In short: yes, prostate cancer is one of the most curable tumours. In Germany about 90 % of men are alive five years after diagnosis, and practically all if the tumour has not spread beyond the prostate. Even with metastases, modern hormone and drug therapy allows many patients to live for years.
Why the prognosis is usually good
Many prostate tumours grow slowly, and thanks to PSA testing and MRI they are often found early, when a complete cure is possible. The key is correct risk assessment: some small tumours need no immediate treatment at all, while aggressive forms must be treated promptly and decisively.
How the tumour is assessed
- PSA level in the blood and its trend;
- multiparametric MRI of the prostate and targeted biopsy;
- Gleason score (ISUP grade group) — how aggressive the cells are;
- in high-risk cases, PSMA PET/CT to look for metastases.
Treatment depending on the situation
| Situation | Treatment options | Prognosis |
| Low risk (small, non-aggressive tumour) | active surveillance: regular PSA, MRI, repeat biopsies; treatment only if the disease progresses | excellent |
| Localised intermediate- and high-risk cancer | radical prostatectomy (often robotic, nerve-sparing) or radiotherapy including brachytherapy, sometimes with hormone therapy | cure in most patients |
| Locally advanced cancer | radiotherapy with long-term hormone therapy, or surgery as part of combined treatment | cure possible |
| Metastatic cancer | hormone therapy + new-generation drugs (abiraterone, enzalutamide, apalutamide, darolutamide), docetaxel chemotherapy, lutetium-177 PSMA, PARP inhibitors for BRCA mutations | disease control for years |
Surgery or radiotherapy?
For localised cancer, surgery and radiotherapy offer comparable chances of cure. The side effects differ: after surgery temporary urinary incontinence and erectile problems are more common, after radiotherapy irritation of the bowel and bladder. The choice is made together with a urologist and a radiation oncologist, taking into account age, prostate size, symptoms and the patient’s wishes. In Germany these decisions are made by an interdisciplinary tumour board in certified prostate cancer centres.
What you should know
- Early detection — men over 45–50 should discuss PSA testing with a urologist, earlier if a father or brother has had prostate cancer.
- Surgeon experience — the results of surgery (continence, potency) depend directly on the number of procedures performed.
- Follow-up — regular PSA checks make it possible to detect a recurrence in time and treat it again.
More about the methods: prostate cancer treatment in Germany. We arrange consultations with leading urologists and a second opinion on your MRI and biopsy results.
