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Prostate Cancer Treatment

Prostate Cancer Treatment Abroad

 Prostate is the gland in men that produces the seminal fluid and transports the sperm. When cell mutation initiates in the prostate, abnormal cell proliferation can result in prostate cancer.

Some common signs of prostate cancer include:

  • Weak flow of urine
  • Frequent urination
  • Interrupted flow of urine
  • Sudden urge to urinate
  • Trouble starting the flow of urine
  • Trouble emptying the bladder
  • Pain when urinating
  • Blood in the urine or semen
  • Pain in the hips, back or pelvis
  • Shortness of breath, tiredness, dizziness, pale skin

As men age, prostate may get bigger and block the urethra, which causes trouble urinating and other symptoms similar to prostate cancer. This condition is called benign prostatic hyperplasia (BPH). Although it is not cancer, it requires surgery.

Prostate Cancer Treatment – Diagnosis

In order to detect and diagnose prostate cancer, the doctor can perform a set of tests that examine the prostate and the blood.

The tests and procedures that always precede prostate cancer treatment:Prostate-_Small

  • Digital rectal exam (DRE) – the doctor or nurse inserts a lubricated gloved finger into the rectum in order to feel the prostate through the rectal wall. Lumps or abnormal areas may indicate prostate cancer.
  • Prostate-specific antigen (PSA) test – measures the level of PSA in the blood, a substance made by the prostate which is usually found in an increased amount when men have prostate cancer.
  • Transrectal ultrasound – a probe about the size of a finger is inserted into the rectum. The procedure checks the prostate using high-energy sound waves, so that internal tissues or organs bounce and make echoes. The result is a picture of the body tissues (sonogram).
  • Biopsy – the pathologist collects a tissue sample and views it under the microscope, to detect cancer cells out of the Gleason score (which ranges from 2-10 and describes how the tumor will spread). There are two types of biopsy procedures.
    • Transrectal biopsy – a thin needle is inserted through the rectum into the prostate, using transrectal ultrasound.
    • Transperineal biopsy – the thin needle is inserted through the skin between the scrotum and rectum into the prostate.

Once prostate cancer has been diagnosed, specialists have to find out if the cancer has spread to other parts of the body. This process is called staging and it is essential in order to plan prostate cancer treatment.

The following tests are used to determine the staging:

  • Bone scan – checks if there are rapidly dividing cells in the bone.
  • Magnetic resonance imaging or MRI - uses a magnet, radio waves and a computer to make detailed pictures of the inside of the body.
  • CT Scan – makes detailed pictures through an X-ray machine.
  • Pelvic lymphadenectomy – a surgical procedure which removes the lymph nodes in the pelvis in order to look for cancer cells.
  • Seminal vesicle biopsy – removes fluid from the seminal vesicles using a needle to look for cancer cells.

Cancer can spread in the body through tissue, the blood and the lymph system. This is called a metastatic tumor.

Prostate Cancer Treatment

Prostate cancer treatment depends on the following factors:

  • Patient’s overall health
  • Expected side-effects of the treatment
  • Previous cancer treatments
  • Most importantly, however, prostate cancer treatment depends on the stage of the cancer, according to the level of PSA, Gleason score, the grade of the tumor, and whether the cancer has spread to other places.
  • The patient’s age
  • Whether the cancer has been just diagnosed or is recurrent.

Different types of prostate cancer treatment are available. Some of them are currently in mainstream use and some new prostate cancer treatments are performed only in clinical trials.

Prostate cancer treatment options include:

Eight types of standard treatment:

  • Watchful waiting or active surveillance – used for older men without signs or symptoms but who suffer from other medical conditions. It consists of a close monitoring without actual treatment, until changes appear which shows worsening.
  • Surgery – for healthy patients whose tumor is in the prostate gland only. Among the types of prostate cancer surgery we can distinguish:
    • Radical prostatectomy – removes the prostate, surrounding tissue and seminal vesicles. There are two types:
  1. Retropubic prostatectomy – the prostate is removed through an incision in the abdominal wall.
  2. Perineal prostatectomy – removes the prostate through the perineum.
  • Pelvic lymphadenectomy – removes the lymph nodes in the pelvis.
  • Transurethral resection of the prostate, TURP – removes tissue using a resectoscope (a cutting tool) inserted through the urethra. The procedure is used to treat benign prostatic hypertrophy
  • Radiation therapy – uses high-energy X-rays to kill cancer cells. There are two types:
    • External radiation therapy – uses a machine outside the body to send radiation.
    • Internal radiation therapy – uses catheters placed directly or near the cancer

Prostate-_Big

Both techniques can cause impotence and urinary problems.

  • Hormone therapy – removes hormones to stop cancer cells from growing. It is one of the most common prostate cancer treatment options available. The therapy may include the following:
    • Luteinizing hormone – stops testicles from making testosterone
    • Antiandrogens – blocks the action of androgens
    • Adrenal glands preventers
    • Orchiectomy – a surgical procedures which removes both testicles
    • Estrogens – prevent testicles from making testosterone.
  •  Chemotherapy – uses drugs to stop the growth of cancer cells
  • Biologic therapy – uses the patient’s immune system to fight cancer
  • Targeted therapy – uses drugs to find and attack cancer cells

New types of prostate cancer treatment are being tested in clinical trials.

  • Cryosurgery – uses an instrument to freeze and destroy prostate cancer cells
  • High-intensity focused ultrasound – uses high-energy sound waves to destroy cancer cells
  • Proton beam radiation therapy – the high-energy, external radiation beam targets the tumor