Article in the Badische Zeitung newspaper, 17 September 2025
In the district of Emmendingen, the number of hospital stays due to prostate cancer is up to 56 per cent above the national average. A special treatment is offered here.
Mr Carl, the figures for prostate cancer treatments are particularly high in the Emmendingen district. Why is that?
We have a centre for LDR brachytherapy at Emmendingen District Hospital. There, patients with prostate cancer are treated by inserting small radioactive pellets into the prostate, which kill the cancer from within, so that the prostate does not have to be removed.
In your practice? Patients first come to our practice for an initial consultation. We then carry out the treatment as affiliated doctors at Emmendingen District Hospital. We founded the Southwest Centre for Brachytherapy specifically for this surgical procedure. Since 2007, we have of course also been treating many patients from outside the area. Our patients come from almost all over Germany – from Bavaria, Baden-Württemberg, Hesse, Saarland, Rhineland-Palatinate and even Bremen. There are only five such centres in Germany: in Cologne, Hamburg, Munich, Berlin and Emmendingen. We are currently the second largest centre nationwide in terms of case numbers.
How many patients do you treat? We treat between 80 and 100 patients annually.
Is this treatment method only applicable in the early stages? No. There are now new guidelines from the German Society of Urology, which were only published in July this year. These guidelines stipulate that this procedure with radioactive seeds should or must even be recommended to patients with low to moderately aggressive prostate cancer. Brachytherapy can also be offered in combination with internal and external radiation for higher-grade, more aggressive tumour stages. This procedure is recognised by health insurance companies and is reimbursed.
Does this mean that there will need to be more treatment centres in the future, or is the current provision sufficient? We are currently working at full capacity, that’s true. But we could increase the frequency of procedures and thus perform the treatment even more often. We have the personnel and organisational capacity to do so.
The Baden-Württemberg Health Atlas shows that there is a spike in the number of cases in Emmendingen every two years. How does this come about? Our figures are stable from year to year. It is likely that the data is only reported every two years or is not passed on regularly. The atlas is still relatively new and therefore not entirely reliable.
So the good news is that men in the Emmendingen district do not need to worry that their prostate is more at risk than in Freiburg, for example. Good heavens, no! Of course, we treat more patients with brachytherapy
than in Freiburg, for example. It is not performed to the same extent there. This creates a statistical bias because many patients come to us from
outside the area. I would estimate that almost 60 per cent of the patients who appear in the statistics are neither from the district nor from Baden-Württemberg, but from the wider surrounding area. This is simply because it is a very good procedure.
Interview by Philipp Peters
Stefan Carl, 61, is a urologist. He studied medicine in Heidelberg, Montpellier and Lausanne. He has been working as a urologist in private practice since 2001. In 2007, he founded the Centre for Brachytherapy Southwest at the Emmendingen District Hospital together with Johannes Andreas and Michael Meilinger.