Media Center

Ständig versuchen wir alle Informationen, die unseren Patienten und Partnern helfen könnten, auf unserer Seite zu veröffentlichen. In unserer Mediathek finden Sie Dokumente, Filme und Präsentatione

Wenn Sie Themen oder Aspekte vermissen sollten oder Ihnen Fehler auffallen, so lassen Sie es uns wissen.
Danke

Die Blaue Scleife hilft aufzuklären

In Zusammenarbeit mit ONKO TV (www.onko.tv) ist dieser Beitrag über die Operation mit dem da Vinci System entstanden (2011)

Unser Kanal bei YouTube

http://www.youtube.com/user/Prostatazentrum?feature=watch

Diseases

This is an Overview of the diseases we traet at the PZNW.

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The PZNW

Welcome to the PZNW! Here’s something about it’s history.

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Saying Thanks

Saying Thanks.

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Only with us

Beyond the standards: the Prostate Center Northwest offers special services which are really patient-oriented.

Here you can read more about our special services:

Patient-Concierge: Doris Noetzel’s task is to make sure that everything that we do for our patients, meets with their personal needs and requirements. This includes for example the preparation of a personal treatment plan, an individual counseling in accordance with the latest scientific findings, and deals with the arrangement of accommodation for the relatives and family members.

Case manager: The patient admission, the patient treatment and the discharge are all the steps which are associated with formalities. To relieve our patients from these formalities during their stay in our hospital, our case managers take the successful control. This provides a complete documentation. The case managers’ work results smooth implementation of the therapy and the shortest hospital stay for our patients.

 

Treatment plan: Even if we are talking about the same disease, each person is different. Because of this, we bring with us different requirements and expectations. During patient admission we give individual treatment plan to our patients. On this individual treatment plan we write down all the services what the patient is going to receive (therapeutic, physiotherapists, care). In this way the patients receive a clear schedule with all therapeutic measures. Of course we also offer a wide selection of optional services which are available for our patients on request. You can find more information in our flyer: ’Wahlleistungen’. The PZNW is certified by DEKRA. Please click here to view the certification.

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Counseling

Prostate cancer is not only a disease of the organ. It also brings significant psychological and social burden for the patients.

Psycho-oncological and nutrition counseling

New power, flexibility and confidence building

The psycho-oncology is the interdisciplinary form of psychotherapy, which deals exactly with this topic. That is why we offer our patients the opportunity to the oncological counseling, before they participate in the follow-up treatment (Rehab). So they learn how to handle the evolved stress situations, thus the best possible treatment outcome can be achieved. Of course we also offer the nutrition counseling before you start the rehabilitation. Furthermore alimentation plays an important role in cancer diseases- like the prevention during the therapy, or in assuring the success of the treatment. Our patients during their stay in our hospital elaborate the best alimentation plan together with our dietitian, Anna Lugt-Widmayer in order to help the regeneration, and to preserve health at home, at work and in the spare time.

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Course of Treatment

What can a patient exactly expect in the PZNW? You spend your time at us like this:

One week in the PZNW

The treatment of the prostate cancer roughly takes one week – it means: we do the patient admission on Monday, and we let you go home on the following Monday. The following treatment plan shows you your appointments for this week. Besides the obligatory appointments – such as the surgery, the blood tests and the physiotherapy- there are also offers, what we recommend: social services, psycho-oncological counseling and nutritional counseling.

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Second Opinion

Which therapy is good for me? This is the question wherewith both men and their families have to face after the overcome of the initial shock of the diagnosis, and when they can rationally approach the issue of prostate cancer. This question is complicated not only for patients. Therefore to get a second opinion is a very good decision. Ask a second opinion not only from friends and self-help groups, but also from another doctors.

The guidelines of the German Society for Urology e V help you to make your decision: (http://www.urologenportal.de/fileadmin/MDB/PDF/S3_LL_PCa_-110331_Version1.03.pdf)

For the guidelines compilation -which are listed here- the results originate from the whole territory of Germany. This shows a general value and do not necessarily reflect the results of the treatment at a specialized clinic. A further support, which our doctors apply for each patient is called nomogramm. These tools are purely statistics based, and provide an overview of risk distribution in different therapies, and they are individually adjustable. It is important to note here that this is a statistical value, not a guaranteed event.

http://www.mskcc.org/cancer-care/adult/prostate/prediction-tools

 

In addition to the guidelines, the personal anxiety and risk patterns should be considered at each individual man. For some men watchful waiting can be quite a good decision, while for others the thought that there is a growing tumor inside is insupportable.

Our recommendation is that you should talk to different people and institutions in order to get a broad spectrum of opinions and then you can make the decision together with your family that which therapy suits you the best.

Find a self-help group nearby: http://www.prostatakrebs-bps.de/

If you would like to get a second opinion from us, please contact us.

 

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Diagnosis

Prostate cancer causes only late symptoms – during the early stage it does not show any symptom.

The sooner, the better

That is why the prostate screening is so important. The first medical indication can be the increased level of the prostate specific antigen –shortly PSA – but of course it is just an indication, not a result. An increased PSA level indicates changes in the prostate. This may just be an inflammation, but it can also be prostate cancer. As long as the PSA level is high, the measurement should be repeated and further examinations, such as ultrasound, magnetic resonance imaging (MRI) or biopsy should be applied. In the PZNW we mainly work with the MRI, which is currently the best imaging method, and we combine these images with those of the ultrasound examination or with the histo-scanning. If the MRI scan shows abnormal tissue structures, we take a targeted biopsy (prostate biopsy). The laboratory examination leads to a more precise result as far as the tumor extension and the type of tumor (Gleason score) are concerned.

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Treatment

The whole spectrum of the possibilities: in the PZNW we offer all the approved therapies – from radiotherapy, brachytherapy to the minimally invasive robot-assisted surgery with the da Vinci system:

Robot-assisted prostatectomy

Brachytherapy

External beam radiation therapy

HIFU therapy

Hormone therapy

 

Open total prostatectomy

The gold standard is not so shiny

We do not use this procedure in the PZNW. We mention this form of therapy only for completeness. The open prostatectomy is the classic form of the prostate removal, because earlier only this method allowed the surgeon full view and control of the surgery steps. There are two possible ways to access the prostate: either via an incision in the perineum or via the abdomen. Even though this form of intervention is the best studied, we prefer the robot-assisted method. It has many significant advantages: less blood loss, less risk of infection, rare wound healing difficulties, less stress for the patient, shorter healing process. The prognosis of the patients with minimal invasive surgery seems to be better – presumably the operation is performed by an experienced surgeon, in a center with high number of cases.

 

 

 

Minimal invasive total prostatectomy

Protective, but inaccurate

During laparoscopic, minimal invasive total removal of the prostate the surgeon puts in specific instruments through small incisions – inter alia a camera, with which the surgeon can lead the instruments under video control. Contrary to open surgery, this procedure is more sparing for our patients. However, it requires appropriate education, and in comparison to open surgery the costs are higher, and more effort is needed.  Compared to the da Vinci-system, the three- dimensional imagery and the high level of precision are missing.

 

Brachytherapy

Attack from closeness

During brachytherapy from short distance the tumor is radioactive irradiated directly from the body surface, or in the tissue, or in body cavities. We distinguish 2 forms of the internal radiation- one of them is the so-called afterloading, and the other form is the seed implantation. During afterloading the tumor tissue is first ‘quilted’ by guide tubes, hollow tubes, or needles. Through them source of radiation is led into the tumor, and it remains there until the end of the treatment. Afterloading is not only used for the treatment of the prostate cancer, but it is used for example in cancer of the mouth floor, esophageal-, ENT (ear, nose, throat), breast, – and gynecological cancers. In case of prostate cancer, the afterloading – as well as in cases of other cancers- is often combined with external beam radiation. In contrast, the seed implantation uses low-dose radioactive implants which are implanted into the tumor, and the tumor is destroyed from inside.

 

External beam irradiation

Focusing to the radiation field

During the external, so-called ‘percutaneous planned 3D conformal radiation’ the tumor tissue is irradiated from outside, through the skin. In order to protect the surrounding tissue the radiation field is exactly pre-calculated with the help of computed tomography, and then it is irradiated in single doses for a few seconds or minutes. The external beam radiation is made at a long-standing cooperation partner. The irradiation affects the general condition of the patient, and it especially affects the surrounding tissues of the tumor. In case of the prostate the irradiation can lead to the irritation of the rectum, bladder, and the erection vessel bundle.

 

HIFU therapy

With sound against the tumor

HIFU means ‘High-Intensity Focused Ultrasound’. With this minimal invasive treatment method we collect ultrasound waves, and we use this 80-100 °C temperature to destroy the tissues which are affected by the tumor. After millimeter precision computerized planning, under anesthesia an ultrasonic probe is inserted through the rectum. Due to the intensive, but precise irradiation, HIFU therapy is especially appropriate for locally limited prostate cancer. It is also applicable in case of recidiv prostate cancer or in case of advanced tumors. We combine the HIFU therapy with the transurethral resection of the prostate (TUR) to make sure that every diseased tissue is destroyed. In the PZNW we have been applying the HIFU therapy for more than 5 years- but we only apply it in studies, because the guidelines classify the HIFU therapy only as an experimental procedure.

 

Hormontherapy

No healing, but slower growth

The cell division of the prostate tumor usually depends on the hormones – especially on testosterone. The therapeutic use is briefly called ‘hormontherapy’ which consists of hormone withdrawal and the use of counter hormones. They affect in different places, but their goal is common: the slow-down of the tumor growth. Even the complaints alleviate which are caused by the tumor. Nevertheless complete recovery is not possible with the hormone therapy. That is why we use hormone therapy in case of the treatment of advanced prostate cancer, or when other therapeutic options are cannot be used. We treat with tablets or with injections- with its help we place medicament depots under the skin, which have a longtime effect and the intervals of injections are extended. Hormone therapy is not a risky therapy. The typical side effects are hot flashes, sexual disinterest, and infertility. These symptoms can be counteracted by sport.  During a fertility treatment unfortunately for men with prostate cancer this is not a possible tumor therapy method.

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