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The Prostate Centre hero

The Prostate Centre

The Prostate Centre hero

Dedicated to men's health and uro-oncology

Enquiries and Appointments

020 7935 9720

18 Devonshire Street

London W1G 7AQ

Services at The Prostate Centre

Unlike other centres, The Prostate Centre is entirely independent, created by specialists to provide an enhanced model of care for patients.

Consultations, diagnostic tests and some treatments take place under one roof in the centre of London’s Harley Street medical community. (Operations, radiotherapy and major imaging are not performed on site but at nearby hospitals and centres).

Whether you are a patient, or a doctor referring a patient, you will have access to

  • highly acclaimed experts
  • a fast, accurate results service
  • state-of the art technology
  • unrivalled patient support

Our Centre Expertise

  • Prostate tests icon plus

    Recently there has been a surge in public interest in the prostate, largely as the result of a spate of media attention. Scarcely a week goes by without a newspaper or television feature on this aspect of men’s health. Prominent personalities, including Bob Monkhouse, Sir Harry Secombe, former England rugby union star Andy Ripley, Stephen Fry and Bill Turnbull have all spoken openly about their prostate problems.

    This increasing focus can only be good news, as men with prostate disease can increase their chance of cure with a little knowledge and timely action. Men, and their partners and family who love and support them, need to be aware of the symptoms and signs of prostate problems, and the possibilities of a simple examination and a blood and/or urine test. 


    Raised PSA – what next?

    If your GP finds that you have a raised or rising PSA level (usually above 4 ng/mL, but in younger men above 2.5 ng/mL), or a reduced percentage of free PSA (less than 18%) you will probably be referred to a urologist – a specialist in disorders affecting the kidney, bladder and prostate in men (and the urinary tract in women). 


    Tests

     

    Blood tests

    PSA, prostate-specific antigen, is a protein-like substance that occurs in abundance in the fluid within the prostate. Testing blood samples to determine the amount of PSA (a ‘PSA test’) is central to the early detection and selection of the most effective treatment for prostate cancer. It is worth emphasising that a PSA level that is higher than normal does not necessarily mean that you actually have prostate cancer.

    Conversely, a normal PSA value does not conclusively exclude the presence of the disease. Both BPH and prostatitis can result in elevated PSA levels in the blood, and your doctor will cross-check your PSA result with your symptoms, the result of a digital rectal examination and probably the results from a biopsy to make the diagnosis. Other tests, such as your fasting blood sugar and cholesterol level, may be used as indicators of your general health and to rule out diabetes or an abnormal lipid profile (e.g. raised HbA1c or cholesterol). They can also be used to estimate the risk of future problems, such as heart disease or stroke.

     

    Urine tests

    You may be asked to provide a urine specimen. This could be checked for bacteria, as you may have a urinary tract infection. It may also be tested for the presence of blood. Blood can be found in the urine if prostate cancer has spread into the urethra, which runs through the prostate, so its presence is a clue to the urologist about the nature of your problem. Other important causes of blood in the urine include bladder stones and bladder cancer, so this is a finding that should not be ignored. Urine may also be routinely tested for sugar in order to detect diabetes.

     

    Physical examination and digital rectal examination

    The urologist may examine you in general, but will almost certainly perform a digital rectal examination. Undeniably, it is an uncomfortable experience and one that some men dread, but the discomfort is actually only mild. Urologists perform this day in, day out, but if that does not reassure you, just keep thinking about the consequences of ignoring your condition. A few moments of minor discomfort are surely worthwhile.

    Your urologist will put on a glove and apply some lubricant jelly to his finger. He will tell you which position to adopt – probably one where you lie on your side with your legs pulled up towards your chest. He will then gently insert his finger into your rectum, passing through the sphincter muscle that keeps the anus closed. He will then feel your prostate, noting its size, shape, firmness and how its surface feels – an enlarged but soft prostate suggests benign enlargement of the gland, while a firm nodule may indicate cancer. The examination is not painful, just uncomfortable. Try to relax until it is over – it literally only lasts a few moments.

     

    Urination questionnaire

    Prostate cancer may be affecting your ability to empty your bladder or you may have BPH that is affecting your urine flow. In order to investigate your symptoms in a meaningful way, your urologist may give you a questionnaire to fill in. 

     

    MRI scan

    An MRI (magnetic resonance imaging) scan uses magnets to create a detailed picture of the prostate and pelvis. The use of a multi-parametric MRI (mpMRI) scan helps to identify if there is any cancer inside the prostate.

     

    Transperenial (Template) Biopsy of the Prostate

    If cancer is suspected, your urologist will first need to check whether you do in fact have cancer by performing a biopsy, which involves taking some tiny samples from the prostate. Template biopsies are invasive, requiring a general anaesthetic, however they offer a very thorough insight into the prostate which can provide a more accurate diagnosis. Download a Guide to Template Biopsy

  • Benign prostatic hyperplasia (BPH) treatments icon plus

    Nearly half of men over the age of 65 have either urinary symptoms or a reduced urinary flow due to benign prostatic hyperplasia (BPH). BPH is characterised by the benign (non-cancerous) overgrowth of prostate cells, with the effect that the central portion of the prostate progressively enlarges. The result is that the part of the urethra that is surrounded by the prostate becomes constricted. This reduces the urinary flow and the man finds that his urine stream becomes weaker and it is more difficult to empty his bladder. These symptoms may significantly impair quality of life.

    In response to the increasing obstruction, the muscular bladder wall thickens and becomes stronger. Consequently, the pressure inside the bladder needed to produce urinary flow has to increase to overcome the effect of the obstruction; this high pressure causes pouches or ‘diverticula’ to form. Less commonly, the raised pressure results in what is known as ‘back pressure’ on the kidneys, causing kidney problems. If BPH is not treated, either chronic urinary retention (characterised by a massively over-distended bladder) or acute urinary retention (the sudden inability to pass any urine, with painful overdistension of the bladder) may develop. In either situation, hospital admission, catheterisation and, often, prostate surgery are usually required.

    BPH is most commonly treated with either drugs or surgery. Some men with mild symptoms opt for active surveillance, which involves monitoring their condition so that any worsening can be quickly spotted and treated. There are also several ‘minimally invasive’ alternatives.


    Drug treatment

    Drug treatment may be recommended if your symptoms are moderate, though it may also be beneficial if your symptoms are severe. Certain complications of BPH, such as kidney problems, urinary retention or bladder stones, make surgery a more appropriate option.


    Surgery

    If surgery is required for your condition, be assured our consultants specialise in a wide range of treatment options. Some of the procedures we offer include:

  • Prostate cancer icon plus

    When it comes to choosing a treatment option, you may find yourself in a dilemma – because no single treatment has been proved beyond doubt to be superior, long-term, to any other. This means that you should explore all possibilities, weigh up the pros and cons, and then, with the help of your urologist and oncologist, decide on the treatment and the specialist you feel most comfortable with.

    Not every treatment is suitable at every stage of the disease. For example, surgery to remove the prostate would not be appropriate if the cancer is shown on MRI or bone scan to have spread to other parts of the body.

    It is important to find a specialist who has a great deal of experience, whichever route you decide to follow.

    At The Prostate Centre we do not offer every treatment that is available. That’s because we focus on what we do best, and know who best to refer you to if you wish to explore other options – in London, elsewhere in the UK, or internationally.

    Our surgeons specialise in robotic prostatectomy (prostate removal), using laparoscopic (keyhole) surgery with the latest da Vinci robot technology. Our oncologists can offer conformal radiotherapy, low-dose and high-dose brachytherapy, CyberKnife and hormone therapy or chemotherapy.

    Download a Guide to Robot-assisted Laparoscopic Radical Prostatectomy

  • Kidney cancer icon plus

    Kidney cancer, or renal cancer, happens when your kidney's cells develop cancerous growths - often in the lining of the organ and known as carcinomas.

    Treatment options we offer both men and women at The Prostate Centre include:

  • Bladder cancer icon plus

    Bladder cancer occurs when a cancerous tumour develops within the lining of your bladder. The most common symptom to be aware of is blood in your urine.

    Treatment options we offer to male and female patients with bladder cancer include:

  • Benign and other urological conditions icon plus

    We diagnose and treat a full range of other benign (non-cancerous) urological conditions and lower urinary tract symptoms in both men and women.

    Some of these urological conditions and treatments include:

  • Sexual dysfunction icon plus

    Sexual dysfunction describes any problems or difficulty that you may experience in relation to sexual activity. Sexual dysfunction can occur on its own or in relation to treatments for benign or malignant urological conditions. We offer both assessment and treatment options for men and women, including:

    • Medication
    • Mechanical aids
    • Psychosexual therapy
    • Education and communication

    Post-surgery sexual dysfunction

    All forms of urological treatment can affect sexual function. Temporary use of drug therapy and mechanical aids can be helpful, and patients can regain normal function over time – although some may need to continue with their preferred therapy in the long-term. In addition, if you are in a relationship, the emotional impact of your diagnosis and treatment on both you and your partner should not be underestimated. It is therefore important to be aware of the changes that may occur, in order to manage your expectations and understand what can be done to help you and your partner overcome any problems.   

    We take your sexual wellbeing very seriously at The Prostate Centre, as we are fully aware of the positive difference that good advice and appropriate guidance can make. We are very fortunate to have two dedicated and knowledgeable specialists on our team; Mrs Lorraine Grover and Dr Kam Mann.

    We strongly advise all patients that to help give yourself the best possible chance of sexual recovery, you should address these issues early and consult Lorraine or Kam both before and after your operation, and even while you are still weighing up your treatment options. We would of course like to include your partner, although this is equally important if you are not currently in a relationship.

  • General men's health icon plus

    We believe passionately that if you come to us with a prostate problem, we should not neglect your general health.

    So often, a man who is of an age to have prostate disease,usually middle age and beyond, will also be suffering, whether he knows it or not, from some other disorder that comes with modern living. Ironically, for many men it is their high blood pressure, heart disease, un-diagnosed diabetes, stress, excess weight, smoking and lack of exercise that will lead to disaster before their prostate does.

    That’s why we routinely look out for these things when you are referred to us, and why we run thorough blood tests, perform pre-anaesthetic assessments (including ECG, or heart trace) if you are to have an operation, and try to motivate changes in your lifestyle to help you reverse any undesirable effects on your health.

    Of course we offer basic prostate health checks to men who simply want to make sure that all is well in that department. We also offer a more comprehensive 'executive' health check, with the focus nevertheless firmly on the prostate. However there’s a difference between these 'men’s health' screens and our wider agenda to ensure your safety when you are a patient of ours.

    No amount of testing can rule out conclusively any untoward event in the future. But we do know that, thanks to our approach, many men have been spared the trauma and inconvenience of facing an unexpected major crisis. 

  • Second opinion icon plus

    It is quite natural that some patients wish to seek a second opinion, and we are always happy to refer our patients for an opinion elsewhere. We even encourage it, because we believe you should decide on your preferred treatment only after exploring all the avenues open to you.

    More often, we see men who have been investigated or treated elsewhere and are looking for further advice or confirmation that they are on the right path. Most insurance companies are happy to cover the cost of such a reassessment.

    Typically, we start with detailed medical history and a physical examination; if required we can include a cardiovascular risk assessment, which may not have been done elsewhere. For prostate cancer, rather than re-biopsying the prostate we arrange for a review of the original pathology by our highly experienced consultant pathologists at HCA UK Laboratories. It is most helpful if you bring your own pathology slides with you, otherwise we can request them from the hospital where they were originally examined. We may also need to request a review of MRI, CT and/or bone/PET scans by one of our specialist uro-radiologists.

    We then go through your treatment options (which may include active surveillance, robotic surgery, radiotherapy, hormone therapy or chemotherapy) with you, your relatives and supporters, and the most appropriate specialist within our team. We also offer the opportunity to talk through some of the clinical issues with our experienced nurse specialist.

Contact The Prostate Centre

If you would like more information about The Prostate Centre or would like to book an appointment, contact our team who will be happy to help

020 7935 9720
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