancerous cells. Around 10-12 biopsies are taken under a local anaesthetic and transrectal ultrasound (TRUS) guidance.
• MRI / TRUS fusion prostate biopsies – In addition to the systematic biopsies, we offer targeted sampling of any abnormal areas seen on a multiparametric prostate MRI (mpMRI) by performing an elastic fusion of MRI images to the trans-rectal ultrasound (TRUS) images – this is done under local anaesthesia. We perform this using the UroNav prostate biopsy system. Any abnormal looking areas on mpMRI are marked by an expert radiologist. This MRI image is fused with the US image during the prostate biopsy. The UroNav prostate biopsy system allows accurate sampling of these abnormal areas.

Transperineal template guided  prostate biopsies – This examination involves using a needle biopsy to locate any cancer cells in the prostate. Your consultant will obtain the biopsies by the trans-perineal route, this involves inserting a needle into the prostate via the skin behind the testicles. A number of samples are taken which are then sent to a lab to be examined through a microscope. This kind of procedure is useful for finding a prostate cancer that may have been missed by other tests.

Please see the British Association of Urological Surgeons (BAUS) patient information leaflets below:

• Transrectal Ultrasound-Guided Biopsies of the Prostate Gland
• Transperineal Ultrasound-Guided Biopsies of the Prostate Gland