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The factor that influences the tactics of prostate cancer treatment the most is the timely diagnosis making. The complexity of this is connected with the similarity of manifestations of malignant and benign prostate neoplasms at their early stages.
All cases of prostate cancer require an individually planned examination and subsequent therapy. When drawing up a treatment scheme, specialists evaluate the severity of the condition, the potential efficacy of methods selected and their side effects.
The choice of treatment technique for prostate cancer isn’t always clear. Even in one country, treatment options for pathology with the same features might be radically different. For example, for initial stages of prostate cancer, surgical treatment and radiation therapy compete with each other, while sometimes the best method is watchful monitoring of the health condition.
However, many different treatment regimens are established worldwide for prostate cancer. The selection of sequence of prostate cancer treatments is influenced by the patient's general health condition, and the overall prognosis for survival.
At the first two stages, radical prostatectomy is conducted. If metastases in regional lymph nodes are revealed, lymph nodes dissection is indicated. Erectile dysfunction and urinary incontinence are possible side effects of such a surgery.
Removal of testicles is also performed to cease the hormone synthesis in the body, resulting in a decrease in the tumor size and slowing down its progression. For metastatic processes, androgen deprivation is also indicated. The possible side effects after hormone therapy are erectile dysfunction, gynecomastia (male breast enlargement), and osteoporosis.
For localized prostate cancer, surgery or radiation therapy is performed. Considering the peculiarities of cancer, different types of radiation therapy are possible. For external radiation used for cancer treatment alone, several different techniques are used in combination. For aggressive cancers, the best result is likely to be achieved with high-dose brachytherapy and external radiation therapy combined. To decrease the risk of recurrence, hormonal treatment is possible in addition to radiation therapy.
Chemotherapy for prostate cancer is indicated at advanced stages, as well as in cases, where hormone therapy appears to be ineffective. Radiation therapy in the form of distant or internal (brachytherapy) radiation is also administered at advanced stages.
Immediately after making the diagnosis, the patient needs to discuss all possible treatment options with the oncologist. Based on the results of clinical examination, experienced specialists of European hospitals explain to the patients which options of cancer treatment are available for them. After that doctors draw up an individual treatment plan. If necessary, a board of specialists (including attending oncologist, urologist, radiotherapist, radiologist, diagnostician, etc.) elaborates the treatment plan.
Prostate cancer stages describe tumor size, presence of metastases and lymph nodes affection. At stage 4, tumor is large or metastases are present.
The latest cancer treatment options are da Vinci surgery and PSMA therapy with Lutetium-177 or Actinium-225.
Cost of diagnostics with PSMA PET-CT starts at €2,348. Cost of treatment with transurethral electroresection starts at €5,153. Price for Lutetium-177 PSMA therapy starts at €14,708.
The best hospitals in Europe are:
During surgery for prostate cancer treatment (radical prostatectomy), the entire prostate gland with its capsule and seminal vesicles is removed. Surgery is usually performed under general anesthesia. It is an open operation during which an incision is made in the middle line from the navel to the pubic bone.
In recent years the less traumatic endoscopic radical prostatectomy has been implemented in the clinical practice, during which the prostate is removed with thin instruments that are inserted through several small incisions under visual control. Both types of surgery require a well-trained urologist and experienced medical staff. That is why these operations are only performed in large European hospitals. While the wounds are healing, the man is not recommended to urinate on his own, so a catheter inserted through the urethra is left in the bladder for 7-10 days. The next day after removing the catheter the man is allowed to leave the hospital.
Possible side effects of surgery are erectile dysfunction (impotence) and urinary incontinence.
Chemotherapy is a treatment method of choice for many types of oncology. However, the effectiveness of chemotherapy for prostate cancer is rather poor.
Prostate cancer is most sensitive to hormonal medications because it is the male hormones (androgens) that stimulate atypical cellular changes and malignant growth. Although, in some cases, the positive result is seen with several chemotherapy courses after surgical intervention.
Usually, chemotherapy for prostate cancer is indicated in cases of:
Administration of chemotherapeutic agents is not a way to cure prostate cancer, but it can inhibit malignant growth and contribute to a significant reduction in the size of the tumor.
When choosing a radical method of treatment for prostate cancer it’s important to know that not all cancer cases require surgery. Modern, high-precision radiation therapy (like IMRT) can show good results without significantly disrupting the body functions. Treatment of prostate cancer with radiation therapy does not restrict the lifestyle after the treatment sessions.
The total volume of radiation therapy required for prostate cancer treatment is very individual, and is based on general health condition of the patient, presence of comorbidities, etc.
The techniques that allow the precise delivery of tumor-destroying radiation target only the tumor, with minimal impact on the adjacent healthy tissues.
Hormone therapy is used when the tumor has already spread beyond the prostate gland or has metastasized. Male sex hormones regulate the growth of the prostate as well as the division of tumor cells. The principle of treatment is to block the action of the specific male sex hormones, thereby inhibiting the growth of the tumor cells. Although hormone treatment reduces symptoms caused by prostate cancer in most cases, it has not been proven to cure cancer or prolong the life of patients diagnosed with prostate cancer.
Few cases (about 5%) of prostate cancers are not amenable to hormone treatment at all (these are hormone-independent tumors), and a large number of tumors that have initially responded well to hormone treatment become hormone-independent a few years after the treatment start.
People with prostate cancer and PSMA-positive metastases on PET-CT are eligible for Lutetium therapy.
The essence of Lutetium treatment is the delivery of medication with a radiation source (Lutetium-177 PSMA) to malignant cells. Lutetium therapy is a fairly new technique of cancer treatment, but it has already demonstrated its effectiveness and good tolerability.
Lutetium treatment affects malignant cells regardless of where they are located, making therapy possible even when multiple metastases are present. Thus, Lutetium therapy is considered a high precision type of radiation therapy. The substance allows irradiating only malignant cells, which reduces the undesired effects on the body.
Lutetium-177 PSMA therapy is administered taking into account the overall health condition of patients. A course of Lutetium therapy consists of up to 6 sessions, usually one and a half months apart. As a rule, the patient is discharged home straight away after the completion of Lutetium treatment. During the Lutetium-177 PSMA therapy doctors monitor the patient's PSA blood level. The success of Lutetium therapy is monitored by a decrease in tumor size and lowering of the prostate-specific antigen blood level. Another important advantage of Lutetium-177 PSMA therapy is the influence on metastases not only in the bones but also in lymph nodes and internal organs, while healthy tissues are minimally affected.
The most amazing thing about Lutetium treatment is that it works even in cases when none of the existing therapeutic methods are working. Scientific studies have shown a good therapeutic response to Lutetium treatment (Lutetium-177 PSMA therapy) in patients who no longer have any other treatment options.
With prostate cancer stage 4, the main type of treatment both for the primary tumor and its metastases is hormone therapy combined with radiation therapy and radiosurgery.
Hormone therapy also plays an important role in the treatment of prostate cancer stage 4, blocking the effects of testosterone, which is responsible for the rate of prostate cells division in prostate cancer stage 4. Depending on the indications, hormone therapy is used to suppress the production of the testosterone in the patient's body, or to block its effects on prostate tissue.
Surgery for the treatment of prostate cancer stage 4 is used as a symptomatic therapy. The primary surgical technique of improving quality of life is minimally invasive transurethral resection of the prostate, which facilitates normal urine flow.
Transurethral resection implies inserting a special surgical instrument into the lumen of the urethra and creating a "pathway" for the destroyed tumor cells to leave. If the outflow of urine is obstructed but there is no tumor infiltration, a patient with prostate cancer stage 4 may undergo stenting of the urethra.
If you want to undergo cancer treatment, it is important to know the success rates and certification of the clinic you are going to treat prostate cancer in.
European hospitals presented on the Booking Health website meet the quality criteria.
The leading European hospitals for prostate cancer treatment are:
To get qualified help in the selection of the right clinic for you, leave a request on the Booking Health website.
The cost of treatment of prostate cancer abroad depends on a complex of factors. The best way to find out the accurate information about the cost of treatment in your clinical case is to contact a medical representative. Until then, here's a short list of prices for different procedures for prostate cancer treatment:
You can contact Booking Health to get a comprehensive answer to your questions about the price and the content of the medical programs for the treatment of prostate cancer.
Organizing cancer treatment abroad is a matter of choosing a professional who will give a response to a patient's request for treatment in a short period. There are some tips on how to choose a company to organize treatment in a foreign country.
It’s important to choose a legal company rather than any other type. And from the very beginning of negotiations, you should feel the transparency of the company in all matters, especially regarding treatment costs and billing.
With that said, you can entrust the organization of treatment abroad to Booking Health. Booking Health will help you choose a medical institution to undergo prostate cancer treatment abroad and will plan the whole treatment for you.
Cancer treatment abroad is a solution that increases the chances of getting rid of this serious disease and organizing treatment through Booking Health ensures your treatment to be as less stressful as possible.
All you need to do is leave a request on the Booking Health website and our managers will contact you.
Authors: Dr. Nadezhda Ivanisova, Dr. Sergey Pashchenko
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