DR CHEW-LIN YIP | UROLOGIST

Dr Chew-Lin Yip assesses patients with prostate cancer and discusses options according to the cancer, general health and individual priorities. Consultations are available in Mandurah, Murdoch and Rockingham. Prostate cancer can behave very differently from one person to another. A raised PSA does not by itself confirm cancer. Assessment may include repeat PSA testing, examination, prostate MRI and biopsy. If cancer is found, its Grade Group, extent and stage help guide treatment decisions.

Most men are referred after a raised PSA blood test, an abnormal prostate examination, or both. Diagnosis usually proceeds in stages, and not every man needs every step.

PSA. A raised PSA does not mean cancer is present. It is interpreted alongside your age, the size of your prostate, your previous results and the rate at which the level is changing. See raised PSA.

MRI. A multiparametric MRI images the prostate and identifies areas that warrant sampling, and can be reassuring enough to avoid biopsy in some men.

Biopsy. Where indicated, a biopsy establishes whether cancer is present and how aggressive it appears, which is what determines the treatment options available to you. See prostate MRI and biopsy.

Depending on the cancer and your general health, options may include active surveillance, surgery, external beam radiotherapy, whole-gland brachytherapy, hormone therapy or a combination of treatments. Some cancers can be monitored without immediate treatment, while more extensive or aggressive cancers may need a broader treatment approach.

Active surveillance is structured monitoring for selected people with lower-risk prostate cancer. It may include regular PSA tests, clinical review, MRI and repeat biopsy. Treatment can be recommended later if there are signs that the cancer is changing. It is not suitable for every cancer.

Whole-gland treatments address the entire prostate and include radical prostatectomy and whole-gland radiotherapy. Focal treatment targets a selected cancer-bearing area while leaving the remainder of the prostate untreated. Focal treatment is an emerging approach for carefully selected patients, and its long-term evidence is less established.

There is no single treatment that is right for everyone. Important considerations include the likelihood of controlling the cancer, urinary, bowel and sexual side effects, fertility, recovery, the need for ongoing monitoring and the possibility of further treatment. Where appropriate, opinions from both a urologist and a radiation oncologist can help you compare options.

If you have a raised PSA or a prostate cancer diagnosis, an individual assessment can help clarify the next steps. This information is general and does not replace personal medical advice. Treatment suitability, outcomes and side effects vary between individuals.