Prostatakrebs-Screening & Diagnose in Bangkok

Prostatakrebs-Screening & Diagnose in Bangkok

Genaue, frühe Erkennung von Prostatakrebs – fachkundige PSA-Interpretation, multiparametrische MRT und MRT-Fusions-Gezielte Biopsie – im Bangkok Hospital Headquarters.

Medizinisch überprüft von Dr. Soarawee Weerasopone, MD – Fachärztin für Urologie · Wissenschaftliche Mitarbeiterin & klinische Beobachterin, Scott Department of Urology, Baylor College of Medicine

Warum die Prostatakrebsvorsorge wichtig ist

Prostatakrebs ist eine der häufigsten Krebsarten bei Männern, doch in seinen frühen, am besten heilbaren Stadien verursacht er normalerweise gar keine Symptome. Genau deshalb ist Vorsorgeuntersuchung so wertvoll: Sie kann Krankheiten erkennen, lange bevor sie sich bemerkbar machen, wenn die Behandlung am wirksamsten und am wenigsten invasiv ist.

Moderne Vorsorgeuntersuchungen sind auch intelligenter als früher. Anstatt jeden erhöhten PSA-Wert sofort einer Biopsie zuzuführen, kombiniert der heutige Ansatz die PSA-Interpretation mit einer MRT, um zu entscheiden, wer wirklich eine Biopsie benötigt – so werden unnötige Eingriffe vermieden, während gleichzeitig signifikante Krebserkrankungen frühzeitig erkannt werden. Was ein hoher PSA-Wert tatsächlich bedeutet

Wer sollte sich einem Screening unterziehen?

• Männer ab 50 Jahren im Rahmen der routinemäßigen Gesundheitsvorsorge
• Männer ab 45 Jahren mit familiärer Vorgeschichte von Prostatakrebs
• Männer mit Symptomen des unteren Harntrakts oder einer auffälligen Prostatauntersuchung
• Jeder, der seine individuellen Risiken und die Vor- und Nachteile von Screening-Maßnahmen besprechen möchte

The Honest Case Against Screening Everybody

A screening page that only lists benefits is not giving you what you need to decide. PSA testing has real drawbacks, and they are the reason guidelines treat it as a shared decision rather than something every man should simply have:

• False alarms are common. Most raised PSA results are not cancer, and each one leads to further tests and a period of genuine anxiety.
• Overdiagnosis is the central problem. Screening finds some cancers that would never have caused harm in a man’s lifetime. Once found, they are difficult to ignore, and treating them can cost continence and erectile function for no gain — which is precisely why active surveillance exists.
• Age and general health matter more than the number. Screening is aimed at men with a life expectancy of roughly ten years or more, because the benefit takes that long to appear. In a man with serious other illness, or in advanced age, the harms usually outweigh it.
• A normal PSA is not a guarantee. Some significant cancers occur with an unremarkable PSA, which is one reason examination and, where indicated, MRI matter.

None of this is an argument against screening — it is an argument for deciding deliberately, with the trade-offs on the table. That conversation is part of the consultation.

Two Biopsy Routes — and How to Choose

Dr. Soarawee performs both the transperineal and the transrectal approach. The honest comparison is set out below, so that the choice is made with full information.

MRI-Fusion Transperineal Biopsy

Needles pass through the skin of the perineum rather than through the rectum, guided by the fusion of your MRI with live ultrasound. This detects more clinically significant cancers and carries a very low risk of infection, because the needle never crosses the bowel wall.

As a doctor, Dr. Soarawee always wants to recommend what is best for the patient — and for prostate biopsy, that is the MRI-fusion transperineal route.

Transrectal (TRUS) Biopsy

That said, if cost is a real obstacle, a transrectal biopsy should be done. The transrectal route remains a recognized standard of care worldwide and today costs considerably less than the MRI-fusion transperineal approach, which makes it the right answer for a patient who would otherwise be unable to proceed.

The trade-off should be understood clearly before choosing it. Transrectal sampling has a lower diagnostic yield — it detects fewer of the significant cancers that are present — and a higher complication rate, particularly infection, because the needle passes through the rectal wall. What to expect after a TRUS biopsy →

After Any Biopsy: What Is Normal, and What Is Not

Blood in the urine and semen for days to weeks after a prostate biopsy is expected and settles on its own — blood in the semen can persist for a month or more and is not dangerous. Some soreness is also normal.

Fever or shaking chills after a biopsy is the exception and must be treated as an emergency, because infection following a biopsy can become bloodstream sepsis within hours. Go to a hospital immediately rather than waiting to see how the night goes. The same applies to being unable to pass urine, or heavy bleeding with clots.

Asking About Cost

Pricing is handled by the hospital, not by Dr. Soarawee. For the current cost of either biopsy at Bangkok Hospital Headquarters, email the Urology department at bhquro@bdms.co.th. For Samitivej Sriracha, call the department line on 088-022-1445. In consultation, Dr. Soarawee will explain what each approach involves clinically and support whichever choice fits your circumstances.

Wenn Krebs entdeckt wird: Behandlungsmöglichkeiten

Nicht jeder Prostatakrebs muss sofort behandelt werden – der richtige Weg hängt vom Risikograd des Krebses, Ihrem Alter und Ihren Prioritäten ab.

Aktive Überwachung

Bei Krebs mit geringem Risiko kann eine engmaschige Überwachung mittels PSA, MRT und Biopsie die Behandlung sicher vermieden oder verzögert werden, wodurch viele Männer die Nebenwirkungen einer Operation oder Strahlentherapie vermeiden können, bis sie wirklich notwendig sind (oder auch nie).

Roboterassistierte Prostatektomie

For localized cancer that warrants treatment, Da Vinci robotic surgery removes the prostate with a nerve-sparing technique optimized for continence and erectile recovery. Both erectile dysfunction and a period of urinary incontinence are genuine possibilities after any radical prostatectomy, and they are discussed before the decision rather than afterwards. Erfahren Sie mehr über roboterassistierte Prostatektomie

Strahlung & Andere Therapien

Strahlentherapie, Hormontherapie und andere Optionen werden in Abhängigkeit vom Stadium des Krebses und Ihrem allgemeinen Gesundheitszustand in Betracht gezogen – oft im Rahmen eines multidisziplinären Teams für das beste Ergebnis. Bei fortgeschrittener Erkrankung, androgendeprivationstherapie spielt eine zentrale Rolle.

What About Diet and Prevention?

Patients often ask what they can eat to avoid prostate cancer. The honest answer is that dietary evidence is largely observational and shifts risk modestly at best — it is worth eating well, but no food substitutes for screening at the appropriate age. What the dietary evidence actually supports →

Alle Leitfäden für Patienten mit Prostatakrebs durchsuchen →

Häufig gestellte Fragen (FAQ)

Q1: Wer sollte sich auf Prostatakrebs untersuchen lassen?

Screening is generally considered for men from age 50, or from 45 for those with a family history or other risk factors. The decision is individual — it is worth discussing your personal risk and the benefits and limitations of PSA testing with a urologist. It is aimed at men with a life expectancy of roughly ten years or more, because that is how long the benefit takes to appear.

Q2: Bedeutet ein hoher PSA-Wert, dass ich Prostatakrebs habe?

Not necessarily. PSA can rise for benign reasons such as an enlarged prostate (BPH), infection, or recent activity. A raised PSA is a signal to investigate further — often with an MRI — not an automatic diagnosis of cancer.

Q3: What are the downsides of PSA screening?

Three matter. False alarms are common and lead to further testing and anxiety. Overdiagnosis means screening can find cancers that would never have harmed you, and treating those can cost continence and erectile function for no benefit — which is why active surveillance is offered. And a normal PSA does not entirely exclude significant cancer. Guidelines therefore treat screening as a shared decision rather than an automatic test.

Q4: What is an MRI-fusion prostate biopsy?

It is a targeted biopsy that merges a prior MRI with live ultrasound so the urologist can sample suspicious areas precisely. Performed through the perineum (transperineal), it improves detection of significant cancer and carries a very low risk of infection.

Q5: Is a transrectal biopsy still an acceptable option?

Yes. Dr. Soarawee recommends the MRI-fusion transperineal route as the best option for the patient, but if cost is a real obstacle then a transrectal (TRUS) biopsy should be done — it remains a recognized standard of care and costs considerably less. The trade-off is a lower diagnostic yield and a higher complication rate, particularly infection.

Q6: What symptoms after a prostate biopsy need urgent care?

Fever or shaking chills after a biopsy is a medical emergency, because post-biopsy infection can progress to bloodstream sepsis within hours — go to a hospital immediately. Inability to pass urine and heavy bleeding with clots also need urgent assessment. Blood in the urine and semen, by contrast, is expected and can persist for weeks without being dangerous.

Q7: How much does a prostate biopsy cost?

Pricing is quoted by the hospital rather than by Dr. Soarawee. For Bangkok Hospital Headquarters, email the Urology department at bhquro@bdms.co.th. For Samitivej Sriracha, call the department line on 088-022-1445.

Q8: Does prostate cancer always need immediate treatment?

No. Many low-risk prostate cancers grow very slowly and can be safely monitored with active surveillance, avoiding or delaying treatment and its side effects. Treatment is recommended when the cancer’s risk level warrants it.

Q9: Can prostate cancer be cured?

When detected early and confined to the prostate, prostate cancer is highly treatable and often curable with surgery or radiation. This is precisely why timely screening and accurate diagnosis are so important. Treatment does carry consequences — erectile dysfunction and a period of incontinence after surgery — which is why the decision is made together.

Q10: Can I have a telemedicine consultation to discuss my PSA result?

Yes, through Bangkok Hospital. Telemedicine is available for patients who cannot attend in person, including international patients, and is arranged in advance by email to the Urology department at bhquro@bdms.co.th. Samitivej Sriracha is in-person only. A biopsy or MRI, of course, requires an in-person visit.

Book Your Screening Consultation

Take a proactive step for your long-term health with an accurate, modern prostate assessment.

Bangkok Hospital Telemedicine is available for patients who cannot attend in person, including international patients — arrange it in advance by email to the Urology department at bhquro@bdms.co.th. Samitivej Sriracha is in-person only.

This page is provided for patient education only and is not medical advice. It does not create a doctor-patient relationship. Fever after a prostate biopsy needs immediate hospital assessment. Dr. Soarawee does not provide medical assessment, advice, diagnosis or prescriptions through personal messaging channels, direct messages or social media.