Diagnosed During a Routine Check-up: How Prostate Cancer Was Detected and Treated

An abnormal result in a routine test may be the first sign that further investigations are needed, even if the person has no symptoms. In the case of the prostate, PSA values must be interpreted alongside other investigations, as they can rise in both benign conditions and prostate cancer. The diagnosis is confirmed through a thorough urological assessment and, where necessary, through imaging and biopsy.

How it all began

Ioan, aged 59, was feeling well when routine tests carried out through his occupational health programme revealed a rising PSA value of 4.61 ng/mL. He had no urinary symptoms or other signs suggesting a prostate problem. At a follow-up assessment, the value had risen to 5.60 ng/mL, at which point Ioan decided not to delay further investigations.

Investigations and diagnosis

Following a urological consultation, the patient underwent a prostate MRI, which identified a suspicious lesion. A fusion prostate biopsy followed, and the histopathological examination confirmed prostate cancer. Ioan researched his treatment options and was referred to Conf. Constantin Gîngu, consultant urologist and coordinator of Oncological and Reconstructive Urological Surgery at Spitalul Clinic SANADOR.

The surgical procedure

After reviewing the case, the physician recommended robotic radical prostatectomy with curative intent. The indication for robotic surgery was established following analysis of the diagnosis and the specific characteristics of the case. Ioan underwent surgery using a robotic approach with the da Vinci Xi system.

The post-operative anatomopathological examination established a diagnosis of acinar prostatic adenocarcinoma, Gleason score 7 (3+4), prognostic grade group 2. Staging was pT3a pN0 — the tumour had extended beyond the boundaries of the prostate, with no metastases in the regional lymph nodes assessed, and the resection margins were negative.

Recovery after surgery

Ioan's recovery was favourable, and after approximately a month and a half, he returned to work. Subsequent check-ups showed a good general condition, full recovery of urinary continence, and a total PSA value below the laboratory's detection threshold.

The case was also reviewed by Dr Eduard Dănăilă, consultant oncologist and Head of the Medical Oncology Department at Centrul Oncologic SANADOR. Given the favourable progress, Ioan required no additional oncological treatment — only periodic monitoring, with PSA testing repeated approximately every three months.

Services available at SANADOR

At SANADOR, patients with urological conditions have access to specialist consultations and advanced imaging investigations to establish the appropriate diagnosis and treatment. Depending on the indication, patients may benefit from advanced assessment via PSMA PET-CT, available at Centrul Oncologic SANADOR.

Where surgical treatment is indicated, procedures are performed at Spitalul Clinic SANADOR, including minimally invasive surgery, in a well-equipped operating theatre, supported by specialists from the Category I Anaesthesia and Intensive Care Unit with an extended level of competence. Robotic operations are performed using the da Vinci Xi surgical robot.

Article supported by SANADOR. Further details at www.sanador.ro.