Prostate cancer treatment (Tumor)
The prostate is a small gland in the male body, located near the bladder. Sometimes prostate cells begin to divide abnormally and form a malignant tumor. This process is called prostate cancer (PCa).
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Symptoms and early signs
For many men, the early stages of prostate cancer go unnoticed, with few symptoms. However, warning signs gradually appear, such as:
- Frequent urge to urinate
- Difficulty urinating
- Blood in the urine
- Pain in the lower abdomen or lower back
- Erection problems
Sexual dysfunction and decreased libido are common. These symptoms are associated with tumor growth within the prostate, which compresses adjacent organs. However, it is important to understand that the same problems can also occur with benign prostatic hyperplasia. Therefore, any changes in well-being require a doctor's consultation.
The difficulties in early detection of prostate cancer are associated with its asymptomatic course in the early stages. The appearance of clinical signs of the disease usually indicates an advanced stage. All symptoms of prostate cancer can be divided into two groups: symptoms of local tumor spread and symptoms of metastases. Unfortunately, these symptoms are very similar to those of other diseases of the male genitourinary system.
Signs of late-stage prostate cancer
In some cases, patients suffer more from the manifestations of prostate cancer metastases than from the main symptoms of the disease. For example, in the later stages, the following may appear:
- Pain in the bones affected by metastases, most often the lower back and pelvic bones
- Pain due to spinal cord compression
- Bladder dysfunction
- Rectal dysfunction
- Swelling of the legs due to vein compression and lymph node involvement
- Enlarged regional lymph nodes
- Lower back pain
- Weight loss, fatigue and drowsiness, intestinal bleeding
Causes of prostate cancer
The causes of cell mutations that cause prostate cancer and other oncological diseases are not yet fully understood. However, there are certain risk factors that increase the likelihood of developing a tumor.
Age is the main cause of prostate cancer. The longer a man lives, the longer androgens—male sex hormones—stimulate prostate tissue. This, according to modern data, predisposes men to the development of malignant tumors in the prostate. This same theory underlies drug treatment, primarily hormone therapy.
The development and growth of malignant cells in the prostate can also be promoted by:
- Overweight
- Prostatic hyperplasia, chronic prostatitis, and other inflammatory diseases and conditions of the prostate gland
- Trauma
- Prostatic adenomas
- A "fatty" diet
Heredity plays a significant role in the development of prostate cancer. It has been established that malignant tumors are much more common in men whose immediate relatives have also been diagnosed with prostate cancer.
Prostate cancer stages
Stage 1 – the tumor is non-aggressive, small, and confined to the prostate gland.
Stage 2 – the tumor has increased in size, but still affects only prostate tissue.
Stage 3 – prostate cancer begins to spread beyond the prostate gland, affecting the seminal vesicles and other adjacent tissues and organs.
Stage 4 – the malignant tumor invades the bladder, affects the lymph nodes, and metastasizes to other organs (e.g., the lungs) and tissues (bone).
Terminal stage 4 prostate cancer is difficult to treat and has a poor prognosis.
Modern diagnostic methods
To accurately determine the presence or absence of prostate problems, the doctor conducts a series of examinations, including:
- Initial examination - the doctor collects a medical history and examines the pelvic area, then performs a digital rectal examination
- PSA (prostate-specific antigen) test
- Transrectal ultrasound - ultrasound examination of the rectum
If the results of previous tests are unclear, an MRI of the pelvis is prescribed. This method provides a detailed picture of the tissues and allows for more precise localization of possible tumors. If previous tests show abnormalities, a prostate biopsy is performed. Modern diagnostics allow for early detection of problems and the selection of effective treatment.
Prostate cancer diagnosis
To accurately determine the presence or absence of prostate problems, the doctor conducts a series of examinations, including:
- Initial examination - the doctor collects a medical history and examines the pelvic area, then performs a digital rectal examination
- PSA (prostate-specific antigen) test
- Transrectal ultrasound - ultrasound examination of the rectum
If the results of previous tests are unclear, an MRI of the pelvis is prescribed. This method provides a detailed picture of the tissues and allows for more precise localization of possible tumors. If previous tests show abnormalities, a prostate biopsy is performed. Modern diagnostics allow for early detection of the problem and the selection of effective treatment.
The disease can only be completely cured in the early stages of prostate cancer, while the tumor is still small. Therefore, regular screening is crucial.
The following methods are used to detect cancer:
- Digital rectal examination (DRE) - palpation of the prostate gland through the rectum, which allows detection of lumps
- Blood test for the presence of prostate-specific antigen (PSA)
- Ultrasound of the prostate gland using a rectal probe (TRUS), which is inserted into the rectum, with possible tumor biopsy
- Colonoscopy
- Computerized tomography and magnetic resonance imaging (MRI) of the pelvis to assess the extent of prostate cancer spread to the seminal vesicles and other nearby tissues
To verify the diagnosis, a core biopsy of the prostate gland is performed. To rule out distant metastases, abdominal ultrasound, skeletal scanning (bone scan), CT or MRI of the area of interest, and lung X-rays are performed.
A blood test for PSA levels is widely used, but produces inconclusive results. The normal level is 4 ng/ml. A level of 10 ng/ml indicates a 25% chance of prostate cancer. A level above 10 ng/ml indicates a 50% chance. However, in some cases, cancer is detected even with a PSA level below 4 ng/ml. Once prostate cancer is diagnosed, PSA tests can be used to monitor the effectiveness of treatment and assess the extent of cancer spread. Currently, the primary and primary method for diagnosing prostate cancer is a digital rectal examination.
The TRUS procedure not only allows for diagnosis and prostate biopsy, but also for monitoring other prostate cancer treatments, such as brachytherapy or cryotherapy.
A biopsy of prostate tumor cells is the most accurate and reliable way to make a definitive diagnosis. Prostate needle biopsy, ultrasound-guided biopsy with insertion of a probe into the rectum, and other methods may be used to collect cancer cells. The biopsy material is then subjected to histological examination in the laboratory.
During diagnosis, the goal is to determine the tumor type, stage of prostate cancer, and determine a treatment plan. If the tumor has not spread beyond the prostate, surgical removal of the prostate is possible; if there are metastases, drug therapy is indicated.
Our clinic uses state-of-the-art equipment for prostate cancer diagnostics and laboratory testing. Effective anesthesia is used during biopsies, and preference is given to the safest and least invasive methods for prostate cancer diagnosis.
The most common type of prostate cancer is adenocarcinoma. This tumor develops from the glandular cells of the prostate. There are also rarer forms of cancer, such as neuroendocrine cancer, small cell carcinoma, sarcoma, and transitional cell carcinoma of the prostate.
Prostate cancer treatment
The doctor selects the method of treatment for prostate cancer individually. The main methods of fighting the disease:
- Surgery - removal of the affected part or the entire prostate along with surrounding tissue
- Hormone therapy. Some types of cancer depend on male sex hormones - androgens. To slow tumor growth, testosterone levels are reduced with special drugs
- Radiotherapy (radiation therapy). Radiation destroys cancer cells with targeted radiation. There are two types of therapy: external beam and internal brachytherapy. External brachytherapy is performed with a device outside the body, internal brachytherapy is performed by introducing radioactive particles directly into the gland
- Chemotherapy. This option is used less frequently, mainly when the tumor has metastasized to other organs
The choice of treatment for prostate cancer depends on the stage of the disease, the size of the tumor, as well as the presence of concomitant age-related diseases that may affect the possibility of surgical treatment. When treating prostate cancer, one of the following methods or a combination of them is used.
Surgical operations for prostate cancer
Prostate cancer is treated with surgical removal of the prostate gland and surrounding tissue. The procedure is performed using traditional open surgery, laparoscopy (a more conservative approach), or the da Vinci robotic system. Early forms of prostate cancer are treated surgically. Surgeons at the K+31 Oncology Clinic are proficient in modern surgical techniques that allow for nerve-sparing procedures. The clinic utilizes minimally invasive prostate removal technologies, which eliminate the need for patients to undergo rehabilitation.
Radiation therapy
It is used when surgery is contraindicated, as well as in combination with hormonal therapy, in the treatment of recurrent prostate cancer, and as palliative therapy. Radiation therapy can be external or internal. Modern methods of external beam radiation therapy:
- Three-dimensional conformal radiation therapy – involves targeted radiation therapy from multiple points on the tumor, with minimal impact on healthy tissue.
- Stereotactic radiation therapy – a method in which a device delivers a concentrated dose of radiation to the prostate tumor, allowing for a shorter course of treatment in days instead of weeks.
Brachytherapy is a type of external beam radiation therapy. The radiation source is placed in the prostate gland. This method is relatively gentle, as the patient achieves maximum results with minimal side effects.
Hormone therapy
It is prescribed for advanced prostate cancer, as a palliative treatment for aggressive tumors, and before radiation therapy to slow tumor growth. However, after several years, prostate cancer stops responding to therapy, i.e., enters a hormone-resistant phase. In this case, medications are changed or chemotherapy is used.
Chemotherapy
Chemotherapy is possible if the tumor doesn't respond to hormonal drugs or if prostate cancer has spread to distant organs.
Metastatic prostate cancer is also treatable in some cases. Radiation therapy, chemotherapy, and other methods are aimed at slowing the division of cancer cells and destroying them, even if they are located in the bones or lungs.
Treatment methods at different stages
- Stage I prostate cancer is treated with radiation therapy or radical prostatectomy (removal of the prostate gland).
- Stage II prostate cancer can be treated with surgery (prostatectomy), radiation therapy, brachytherapy, or a combination of the latter two.
- Treatment for stage III prostate cancer, when the malignant tumor has spread to adjacent tissues but has not yet affected the bladder and rectum, often involves monitoring the tumor's dynamics and disease control. However, treatments such as hormonal therapy, chemotherapy, radiation therapy, radical prostatectomy, transurethral resection of the prostate, and various combinations of these methods may be used.
- Stage IV prostate cancer is treated with the same methods as stage III tumors. This is primarily a palliative treatment to reduce symptoms, relieve pain, and prolong the patient's life.
General information
Prognosis for prostate cancer
The five-year survival rate for prostate cancer stages 1, 2, and even 3 is almost 100%. However, at stage 4 prostate cancer, the prognosis drops sharply to 30% or less. However, in this case, there are quite effective methods for prolonging the patient's life, even with prostate cancer metastases in other organs and tissues.
The 10-year survival rate after prostate cancer treatment (specifically, prostate removal) at any stage is 98%, and the 15-year survival rate is 96%. In most cases, recurrence is not observed after treatment.
Why is prostate cancer best treated at the K+31 clinic?
To treat prostate cancer, our clinic brings together a team of specialists from various fields who examine the problem from all angles, taking into account the patient's condition and individual needs. The choice of treatment method is based on the most effective and safe therapy for each specific case.
Our clinic's doctors also treat breast cancer, stomach cancer, lung cancer, liver cancer, uterine cancer, lymphoma, melanoma, and tumors of any etiology and location. In their clinical practice, they use only proven diagnostic methods and effective treatment techniques with minimal complications.
Call us to schedule a consultation or book an appointment online directly on our website.
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What is prostate cancer?
This type of cancer most often occurs in men over 50. Statistically, it is one of the most common types of cancer in men. The earlier a malignant tumor is diagnosed, the more successful the treatment. It is important to remember that regular screenings help detect the disease early and increase the chances of a full recovery.
According to some data, the increase in prostate cancer cases has reached over 500% (!) compared to the early 1990s. This surge is primarily due to the widespread introduction of early detection programs for this pathology.
On the other hand, prostate cancer has a clear correlation with age: the risk of developing a malignant tumor in the prostate is significantly higher in men over 65 compared to men aged 50. Given that life expectancy, especially in developed countries, is increasing significantly, this factor can also be considered a reason for the increase in prostate cancer incidence.
Prostate cancer is the leading cause of malignancy in the male population, so prostate cancer treatment is receiving significant attention today: surgical approaches are being revised, minimally invasive tumor surgery techniques are being developed, radiation therapy (including contact brachytherapy) is being refined, and new drugs are being developed for drug treatment.
Prostate cancer develops due to mutations in prostate cells. These mutations can trigger uncontrolled cell division and tumor formation.