Dorchester Urology offers some of the best prostate cancer management in the world. This centre provides the very best care available, stemming from the most qualified treatment centres in the world. There are a number of designated pathways which cater to the need of all grades and stages of prostate cancer patients.

Each individual patient’s case is reviewed by a team of experts who triage their case into appropriate investigations and treatment pathways. Patients with high age specific PSA who run the risk of early stage prostate cancer would be referred to undergo an MRI scan. After careful analysis of their MRI findings, immediate plans are then made for either TRUS (Trans rectal Ultrasound & Biopsy) or TPTB (Transperineal template Bx). Patients with suspected advanced prostate cancer will have their treatment started on the very same day followed by a Nuclear medicine bone scan to determine if they have metastatic disease.

Once the level of cancer is confirmed through the biopsy, immediate plans are then made at the MDT (Multi disciplinary team ) meeting. Depending on their stage and grade of cancer, patients will then undergo either Radiotherapy, Brachytherapy (Radioactive seed implantation), or Robotic surgery.

www.mskcc.org/nomograms/prostate
http://urology.jhu.edu/prostate/partintables.php
deb.uthscsa.edu/URORiskCalc/Pages/uroriskcalc.jsp
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Dorchester Urology is one of the very few centres in the country where Mr Afzal runs a fast track prostate cancer clinic. Patients referred with high age specific PSA or suspected prostate cancer are seen in the clinic and with a pre arranged multparametric MRI. A decision is made straightaway whether to offer patients either a highly specialized Transperineal template biopsy or a conventional Trans rectal US biopsy. Results are processed with in 24 hrs and patients are immediately offered either Robotically assisted Radical prostatectomy, HIFU, Brachtherapy or IMRT( Intensity modulated Radiotherapy).

Your GP will normally investigate blood in the urine as a matter of urgency. Most GPs will perform some simple, baseline tests. You may be commenced on antibiotics to treat a presumed infection. However, if the urine test result comes back showing no evidence of infection, you will normally be referred to your local urology department for more detailed investigations using the “2-week wait” (fast-track) system.The commonest cause of blood in the urine in the UK is infection (cystitis).

Proven blood in the urine, whether visible or non-visible (found on a urine test), should always be investigated. 1 in 5 adults with visible blood in the urine and 1 in 12 adults with non-visible blood in the urine are subsequently discovered to have bladder cancer. Children with blood in the urine rarely have cancer – they usually have infection in the bladder or kidney inflammation (nephritis). A “one-off” finding of a small trace of blood in the urine on routine testing may not be significant.Some drugs (e.g. rifampicin, nitrofurantoin) and foodstuffs (e.g. beetroot) can turn the urine red and mimic blood in the urine.
Following tests are performed on urgent basis: CT scan, or Ultrasound scan & Flexible cystoscopy:
This is a telescopic check of the bladder. It is performed under antibiotic cover & local anesthetic using a small, flexible telescope which allows the Urologist to see inside your bladder . If you have concerns about this or have experienced problems with local anaesthetic in the past, you should ask about having yourexamination under a brief general anaesthetic (i.e. whilst you are asleep). When your tests have been completed, the medical staff will advise you on what to do next: http://www.auanet.org/education/hematuria.cfm

Mr Naveed Afzal, Lead Consultant Urological / Robotic Surgeon & MDT chair​
Mr Afzal moved to Dorset in 1999 and has been working as the Lead Consultant Urological Surgeon at Dorset County Hospital and at the BMI Winterbourne Hospital, Dorchester. He chairs the MDT (Multi Disciplinary Team) and is also the clinical lead for Prostate cancer. He has introduced various new techniques to the Urology Department. His main areas of interest are:

Mr Afzal has acquired highly specialized training for the treatment of prostate cancer. He did his postdoctoral Oncology fellowship at Stanford University, California, USA. Under his leadership, West Dorset patients are provided with one of the best prostate cancer diagnostic and treatment facilities in the world. These include Rapid Access one stop PSA clinics, TRUS Bx, Trans Perineal Template Bx, Multiparametric MRI, HIFU and above all Robotically Assisted Nerve Sparing Radical Prostatectomy.

BMA (British Medical Association)

MPS (Medical Protection Society)

Registration
Full Registration with GMC, No:4198376
Specialist Register Urology