Best Prostate Cancer Treatment Options

Prostate cancer is one of the most severe, dangerous, and frequent oncological diseases. Every year, 1.6 million new cases of prostate cancer are diagnosed worldwide, and almost 400 thousand deaths from this illness. The disease responds well to treatment in the initial stages. In patients with Ⅰ stage of prostate cancer, the five-year survival rate is 90-95%, and in patients with ⅠⅠ stage – 80%.

Treatment for prostate cancer may include surgery, radiation therapy, chemo-, and hormone therapy. Prostate ablation using HIFU (High-Intensity Focused Ultrasound) is gaining popularity. In recent years, doctors have been armed with an innovative treatment option of point radiation therapy with a lutetium isotope (177Lu PSMA). In some cases, the doctor adheres to the tactics of active observation.

Lutetium-177 PSMA Therapy

Lutetium-177 PSMA may help patients with advanced stages. An innovative treatment option for prostate cancer often becomes the last hope for patients with progressive inoperable tumors when other types of therapy do not help.

The results of the studies showed that in 50% of cases, the condition of patients improved significantly up to the destruction of distant metastases. In addition, thanks to the targeted action of lutetium 177, it is possible to quickly reduce the tumor, slow down the growth of metastases and relieve the pain and other symptoms. 

Despite the success, the treatment option is not suitable for all patients. Therefore, it is recommended to learn more about Lutetium-177 PSMA therapy.

Surgical Treatment

The surgical prostate cancer treatment option aims to remove the entire tumor, preserving the function of urination and minimally affecting the sexual activity of a man. Removal of the prostate gland – radical prostatectomy is the primary method of treating prostate cancer. Surgery is performed when the tumor does not extend beyond the prostate gland. At the risk of metastasis, doctors also remove nearby lymph nodes. 

The operation is performed traditionally (through an 8-10 cm incision on the abdomen or perineum) or laparoscopically (through small incisions up to 1 cm on the anterior abdominal wall) using a DaVinci robot. The robotic treatment option’s advantages are a shorter recovery period, fewer complications, etc.

Radiation Therapy

Radiation therapy is used as an independent or an additional treatment option when the patient is contraindicated from surgery or wants to avoid it.

The effect of ionizing radiation on a tumor is more selective. Therefore, various methods of radiation exposure can successfully perform treatment of prostate cancer in the early stages:

• Brachytherapy – the destruction of the cancer cells by radiation of “grains” of radioactive drugs. The smallest particles of radioactive substances, iodine or palladium, are injected into the tumor using a particular device. The treatment option only affects the malignant neoplasm. Other organs and tissues are not affected.
• Remote radiation therapy. The lymph nodes are usually included in the irradiation zone. During the session, “beams” of radiation are directed at the tumor with the help of a particular device. The rays affect healthy tissues as little as possible.
• Radiosurgery. High-precision exposure to cancer tissue with a dose of radiation causes cell death. Radiosurgical treatment option with CyberKnife or GammaKnife installations is more often always used for patients with early-stage prostate cancer as the only treatment option. Sometimes it is used in combination with remote radiotherapy for patients with prostate cancer that extends beyond the gland. According to the results of more than a dozen clinical studies, 97.1% of patients had a five-year survival rate without prostate cancer recurrence.

Hormone Therapy

Male hormones, or androgens, usually support the growth of prostate cancer cells. Therefore, the purpose of that treatment option is to reduce the release of these specific hormones to control the growth of prostate cancer cells. A hormone treatment option is usually prescribed with other methods, including remote radiotherapy, brachytherapy, or before surgery. Side effects associated with hormone therapy may include decreased libido, impotence, hot flashes, osteoporosis, and chest pain.

Chemotherapy

It is prescribed to patients with metastatic prostate cancer and as a postoperative treatment option. Chemotherapy drugs are used in combination with hormonal drugs that suppress testosterone synthesis. In addition, many drugs are effective in specific cycles of tumor cell growth. So, the doctor prescribes a combination of medications and tries different dosages to choose the most effective treatment with minimal side effects.

The choice of prostate cancer treatment option depends on the stage and risk group, the patient’s desire, the general condition of the body, and possible side effects. Active monitoring is possible if the patient is contraindicated in all types of treatment and has no pronounced symptoms. That means a man should be regularly examined by an oncologist and begin prostate cancer therapy if the disease has begun to progress. 

Treatment tactics are selected by a consultation consisting of a surgeon, a radiotherapy specialist, a chemotherapist, and other doctors.

TOP-10 best hospitals for prostate cancer treatment

Treatment of prostate cancer is carried out in large multidisciplinary clinics and specialized hospitals. Modern oncology centers use innovative therapy methods: surgery, chemotherapy, radiation, and hormone therapy. Among the clinics that regularly demonstrate high success rates of prostate cancer treatment, it should be noted:

• Helios Hospital Berlin-BuchUniversity Hospital rechts der Isar Munich;
• University Hospital Frankfurt-am-Main of Goethe-University;
• University Hospital of Marburg;
• University Hospital Saarland Homburg; 
• Radiotherapy and Gamma Knife Centre Krefeld; 
• Teknon Medical Center Barcelona;
• Ichilov Sourasky Medical Centre Tel Aviv;
• Anadolu Medical Centre;
• Proton Therapy Centre Prague.

Benefits of medical tourism for prostate cancer

More than half of all cancer patients prefer clinics abroad, and about 20% receive healthcare in Europe. In addition, the main flow of medical tourists with prostate cancer is directed to Germany, Spain, Israel, and Turkey. 

Patients going abroad for prostate cancer treatment can optionally participate in clinical trials of innovative antitumor drugs, thus receiving the most advanced therapy with no analogs.

All the advantages and privileges of medical tourism that foreign patients will discover can be briefly listed as follows:

• Medical centers with international accreditation.
• Excellent equipment of clinics, wide use of robotic surgery.
• The latest treatment technologies, including in the field of experimental oncology.
• Doctors of the highest category and qualified medical staff.
• The concept of “everything for the patient”: private wards, translators, personal managers, individual approach, custom services, and much more.
• Complete support – from preliminary medical consultation and up to assistance regarding all services associated with a trip for treatment, such as visa, transfer, accommodation, etc.
• Prostate cancer treatment can be combined with a vacation or business trip.
• Post-hospital care and rehabilitation.

When choosing a country, you need to take into account various factors:

• discoveries in oncology;
• cost difference;
• the need for a visa;
• list of services provided in clinics.

Medical tourism has gained wide popularity worldwide and is rapidly developing every day. Patients choose prostate cancer treatment abroad to receive more effective, faster, and often more affordable healthcare than at home. Large clinics in Europe often provide significant discounts to patients from other countries. 

The organization of prostate cancer treatment abroad is also being improved. In addition to international departments in hospitals, some companies take on all the hassle associated with choosing a clinic and a doctor, accompanying a stay in the country, and planning and coordinating diagnostic and treatment option.

References:

1. National Library of Medicine: Gleason Score
2. Cancer.Net: Prostate Cancer
3. National Cancer Institute: Prostate Cancer Treatment
4. Centers for Disease Control and Prevention: How Is Prostate Cancer Treated?
5. AiroMedical: Lutetium-177 PSMA Therapy