Patient-Based Council

Prostate Cancer Council

In prostate cancer the right decision emerges when risk group, life expectancy and the patient’s own priorities are weighed together. Our council brings urology, radiation oncology and medical oncology to the same table.

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About the disease

Prostate cancer is one of the most common cancers in men, and a significant proportion progresses slowly. Active treatment is therefore not required for every patient; in selected low-risk cases active surveillance may be the most appropriate approach.

The treatment decision is shaped by PSA level, Gleason (ISUP) grade, clinical stage, multiparametric MRI and PSMA PET findings, together with the patient’s age and comorbidities. Radical prostatectomy, radiotherapy and hormone therapy are the main options.

In advanced disease, hormone sensitivity, the extent of metastasis and genetic test results (such as BRCA) determine the treatment sequence. Making these decisions together strikes the balance between overtreatment and undertreatment.

Which specialties evaluate it?

In this council your case is reviewed jointly by the disciplines below.

Urology
Radiation Oncology
Medical Oncology
Radiology
Pathology
Nuclear Medicine
Genetics

Files requested from the patient

Pathology report (biopsy or prostatectomy; Gleason / ISUP grade)
PSA values and their trend over time
Multiparametric prostate MRI images and report
PSMA PET/CT or bone scan report (if available)
Discharge summary and a summary of treatments received
List of comorbidities and current medications

Clinical questions answered

Is active surveillance a safe option for me?
Is surgery or radiotherapy more suitable, and how do the outcomes compare?
Is hormone therapy necessary, and if so for how long?
How will urinary control and sexual function be affected?
Do my PSMA PET findings change my treatment plan?
Should I have genetic testing, and what would the result mean for my family?

Scope of the council report

Written opinion confirming the case was reviewed by a multidisciplinary council
Council confirmation of the diagnosis, stage and risk group
Recommended treatment options and the reasoning behind them
Alignment with current guidelines (ESMO / NCCN) and a level-of-evidence note
Comparison of alternative options and their expected side-effect profiles
Recommendations for any additional tests or consultations
Potentially suitable clinical trial options

Scope of the second opinion

Independent review of the current diagnosis and staging
Re-evaluation of pathology and imaging findings
Confirmation that the ongoing or planned treatment is appropriate
Comparative presentation of alternative treatment approaches
Clarification of unanswered clinical questions
Assessment of how well the decision fits the patient’s priorities and quality-of-life goals