Advancement in technology and development towards prevention of prostate cancer along with effective treatment methods are now available for better outcomes, says Dr Yogen Chedda, Consultant- Surgical Oncology, HCG Apex Cancer Centre, Mumbai
Prostate cancer accounts to about 7-8 per cent of all newly detected cancers and it is found to be the second most common cancer in males. With changing lifestyle and work-life balance, there is an increase in the cases of prostate cancer over the last few years. Advancement in technology and development towards prevention along with effective treatment methods are made available now for better outcomes.
There is no ‘one size fits all’ treatment for prostate cancer. It is important to understand about various treatment options that are available and along with a tumour board approach, a personalised treatment specific to individual health and disease condition is suggested. Newer treatment and diagnostic methods have enabled men detected with localised prostate cancer, to be a survivor today. It is important to discuss not only cure, but also a desired quality of life.
As we are moving towards a more precise-based medicine with value-based treatment, diagnosis and treatment of cancers are following the pace and adapting to the newer modalities of treatment options.
Recent advancements in the treatment of prostate cancer
Robotic prostatectomy, also known as Robotic Assisted Laparoscopic Prostatectomy, is a standard prostate surgical procedure for prostatic cancer. This state-of-the-art, revolutionary and advanced surgical procedure profoundly decreases pain, blood loss, recovery time, and unwanted side effects produced by conventional treatments. It enables faster recovery for male patients because the vessels and nerves responsible for bladder and sexual function are saved unlike the damage done to nerve tissue during perineal prostatectomies.
Radiation treatment for prostate cancer requires accuracy and precision. Various modalities of radiation therapy are available for treatment of prostate cancer.
Two primary types of radiation therapy for the treatment of prostate cancer:
External beam radiation therapy (EBRT) is intended to deliver high dose of radiation to prostate cancer cells from outside the body, using a variety of machine-based technologies.
Though High-dose rate (HDR) brachytherapy (internal radiation), the procedure delivers high doses of radiation from implants placed close to, or inside, the tumour in the body.
Stereotactic body radiosurgery (SBRT) involves using innovative imaging technologies to deliver high doses of radiation to tumours in the prostate. Stereotactic radiosurgery is a non-surgical, highly precise form of radiation therapy we use to treat cancers of the brain, lung, as well as other types of cancer that require a high degree of precision.
Hormone therapy, also known as androgen-deprivation therapy or ADT, is designed to stop testosterone from being released or to prevent it from acting on the prostate cells. Although hormone therapy plays an important role in men with advanced metastatic prostate cancer, it is also increasingly being used in localised or locally advanced prostate cancer. However, for most men hormone therapy alone is not a recommended treatment strategy for non-metastatic prostate cancer. There are drugs which being studied to treat prostate cancer, either to supplement active surveillance or if the PSA level rises after prostatectomy.
Immunotherapy (Role of Vaccine) is a new approved form of treatment where the immune cells are activated to fight cancer cells. This treatment involves minimal or no pain, and is most commonly given before chemotherapy.
Radiofrequency ablation (RFA) involves the insertion of an electrode into the centre of the tumour using a percutaneous, intraoperative or laparoscopic approach. RFA is guided by ultrasound (US) or computed tomography (CT). The tissue absorbs the radiofrequency energy emanating from the non-insulated part of the electrode. The goal is to destroy the entire area of the tumour, plus a margin of normal tissue, to control local disease, relieve symptoms and prolong survival.
Cryotherapy is an innovative and minimally invasive therapy that uses ultrathin needles and freezing gases to destroy the cancerous tissue.
High-intensity focussed ultrasound, or HIFU, has been recently approved by FDA for prostate disease, but not specifically prostate cancer. A probe is inserted into the rectum, from which very high-intensity ultrasound waves are delivered to the target area.
As it is widely believed in onco-fraternity that early detection is the key to better outcome and survival rates, it is important that men post the age of 50 undergo periodic health check-up and cancer screening. Early diagnosis of prostate cancer by way of Prostate Specific Antigen (PSA) screening (a marker for prostate cancer) and digital rectal examination (DRE) should be undertaken routinely, since prostate cancer is more common in men in this age group.
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