- What is prostate cancer and how it spread spreads?
- What causes prostate cancer?
- Prostate cancer symptoms
- How to diagnose prostate cancer?
- Staging of prostate cancer
- Prostate cancer treatment options
- Best prostate cancer centers
- Survival rate of prostate cancer
What is prostate cancer and how it spreads?
Malignant neoplasm developing in the prostate gland is called prostate cancer. It has C61 code according to ICD-10 (International Classification of Diseases). In most of the cases, prostate cancer spreads slowly not affecting the organism significantly. Rarely it is aggressive and progresses rapidly.
How serious is prostate cancer?
Prostate cancer is one of the most frequently diagnosed malignant tumors in men aged 55-65. The statistics shows 400,000 registered prostate cancer cases annually. The disorder takes the 3rd place among male oncological diseases in Europe, and 1st place in America.
Over 300,000 prostate cancer deaths per year are registered worldwide. Prostate cancer mortality rate depends on the disease stage. In early stages, it is quite low — up to 10%, in the advanced ones — up to 40-50%. Prostate cancer spreads quite slowly, and it can be asymptomatic for years. In prostate cancer stages 3-4, metastases affect bones, surrounding lymph nodes, rarely — the lung, liver and other soft tissues.
What causes prostate cancer?
Nowadays, the causes of prostate cancer are still unclear, but specialists explain the oncology development with the following factors:
1. Age. Starting from 55 years old, men get into the prostate cancer risk factors.
2. Hormone imbalance. It is explained by hormonal changes occurring in the man’s body. Prostate malignant tumors are hormone-dependent. Men with increased luteinizing hormone and testosterone belong to the prostate cancer risk group.
3. Hereditary background. The prostate cancer risk increases if somebody among close patient’s relatives has the disease. In this case, cancer even appears in younger men (35-45 years old).
4. Previously diagnosed prostatitis and prostate adenoma.
5. Lifestyle. Smoking, drugs, alcohol overuse can cause mutations in the cells, enabling transformation of a benign tumor into a malignant one.
6. Nutrition features. For men who prefer fatty food, prostate cancer risk increases by 2 times.
7. Bad ecology.
8. Harmful working environment.
If a man is willing to prevent prostate cancer, he needs to reduce consumption of an alcohol and junk food. Also, it is necessary to exercise regularly.
Men aged over 50 should control hormone balance and visit a urologist every 6 months.
Such simple rules can safe time, money, and LIFE.
Prostate cancer symptoms
In the early stages, prostate cancer symptoms are absent and appear when a tumor is growing. It constricts the bladder causing early signs of prostate cancer.
The disease progresses slowly and sometimes can manifest itself in several years. Only a doctor can detect a tumor in early stages providing a complete diagnostics.
Typically, men notice such early prostate cancer symptoms featured for stages 1-2:
- frequent and difficult urination, especially at night
- disruptive urination
- a feeling of incomplete emptying of the bladder
- burning when urinating.
A large tumor size, metastases in bones and lymph nodes cause symptoms of prostate cancer stage 3-4, so that a man can feel:
- swelling of lower limbs
- blood in the urine
- potency disorders
- pain in the spine and pelvis bones
- painful dry cough if metastases are in the lung
- painful defecation (metastases have affected the intestine)
- ochrodermia (metastases are in the liver).
Also, a man can feel weakness and lose weight rapidly.
These symptoms are progressing each year; they are not sudden. If a person has any of the above-mentioned prostate cancer signs, it is necessary to consult a doctor.
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How to diagnose prostate cancer?
Due to the fact that prostate cancer does not manifest itself with specific symptoms in early stages, the disease is possible to be detected only by applying the particular diagnostics. The screening for prostate cancer is prescribed after consultation with an urologist.
The diagnosis may include:
- Digital rectal exam (DRE). During this procedure, a doctor examines the prostate through the rectum by lubricated finger. If a specialist notices any abnormalities of the prostate, further tests are prescribed.
- PSA (prostate-specific antigen) test. The prostate gland produces this antigen. If its level is increased in the blood, a doctor may suspect prostate cancer. It is used for early detection of prostate cancer.
- Ultrasound. The procedure is performed through the rectum. The special probe is inserted inside to evaluate the prostate.
- Prostate biopsy. It is a sample collection of prostate tissue. A doctor inserts the thin needle to take some tissues. Then, specialists determine whether cancer cells are present in the organ.
If oncology is confirmed, prostate cancer biopsy also shows whether prostate cancer is aggressive. The Gleason score scale is used to determine prostate cancer grade:
- 2-6 scores. A tumor grows slowly and does not spread to other organs.
- 7 scores. A tumor grows moderately but soon can become dangerous.
- 8-10 score. Cancer is aggressive and spreads rapidly. An urgent treatment is required. In most of the cases, prostate cancer is diagnosed when Gleason score is 6-7. It means that the treatment achieves good result on this stage.
Undergo the accurate diagnostics
When the diagnosis is established, a doctor detects how far a tumor has spread. In most of the cases, bone scan (scintigraphy), CT, PET-CT, MRI for prostate cancer may be prescribed.
Staging of prostate cancer
The prostate cancer stage shows the tumors size and presence of metastases in other organs.
Below you can see the division of the prostate cancer stages, the appropriate treatment for each stage, 5-year survival prognosis. The survival prognosis is a period when a patient lives without relapses and deterioration of health.
| Stage | Description | Prognosis and recommenations |
|---|---|---|
| Stage 1 | Up to 5 Gleason scores. Cancer is limited only with 1 lobe of the prostate. Prostate cancer stage 1 is rarely diagnosed due to an absence of symptoms. |
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| Stage 2 | Cancer has spread into both prostate lobes. It can be detected during ultrasound procedure and blood tests. |
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| Stage 3 | A tumor has grown beyond the prostate capsule. |
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| Stage 4 | Metastases are detected in the scrotum, testicles, pelvic muscles. Gleason score is 8-10. |
|
Prostate cancer treatment options
Prostate cancer treatment depends on how is a tumor aggressive, its size, how much prostate cancer has spread, and general health condition of a patient.
According to these, a doctor chooses the best treatment for prostate cancer.
It is worth noting that prostate cancer does not require treatment if:
- a patient is elderly
- a tumor grows slowly
- treatment side effects negatively influence a patient's health condition.
In such cases, examination and regular visiting of a doctor will be enough.
If the follow-up tests show the progression of oncology, a doctor prescribes treatment for prostate cancer such as a surgery, radiotherapy or chemotherapy.
See the prices for prostate cancer treatment in different countries here
Surgery for prostate cancer — prostatectomy
Surgery for prostate cancer (or prostatectomy) is a removal of a tumor and some surrounding tissues to exclude the cancer spread beyond the gland. The surgical treatment method is the most effective one but is prescribed when a tumor is within the prostate gland and does not spread to other tissues.
Traditional prostatectomy
Traditional prostatectomy is performed through the 12-cm incision in the abdomen area.
The traditional surgery may cause such side effects including impotence or urinary incontinence.
Robotic surgery for prostate cancer
Robotic prostatectomy is performed on Da Vinci robotic system. It is less traumatic operation compared to traditional one. A doctor removes the prostate gland through 5 incisions 1-1.5 cm in size.
This type of prostatectomy shortens postoperative rehab period by 2 times. The side effects of robotic prostate cancer surgery are reduced because nerve endings are damaged minimally. 90% of patients after robotic prostatectomy preserve the erectile and urinating functions.
The surgical prostate cancer treatment success rate in the initial stages is 90-92%.
Radiation treatment for prostate cancer
Radiation treatment for prostate cancer is applied to destroy malignant cells with powerful X-rays. Healthy tissues are affected minimally. Radiotherapy is prescribed:
- after prostatectomy in the advanced cancer stages
- if surgery is contraindicated because of patient’s health condition
- if other methods are ineffective.
Radiation therapy for prostate cancer can be delivered in 2 ways:
1. External radiation. The prostate is irradiated outside the body. A patient lies on the table when linear accelerator moves around the body directing high-power radiation beams to the prostate. External radiotherapy is performed 5 days a week during several weeks.
2. Brachytherapy. The radiation influences a tumor from the prostate inside. A doctor places tiny radioactive seeds inside the prostate. The procedure takes 1.5 hour under general anesthesia. Then these seeds irradiate the malignant tumor for several months until it disappears. The seeds are not removed when they stop emitting the irradiation. They do not cause any discomfort or harm.
The success rate of external radiation treatment for prostate cancer depends on its stage. In the initial stages, it is 80% on average. Brachytherapy success rate is up to 87% for stages 1-2.
Such side effects caused by radiation therapy may occur:
- painful and frequent urination
- losing stool
- erectile dysfunction
- hemorrhoids
- tiredness.
Patients often wonder how to decide between radiation or surgery for prostate cancer. Both these methods can be applied together or separately. It depends on patient’s health condition, age, and financial ability. The surgery is cheaper than radiotherapy, but the chance of side effect appearance is higher. That is why you can choose the right option only together with your doctor.
Calculate the prostate cancer treatment cost
Cryotherapy for prostate cancer
Cryotherapy is a freezing of prostate tissues affected with malignant cells. This treatment option is applied when radiotherapy is ineffective.
Cryotherapy is carried out the following way: a doctor inserts small needles with cold gas in the prostate using ultrasound. The gas influences the tissues and destroys a tumor.
Freezing is prescribed when preservation of an erectile function is not a primary goal. The deal is cryotherapy often causes impotence due to significant damage of nerve endings.
Proton therapy for prostate cancer
The treatment with proton beams is the most accurate method to destroy cancer cells. It treats oncology of the prostate gland with minimal radiation exposure. Due to the high speed of protons movement, they do not affect healthy tissues and target only cancerous ones.
The procedure is painless and minimally invasive. Doctors may prescribe it instead of surgery.
The success rate of proton therapy for prostate cancer is up to 99%.
HIFU for prostate cancer
HIFU for prostate cancer is a destruction of the malignant cells applying high intensity focused ultrasound. A special detector is inserted in the patient’s rectum to influence the prostate tumor with ultrasonic waves. They heat malignant cells up to 90-110°C and destroy them.
HIFU for prostate cancer treatment has its pros and cons. The advantages are the following:
- only 1 therapeutic session is required
- the 5-year survival rate is observed in 85-90% of patients
- side effects of HIFU are minimal.
The main disadvantage is that HIFU is possible to be applied only in the initial stages of cancer. The cost of therapy is higher compared to traditional surgery.
Focal-One® device
Hormonal therapy for prostate cancer
Specialists apply hormone therapy for prostate cancer to stop the body producing the male hormone called testosterone. The deal is that testosterone stimulates prostate tumor growth. If testosterone level is reduced, the malignant cells are likely to grow slowly or even die.
There are such options of hormone therapy for prostate cancer:
- Medications to stop the body testosterone production. The drugs prevent the testicles from the hormone producing. The most commonly used medications are Lupron, Zoladex, Trelstar, Vantas, etc.
- Medications to block testosterone reaching malignant cells. Such drugs are known as anti-androgens. They block testosterone to reach the tumor. Among the medicines are Casodex, Nilandron, Xtandi, etc.
- Hormonal therapy for prostate cancer prolongs life expectancy but does not cure oncology completely. Usually, it needs additional therapeutic methods to get rid of cancer forever.
Hormonal therapy for prostate cancer may cause such side effects: erectile dysfunction, reduced sex drive, weight loss, mood swing.
Chemotherapy for prostate cancer
Chemotherapy is commonly used for advanced stages of prostate cancer when the metastases spread to other organs. It is considered medicamentous treatment option.
In most of the cases, doctors apply chemo as palliative therapy to slow down the growth of malignant cells and block their division.
Chemotherapy is also applied when hormonal therapy is ineffective.
This treatment option may cause such side effects:
Chemotherapy may be applied in combination with other therapeutic options to increase patient’s life expectancy.
Above-mentioned treatment options may be combined together or applied separately. It will depend on the prostate cancer stage and therapeutic methods available in a particular hospital.
Best prostate cancer hospitals
Czech Republic Best price for robotic prostatectomy |
Turkey All prostate cancer therapies are available |
Germany Best doctor for prostatectomy |
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Survival rate of prostate cancer
The prognosis for prostate cancer is positive even in the advanced stages. Oncology of the prostate is that rare case when a patient has time to choose the most appropriate treatment and prolong life expectancy.
Prostate cancer stage 1: survival rate
The oncological disease is rarely diagnosed in this stage because during usual examination a tumor is difficult to be detected. Only biopsy and PSA test show the pathology.
In the 1st stage of prostate cancer, a tumor does not penetrate into the gland tissues.
The 5-year survival rate is 95-100%.
Prostate cancer stage 2: survival rate
A tumor is possible to be palpated, it is still within the capsule, the metastatic spread is absent. Specialists choose the best treatment options among radiation therapy, surgery, proton therapy or hormone therapy.
The 5-year survival rate is 80-95%.
Prostate cancer stage 3: survival rate
The life expectancy for prostate cancer stage 3 depends on the chosen set of therapeutic options and general health condition of a patient. Radio-, chemo-, hormone therapy, and/or surgery are applied.
The 5-year survival rate is 60-80%.
Prostate cancer stage 4: survival rate
In stage 4, prostate cancer spreads rapidly: metastases appear in the lymph nodes, bones, and other organs. Still, the life expectancy depends on the chosen treatment options. For instance, innovative radiotherapeutic drug Xofigo Radium 223 stops the metastatic spread, so a patient can live up to 10 years with oncology.
In general, the survival rate for prostate cancer stage 4 is less than 50%.
The treatment in the best prostate cancer shows the high efficiency with minimal side effects.
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