Urology Casablanca

Prostate Cancer:

The discovery of prostate cancer is done in two ways, either by chance during a screening or because it is already symptomatic. In the first case, everything generally begins with a consultation with the general practitioner who, after discussing the possibilities of early detection of prostate cancer, prescribes a PSA assay and suggests examining the prostate by carrying out of a digital rectal examination. If the digital rectal examination shows a gland of abnormal consistency or if the value of the PSA proves to be too high, the next step is for the doctor to propose a consultation with the urologist for a new clinical examination and appreciation of the context of this clinical or biological abnormality. The diagnostic approach must therefore be: if abnormal PSA, make an appointment with a urologist to assess the need for a diagnostic biopsy or other complementary examinations. In the second, the call to the specialist is more immediate. If the signs are rheumatological (lumbar pain, bone pain, spontaneous fractures, etc.), the general practitioner or rheumatologist is generally the initial contact, who will refer the patient to the urologist. A prostate biopsy is essential to confirm the diagnosis. An MRI can also be performed, but the fundamental examination is biopsies. The diagnosis is made on biopsy and the management is decided according to the results of these samples. When the cancer is localized to the prostate gland, collectively, it is decided on active surveillance or intervention to destroy the tumor. It is then possible to discuss radical prostatectomy, external radiotherapy, brachytherapy. And when the cancer is metastatic, we usually resort to hormone therapy or surgical castration as first intention.