We understand the paralysing feeling when prostate or testicular cancer is suspected. The Hirslanden experts are there for you when the world stands still. With personal and individual care and treatment in our urology, prostate cancer and tumour centres, we ensure that the world keeps turning. Our certified centres are amongst the leading specialist centres of excellence in Switzerland for the prevention, diagnosis and treatment of prostate diseases and other malignant tumours of the urogenital tract such as testicular tumours.
Thanks to modern cancer therapies, many tumours can now be successfully treated or at least enable patients to live longer and have a better quality of life. It’s important to remember that the earlier prostate or testicular cancer is detected, the greater the chance of recovery. It has also now been proven that you have a better chance of survival if you are treated in a certified tumour centre.
Prostate cancer
Every year, around 7,100 men in Switzerland develop prostate cancer, making it the most commonly diagnosed cancer amongst men. The risk of developing prostate cancer increases with age and therefore mainly affects men over the age of 50. Around five percent of prostate cancers run in families. In these cases, prostate cancer tends to occur at a younger age.
What exactly is prostate cancer?
Prostate cancer is a malignant illness of the prostate gland. When cancer cells form in the prostate, the hormone testosterone stimulates their rapid and uncontrolled growth, leading to the development of prostate cancer.
Where is the prostate?
The prostate is located below the bladder and surrounds the urethra. It produces a secretion that is excreted together with the sperm during ejaculation. With age, the prostate often undergoes benign (non-cancerous) enlargement. This is known in medical circles as benign prostatic hyperplasia. It can cause symptoms similar to prostate cancer, but should not be confused with malignant cancer. If you have symptoms, it is advisable to see a urologist for clarification as soon as possible.
What causes prostate cancer?
The exact reasons for the development of prostate cancer are largely unknown. Men who have first-degree relatives with prostate cancer are at increased risk of developing the disease themselves. In addition, there are indications that high meat consumption could also increase the risk of disease.
What are the symptoms of prostate cancer?
Prostate cancer does not cause any problems for a long time. At most, symptoms such as a weak stream of urine, frequent urge to urinate or pain when urinating may occur. Very often, however, the cause of such complaints is nothing but a benign enlargement of the prostate. Sometimes it can also lead to bloody urine or pain when ejaculating. Metastases can also lead to back and lower back pain.
How is prostate cancer treated?
The treatment of prostate cancer depends on the stage and nature of the tumour and the age of the patient. As prostate cancer usually grows very slowly, men over the age of 70 often do not need treatment if they are subject to regular urological monitoring.
Testicular cancer
Every year, around 470 men develop testicular cancer in Switzerland, which accounts for about two percent of all cancers amongst men. Testicular cancer occurs mainly in young men between the ages of 20 and 40. The cancer usually only occurs on one side, in one of the two testicles. The chances of recovery for testicular cancer are often very good – the sooner it is detected, the better.
What exactly is testicular cancer?
Different types of cancer can develop in the testicles, depending on the cells from which the tumour originates. It is important to distinguish between seminomas (germ cell tumours) and non-seminomas. Non-seminoma is the collective term for all types of testicular cancer that do not originate from the germ cells. The distinction is important because these two types of tumour are treated differently. Non-seminomas are not irradiated because they are not very sensitive to radiation.
What causes testicular cancer?
The exact causes of testicular tumour are not known. The most important risk factor is undescended testicles in childhood. An undescended testicle is when the testicle does not reach the scrotum fully or when it should and remains in the abdomen instead. The hereditary component also plays a role in testicular cancer. It often runs in families. First-degree relatives of a testicular cancer patient are therefore at increased risk. In addition, incomplete development of the urethral opening can increase the risk of testicular cancer.
What are the symptoms of testicular cancer?
At first, testicular cancer causes little or no symptoms. Possible early symptoms include swelling or enlargement of the scrotum as well as hardened areas or lumps in the testicle. These are usually painless. Over time, a feeling of heaviness or a pulling sensation in the testicles as well as sensitivity to touch may become noticeable. In advanced illness, fatigue, loss of appetite, weight loss and back pain may occur.
How is testicular cancer treated?
The treatment of testicular cancer depends on the type and stage of the tumour. The affected testicle is usually surgically removed. If the cancer is in an early stage without lymph node involvement or metastases, then often no further treatments are necessary. If the illness is advanced, chemotherapy and possibly radiotherapy follow. Testicular cancer responds well to these treatments, and even in advanced illness with metastases the chances of recovery are high.
‘Movember’ – Men’s Health Awareness Month
Since 2003, November has been used as a month to promote men’s health under the name ‘Movember’. The name ‘Movember’ is a combination of the words ‘moustache’ and ‘November’. The aim of Movember is to raise awareness of men’s health, particularly in relation to prostate cancer, testicular cancer, mental health and suicide prevention. The moustache is the hallmark of the movement and serves as a visible symbol of support and solidarity for those affected.
Throughout Movember, we draw attention to the importance of the prevention, early screening and treatment of these illnesses through numerous campaigns and events, both online and offline.
Early detection
Early detection of prostate and testicular cancer is key. If a tumour is detected early, the chances of recovery are good. That’s why we are committed to preventive strategies, because prevention is always better than cure. Whether through regular examination of the testicles or genetic testing to better assess the individual family risk: regular screenings have been proven to help with the early detection of prostate and testicular cancer.
How can prostate cancer be detected and diagnosed early?
At what point it makes sense to get checked depends on many different factors. A man whose father, brother or son is or has been affected by prostate cancer is at a higher risk of developing the disease than men in whose families prostate cancer does not occur. Members of families with a high incidence of breast, ovarian, pancreatic or bowel cancer also have an increased risk of developing prostate cancer.
PSA levels and physical checks
For the early detection of prostate cancer, regular check-ups are recommended from the age of 45 to 50 onwards. During check-ups, the prostate specific antigen (PSA) in the blood is measured and a medical professional physically checks the prostate via the rectum. If cancer is suspected (increased PSA and enlarged prostate), the diagnosis can be made with a prostate biopsy.
If the diagnosis is confirmed by tissue examination (biopsy), further investigations such as computed tomography (CT) are used. If the tumour is detected early, the chances of recovery are good.
Genetic testing
Genetic counselling and testing can also be used effectively in prostate cancer prevention and treatment, as around 10 to 12% of cases are inherited. The first indications of personal risk can therefore be found in one’s own family history: if your grandfather, uncle, father or brother were affected by prostate cancer at a young age, this is a sign of an increased risk.
Genetic counselling
The incidence of breast, skin, ovarian and pancreatic cancer in the family is also important. A genetic consultation with a specialist can help you determine your risk of prostate cancer and other types of cancer. This estimate can then be confirmed or rejected with a genetic test.
How can testicular cancer be detected early enough?
A testicular tumour can be detected at an early stage by physically checking the testicles regularly (once a month). Routine self-checks are recommended for young men between 14 and 45 years of age. Self-checking should ideally be done standing up under warm water, as this relaxes the skin of the scrotum and makes it easier to feel the testicles underneath. If any enlargement, hardening or a hard lump is detected, this could be a warning sign. In this case, it is advisable to consult a urologist at an early stage for further clarification.
How to check your testicles
Once a month, every man should check his testicles. It is the easiest method for detecting changes in the testicles and finding testicular cancer at an early stage. Find out how to check your testicles properly and what testicular changes you should watch out for in this video:
Genetic testing
A genetic predisposition to developing testicular cancer can be inherited. A genetic consultation with a specialist can help you determine your risk of developing testicular cancer, as well as other types of cancer. This estimate can then be confirmed or rejected with a genetic test.
Diagnosis and treatment
Our interdisciplinary team of experienced doctors and highly qualified medical professionals work hand-in-hand to ensure comprehensive and personal care. The treatment is based on various therapeutic options. Specialists from different disciplines come together to determine the form and order in which treatments are to be combined for each patient individually. Tailor-made treatment plans are developed at the weekly ‘Tumour board’ meetings. The specialists are guided by the latest scientific findings and treatment guidelines.
Individual advice and support
Comprehensive advice and support before, during and after treatment are extremely important to us. Because we know that patients who are well and comprehensively informed come with a more positive attitude to treatment and thus make a significant contribution to its success.
Treatment of prostate cancer
The treatment of prostate cancer is determined individually and depends on the size of the tumour, the stage of the cancer and the age of the patient.
Conservative treatment
In the case of smaller tumours that are confined to the prostate, the initial strategy is often active surveillance (monitoring). This means that surgery can often be avoided over several years without compromising your chances of survival.
Surgical treatment
Surgery is considered if the tumour grows into the surrounding tissue or if it is a fast-growing, aggressive tumour. Thanks to modern techniques, postoperative complications such as erectile problems and urinary incontinence have become less common.
Treatment of testicular cancer
The treatment of a testicular tumour depends on the type of tumour and the stage of the illness. Usually, the affected testicle is surgically removed first. Since in most cases only one testicle is affected, the man’s sexual function and fertility generally remain unaffected.
Monitoring and check-ups
If the cancer is found at an early stage, when no lymph nodes or metastases are involved, often no additional treatment is required. However, regular follow-up checks are important to monitor the success of treatment. In advanced testicular cancer, chemotherapy and possibly radiotherapy are usually followed after the surgery, depending on the type of tumour. Testicular cancer responds well to these therapies, so even advanced stages with metastases can often be successfully treated.
Prostate cancer aftercare
After completion of prostate cancer treatment, regular follow-up checks allow early detection of side effects or long-term consequences of the treatment as well as a possible recurrence of the tumour. The PSA concentration in the blood is measured as part of these checks. If the PSA value rises over a certain period of time, that can indicate renewed cancer growth or metastases.
Measures required after completion of treatment
Professional associations recommend checking the PSA level every three months for the first two years after completion of treatment. Six-monthly measurements are recommended for the third and fourth years, and annual PSA testing from the fifth year onwards.
Aftercare for testicular cancer
Follow-up examinations are usually carried out every three months in the first two years, every six months in the third and fourth years and annually from the fifth year onwards. Close monitoring is extremely important if the patient is being cared for at an early stage of the tumour (N0) in accordance with the ‘wait-and-see’ strategy. After five years without a relapse, checks at longer intervals are sufficient.
The most important follow-up examinations are:
- A thorough and comprehensive physical examination
- An ultrasound examination of the remaining testicle
- CT or magnetic resonance tomography of the abdominal cavity and, if applicable, of the lungs
In addition, it is recommended to regularly examine the remaining testicle yourself in order to detect any changes quickly.
Oncological rehabilitation
After a patient has had a tumour surgically removed, the surgeon meets with them to discuss the possibility of inpatient rehabilitation. An inpatient stay is mainly necessary if the patient has to be fed via a tube or has a recently created stoma. However, inpatient rehabilitation may also be required if drainage tubes are still being used to remove wound secretion or the patient’s wounds are not healing properly. The rehab programme focuses primarily on functional disorders affecting the body, but also takes into consideration psychological changes and mental anguish. Depending on the infrastructure and the medical and nursing expertise available at the rehabilitation clinic, patients can be transferred to rehab at a very early stage in their recovery process.
Our partner clinics for rehabilitation
We do everything we can to ensure that you receive the best possible care even after your hospital stay. That’s why we’ve chosen rehabilitation clinics throughout Switzerland as partners. They offer a range of services, meet our high quality standards and work closely with Hirslanden and our h-care insurance.
Living with prostate or testicular cancer
With an active lifestyle, regular exercise and a healthy diet, patients can support their recovery and do a lot for their own well-being. We have compiled some information about life after prostate and testicular cancer that is helpful for patients. We don’t have any taboos. Share your worries and fears with us.
Prostate cancer
Life expectancy without a prostate
In some cases, the prostate, including seminal vesicles, must be removed. However, the removal of the prostate has no effect on life expectancy. An active life is possible, without restrictions. Nevertheless, this operation, known as a ‘radical prostatectomy’, has a different significance for every man. We will support and advise you if you have any worries or fears.
Bladder control and incontinence
Incontinence (unnoticed urine loss) is one of the (sometimes temporary) side effects of prostate surgery. In healthy men, continence training usually helps them regain control of their own bladder. In the case of concomitant illnesses such as diabetes, stroke or Parkinson’s disease, complete control is more difficult.
Potency and erection
The potency of many patients can be influenced by prostate surgery. However, the sensation of touch and the ability to orgasm generally remain unchanged. However, the sexual experience after a prostatectomy can be perceived differently. Due to the removal of the prostate and seminal vesicles and the separation of the seminal ducts from the urethra, there is no ejaculation after the intervention. As a result, affected men are no longer able to father children.
Possible erectile dysfunction after surgery
With a radical prostatectomy (removal of the prostate including seminal vesicles) there is also the possibility that the nerves responsible for an erection may be damaged, despite the use of nerve-saving surgical techniques. As a result, it is no longer possible to have spontaneous erections after the intervention. Depending on the stage of the tumour, the surgeon may attempt to safeguard the nerves in order to maintain sexual function. The success rates are around 50%.
Testicular cancer
Sexual function and fertility in testicular cancer
Because, as a rule, only one testicle is affected by a tumour, the man’s sexual function and fertility usually remain unaffected. However, in some cases, high-dose chemotherapy or radiotherapy may impair fertility.
Take precautions
Freezing of semen should be considered prior to initiation of treatment, especially if the patient wants children. In some cases, the production of sex hormones (testosterone) may be insufficient after removal of a testicle. In such cases, testosterone replacement therapy is required for the patient.
