Innovative treatment methods for prostate cancer

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A timely diagnosis of prostate cancer allows for successful treatment in most patients. Modern oncology, however, has reached a point where simply curing cancer is not enough. Ideally, it should be done quickly, without significant physical suffering, without a long recovery, and without complications such as impotence or urinary incontinence. All of this has become possible with the advent of innovative treatment methods for prostate cancer.

Content

1. Worldwide prostate cancer statistics
2. Why is the incidence of the disease constantly increasing?
3. Treatment methods based on the stage of cancer
4. When do doctors prefer minimally invasive procedures?

Worldwide prostate cancer statistics

Prostate cancer is the most common cancer among men in 112 out of 185 countries. The incidence of this cancer is steadily increasing, with 1.3 million new cases of prostate cancer diagnosed in 2018, increasing to 1.4 million cases in 2020.

In 48 out of 185 countries, prostate cancer ranks first among the causes of male cancer mortality. These are mainly states with a low level of medicine because timely treatment of cancer is usually successful. The five-year survival rate of patients with localized stages is 97%, while at the metastatic stage, it does not exceed 30% even in developed countries, and in countries with a low level of medicine, it is only 10-20%.

Why is the incidence of the disease constantly increasing?

There are three main reasons why the incidence of prostate cancer is constantly increasing. These are as follows:

1. World population growth. There are more and more people on the planet, and accordingly, the number of cancer cases is also increasing.
2. Increased life expectancy. The older a man is, the higher the risk of developing prostate cancer, and in the last 50 years, average life expectancy has increased by 10 years.
3. Improved diagnostic quality. Previously, many cases of prostate cancer went undiagnosed. However, today, screening for this disease is organized in all developed countries, so doctors detect more and more cases of cancer.

 

 

Treatment methods based on the stage of cancer

All patients with prostate cancer can be divided into the following two groups: men with potentially curable and incurable cancer. Only stage IVB with distant metastases is considered incurable. In other cases, patients can count on recovery after undergoing quality treatment in a specialized clinic.

The treatment tactics for prostate cancer depend on the following:

1. Stages of cancer. At stages I-III (localized cancer) and IVA (metastases in the lymph nodes), radical (potentially curative) treatment methods can be used.
2. Risk groups. There are five such groups: very low, low, intermediate, high, and very high risk of tumor recurrence and progression. The lower the risk, the more sparing methods can be used for prostate cancer treatment. If the risk is high, it is better to choose surgery. However, most prostate tumors are non-aggressive, so they can be destroyed with sparing minimally invasive methods.
3. Age. The older the patient, the more sparing methods can be used. Most patients with prostate cancer are elderly men.

Below are the treatment methods for patients with prostate cancer:

Standard treatment methods for localized cancer at stages I-III and IVA include open prostatectomy, laparoscopic prostatectomy, robot-assisted prostatectomy, external beam radiation therapy, and brachytherapy.

Innovative sparing treatment methods for stages I-II include high-intensity focused ultrasound (HIFU), NanoKnife, and photodynamic therapy. With proper patient selection, these methods are as effective as surgery or radiation therapy. At the same time, they are safer, preserve control over urination and erectile function, and do not require a long-term recovery.

Treatment methods for stage IV include hormone therapy, chemotherapy, targeted therapy, immunotherapy, dendritic cell-based vaccines, radionuclide therapy for bone metastases, and Lutetium-177 targeted radionuclide therapy. These are systemic cancer treatment methods that suppress not only the tumor but also metastases. They can help control tumor growth for many years.

 

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When do doctors prefer minimally invasive procedures?

Minimally invasive treatment methods in the early stages of prostate cancer:

• Are as effective as surgery or irradiation
• Do not require a long recovery
• Do not cause any significant postoperative discomfort
• Do not cause any radiation damage to the bladder or the bulb of the penis

These are sparing techniques that practically do not affect a man's daily life. The treatment can be completed in one day, and recovery occurs in three days while maintaining an erection and normal urination.

NanoKnife involves the destruction of the tumor with a low-energy direct current. The procedure is performed under anesthesia and lasts no longer than one hour. Two to six probes (needles) are inserted into the prostate through the perineum. An electric field is formed between them, which causes the death of cancer cells.

NanoKnife treatment is bloodless, fast, safe, and minimally invasive. Healthy tissues near the cancer cells are not damaged since the impact on the tumor is not thermal. Malignant cells are not heated but die due to the perforation of cell membranes, which is a unique mechanism of action.

The PRESERVE trial confirmed the absence of severe side effects (erectile dysfunction and urinary incontinence) after NanoKnife treatment. It also confirmed the absence of cancer recurrence based on a follow-up biopsy after 12 months.

Photodynamic therapy (PDT) is a sparing and innovative method based on the selective destruction of cancer cells through photochemical reactions. During PDT, a photosensitizer is injected into the body, which selectively accumulates in the tumor. The prostate tissue is then exposed to monochromatic red laser light. This light activates a sensitizer that destroys cancer cells from the inside. At the same time, healthy cells are practically not affected because the sensitizer accumulates in them in much smaller quantities.

PDT is an invasive procedure because it is impossible to irradiate the prostate with light from outside the body. Light penetrates to a depth of only 2 cm, so light guides are inserted into the prostate tissue through the perineum. They are placed every 1-2 cm. The number of light guides placed depends on the size of the tumor. The procedure allows for the destruction of the area of the prostate affected by the malignant process or the entire organ. According to the "Study of Photodynamic Therapy in Patients With Prostate Cancer Following Radiation Therapy", PDT can help men even after unsuccessful radiation therapy.

NanoKnife and PDT procedures require specialized equipment and trained personnel, as they are not standard cancer treatment methods. These treatments are therefore not available in every hospital.

Both methods combine well with dendritic cell therapy. This is an immunological method that enhances the effectiveness of treatment and reduces the risk of recurrence. To create a dendritic cell vaccine, the patient's immunocompetent blood cells are “introduced” to standard tumor antigens or cancer cells circulating in the blood (liquid biopsy, the newest and most reliable method) or prostate tumor fragments. The trained dendritic cells are then multiplied in the laboratory and injected subcutaneously into the man. The vaccination is performed on an outpatient basis, and only one injection is usually required in most cases.

Let us assess the effectiveness and safety of different treatment methods:

	Da Vinci robot-assisted surgery	NanoKnife	Photodynamic therapy
Percentage of biochemical recurrences after 10 years	17%	15%	16%
Percentage of urinary incontinence	up to 40%	up to 1.5	up to 1
Percentage of erectile dysfunction	up to 50%	1.5	1
Percentage of ejaculation problems	100%	15%	0
Recovery period	up to 4 weeks	3 days	3 days
Trauma rate	high	low	minimal

You can go abroad if you want to undergo minimally invasive and safe treatment. The Booking Health specialists will help you select the most suitable hospital and fully arrange your trip. An additional bonus is that the cost of treatment for you will be lower than if you seek medical help from the hospital directly. This is due to the absence of additional fees for foreign patients.

 

Send request for treatment

Choose treatment abroad and you will for sure get the best results!

 

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Authors: 

The article was edited by medical experts, board certified doctors Dr. Nadezhda Ivanisova and Dr. Sergey Pashchenko. For the treatment of the conditions referred to in the article, you must consult a doctor; the information in the article is not intended for self-medication!

Our editorial policy, which details our commitment to accuracy and transparency, is available here. Click this link to review our policies.

 

Sources:

National Cancer Institute

American Cancer Society

European Society for Medical Oncology

 

Read:

New Effective Treatments for Stage 4 Cancer (oncology)

Immunotherapy for prostate cancer in Germany

Prostate cancer treatment with dendritic cells in Germany

NanoKnife® prostate cancer treatment

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