Who diagnoses the disease? A urologist and a pathologist are involved in the diagnosis of prostate cancer. If prostate disease is suspected, the examination by a urologist includes a rectal examination, a tumor marker test – PSA, and, if necessary, performing imaging studies (transrectal ultrasound) and biopsy of the gland. Pathologists observe the biopsy material under a microscope and have a decisive say in both diagnosis and subsequent treatment. Who treats prostate cancer? The treatment is determined and carried out by a multidisciplinary team of specialists – medical oncologists, urologists, radiation therapists and pathologists. The results of the performed examinations, imaging, laboratory tests and pathological evaluation are submitted by the patients in the reception offices of the complex oncology centers, where the General Hospital Oncology Committees meet. The documents can also get there by official means, if the health facility where the patient was diagnosed has a contract with an oncology center to present the newly diagnosed cases to committees. These committees decide on the therapeutic algorithm for each patient – ​​whether surgery, radiation therapy (percutaneous or brachytherapy), hormone therapy, chemotherapy, and the sequence of therapeutic methods are necessary. Can I refuse my proposed treatment plan? Yes, after which you may be examined again at the same committee or at another medical facility. What does the proposed algorithm depend on? First of all, the stage of the disease and the histological characteristics of the tumor (degree of differentiation, Glion score, etc.). The age of the patients, accompanying diseases, the benefit/harm ratio of the proposed methods and their combination are taken into consideration. The wishes of the patients are also taken into account. How is the stage of the disease determined? The size of the primary tumor in the prostate is evaluated, whether the process passes the prostate capsule, whether it infiltrates surrounding structures and organs such as the seminal vesicles and bladder, whether there are involved regional and distant lymph nodes, distant metastases. The answers to these questions are presented as the so-called TNM classification or tumor staging. NEWS_MORE_BOX Risk assessment systems for newly diagnosed prostate cancer patients have been developed in global practice. The purpose of these systems is to classify patients into different categories, for each of which a different combination of therapeutic methods would be appropriate, based on certain indicators in the diagnosis of the disease – age, tumor marker PSA, Gleason score, tumor size and others. Such systems are the D’Amico classification and the CAPRA rating. Is there an alternative to removing the testicles? Definitely yes. The removal of the testicles is the so-called operative castration. The goal is to reduce testosterone production to a minimum, to the so-called castration levels.Testosterone is produced in the testicles and is the main stimulator for the growth and division of prostate cancer cells. Today it is also possible to suppress the testicles with medication – the so-called chemical castration. It is carried out through subcutaneous injections over several months, and its results are absolutely equivalent to operative castration. Medicines for medical endocrine therapy in prostate cancer are reimbursed by the NHIF. Special protocols are drawn up for them by medical oncologists. The protocols are certified in the NHOC and with the certified protocols, patients visit the personal physician who prescribes the drugs.