Prostate cancer

The Urology Department at Maria Middelares General Hospital has extensive experience in the treatment of both early and late-stage prostate cancer.

For each stage of prostate cancer, we try to offer you personalised and scientifically based treatment. We base our work on years of experience within our own department and on knowledge gained in various university centres at home and abroad.

New developments that we can offer:

• Extensive diagnostics determine who is a good candidate for watchful waiting (active surveillance) and which patients require aggressive treatment.
• Minimally invasive prostate operations (keyhole surgery, potentially robot-assisted).
• Clinical trials (scientific studies) into new pharmaceutical therapies.

Upon referral, new patients are generally seen for a consultation within three weeks. During this first appointment, you will be able to have an initial conversation about the direction to take with the urologist, radiotherapist or a medical oncologist.

• The urologist is specialised in the surgical treatment of prostate tumours.
• The radiotherapist is specialised in the treatment of prostate tumours with internal (brachytherapy) or external radiation.
• The medical oncologist is specialised in pharmaceutical therapy for prostate tumours, and more specifically in the treatment of prostate tumours through chemotherapy and new, targeted medication.

You may see other colleagues in a supporting role:

• a pathologist specialising in urological tumours
• a radiologist specialising in imaging of genitourinary tumours
• an internist (geriatrist, nephrologist) to assess your general health status
• oncology nurses, specialised in support during cancer treatment
• care providers who focus on mental health (psychologist, psychology nurse), for psychological and emotional counselling during cancer treatment
• a dietary specialist (dietitian) to advise in relation to diet and food during treatment

It is very important to know that we will always try, in consultation with yourself, to balance the benefits of any potential treatment against the potential side effects.

An exact diagnosis and staging are essential to determining the best treatment for you. For instance, to ascertain whether a watchful waiting approach can be adopted safely for your prostate cancer (with active surveillance).

Our Prostate Cancer Team includes a specialised pathologist who focuses on the analysis of genito-urinary tumours, such as prostate cancer. Not only the pathologist is specialised, but also the uro-radiologist who focuses on the newest MRI techniques. To look for potential metastases, we use the latest scientific insights, such as the latest PET scan (PSMA PET/CT) that is available at various hospitals in East and West Flanders. After all, a precise diagnosis and staging results in better treatment.

Minimally invasive procedures limit (the risk of) complications, reduce the length of hospital stays and accelerate recovery after the procedure. Our department has expertise in the classic ‘open’ surgical prostate cancer treatment, but is especially experienced in minimally invasive procedures and operations such as keyhole surgery (potentially robot-assisted). Our centre treats more than 150 patients with a robot-assisted radical prostatectomy every year. We focus on continuous internal quality evaluation as well as patient-oriented evaluation in the context of the ProstaQare care trajectory (see below).

Depending on the size of your prostate and the site of your prostate cancer, internal radiotherapy (brachytherapy) or external radiotherapy are offered in many cases.

External radiotherapy uses the most recent techniques, such as intensity-modulated radiation therapy. During this external radiation, imaging is used every day to focus the radiation as precisely as possible and to minimise the risk of side effects of the radiotherapy as much as possible.

Our centre has extensive experience with internal radiation therapy or brachytherapy. This involves the implantation of radioactive granules in the prostate of patients who are eligible for this treatment after a strict selection process.

These radiotherapy treatments are preferably carried out in collaboration with the Radiotherapy Department at Groeninge General Hospital in the context of the E17 network partnership, but there is also good cooperation with the other Radiotherapy Departments in the region, and the free choice of each patient is always respected.

We can offer patients with a more advanced stage of prostate cancer both the golden standard and innovative medication or treatment. This includes 'targeted therapy' that has truly revolutionised the treatment of prostate tumours. Our departments can offer additional new medication as part of clinical trials: urologists and oncologists participate intensively in these clinical trials, resulting in one of the widest selections of new therapies in our region.

Clinical studies are a form of scientific research into new surgical or radiotherapeutic treatments, medications, new combinations of medication or drugs with a proven effect that are tested in new or other situations. This may involve, for instance, a new radiotherapy schedule or new surgical technique, a new dosage of the same medication or a new chronological schedule for the administration of the medication. Clinical studies are carried out according to very strict scientific guidelines. Their aim is to verify whether new treatments are safe and effective/better than the current standard treatment.

This research is performed at our own initiative, in collaboration with several university departments (KU Leuven, Ghent University or University of Antwerp) or on the initiative of a pharmaceutical firm that wishes to evaluate innovative medication.

For increasing numbers of cancers, a better understanding of the patient's genetic background also means better (more targeted) treatment of their cancer. Within the framework of clinical trials, our departments have access to genetic studies.

As a patient, you will never be obliged to participate in clinical studies. If you do not wish to participate, you will still receive our full attention and receive the standard treatment.

Our service is strongly committed to the development of the ProstaQare Programme, which is developed progressively according to the strict standards of Value-Based Health Care (VBHC), where care trajectories are designed around (from the viewpoint of) the patient and their family, by a dedicated team of physicians and other care professionals. Patient satisfaction with the results of the treatment and side-effects, as well as the broader framework, are monitored by means of validated questionnaires. These questionnaires are reported and compared according to a validated methodology (ICOHM).

Since 2016, our Centre has been recognised as an Affiliate Member of the Prostate Cancer Unit Network which was established by the European Society of Oncology and is supported by the European Society of Prostate Cancer Patients (https://www.prostatecancerunits.org).

This recognition secures the presence of all medical, paramedical and supporting services that are necessary for the correct functioning of a value-driven department, focussed on the diagnostics and treatment of patients with prostate cancer.

• Urologists
• Radiotherapists
• Medical oncologists
• Nuclear
• Physiotherapists/physical therapists
• Oncology nurse
• Psychologist
• (Dietitian)
• etc.