Prostate cancer is the most common form of cancer and the third most common cause of death in men in Germany and other Western industrialized countries. In recent years, the number of new cases per year has risen continuously, and in 2010 the figure had reached 66,000. In 2014, there will be an estimated figure of over 70,000 new cases of prostate cancer. Apart from longer life expectancy, the increase is thought to be due to the more widespread use of the PSA test. In contrast to the growth in the number of cases of prostate cancer, the mortality rate has decreased since the mid-1990s. The earlier the diagnosis of prostate cancer, the greater the chance of a cure.
The risk of developing prostate cancer increases with age. Prostate cancer seldom develops before the age of 50. Therefore, for a 35 year-old male the risk of developing a prostate carcinoma within the next 10 years of his life is under 0.1 %; in contrast, the risk for a 75 year-old man is 6.0 %. Overall, the lifetime risk of developing prostate cancer is 13.2 % and of dying from prostate cancer it is 3.3 %. Today, owing to screening tests, the majority of tumors are discovered at an early stage while they are still restricted to the prostate gland (T1/T2). Therefore, the relative 5-year survival rate in Germany is, at 93%, very favorable. However, as a result of the growth behavior of the prostate carcinoma, mortalities due to prostate carcinoma do occur after a period of illness.
The prostate carcinoma normally develops in the peripheral zone of the prostate and grows, in comparison with other types of cancer, at a relatively slow rate. Benign enlargement of the prostate (BPH) usually develops in the inner zone of the prostate, around the urethra.
The necessity of further examinations depends on the stadium and aggressiveness of the tumor. Important indicators are the results of the rectal examination, the value of the PSA and the Gleason-Score of the biopsy. Depending on these indicators it is individually decided whether further examinations are needed. Quite often this is not the case. Some patients need bone scintigraphy, computer tomography or magnetic resonance imaging as further examinations.