MHL provides information, suggestions and introductions, but we are not doctors and we cannot give medical advice.
MHL (PPM Consult Ltd.) introduces patients to hospitals and treatment centres with the latest medical technologies, special expertise or where we believe the standards of care or medical equipment to be exceptional.
We do not arrange or provide diagnostic services or treatments ourselves and we shall not be responsible for the outcome of any treatment or for failure to diagnose or treat.
Advanced Treatments for Prostate Cancer
Latest treatments for prostate cancer
MHL is always seeking the best new diagnostics and treatments for prostate cancer, as well as outstanding treatment centres for international patients.
Some of the treatments and technologies may not yet be well known in your country so we are pleased to provide an introduction here.
The following list is not exhaustive, but it includes most of the main methodologies in use today.
Proton therapy can be applied wherever conventional radiotherapy can be used, but because the radiation is more closely focussed on the tumour(s) it greatly reduces the impact of radiation on sound tissue.
It can also reduce distressing side effects which are often associated with radiotherapy for certain types of cancer.
This is one of the most common applications of proton therapy, reducing the risk of incontinence and loss of virility sometimes associated with radiotherapy.
Surgical removal of the prostate, known as radical retropubic prostatectomy, can be performed manually or as minimally invasive surgery.
A number of hospitals around the world now use the da Vinci® 'robotic' surgery system for assistance in precisely controlled, minimally invasive surgery, including for prostate cancer.
'Telemanipulation' is more accurate, as the system transfers a surgeon's hand movements to the instruments that are inserted through small incisions in the abdomen.
The skill of the individual surgeon is still paramount therefore. He controls the movements via a three-dimensional view with up to 10x magnification.
Radiotherapy can be used where tumours have grown too far for surgery or as an alternative to surgery in the primary treatment of prostate cancer, as well as for localised advanced tumour stages following prostatectomy and for recurrences
There have been many advances on conventional radiotherapy in recent years, particularly in the introduction of image guided treatments and there are many competing proprietary technologies.
In brachytherapy, the radiation source is placed in direct contact with the the malignant tissue of the target tumour.
The fall-off of in radiation to surrounding tissue is therefore much higher than with external radiotherapy.
Brachytherapy therefore allows a higher radiation dose to be administered in the shortest possible time. Duration of treatment is therefore typically one week rather than six weeks. A further advantage is significantly lower radiation exposure compared to traditional radiotherapy.
Even with advanced tumours or the recurrence of a tumour following radiotherapy, brachytherapy offers patients considerable advantages. It may be used alone or in conjunction with traditional radiotherapy and/or chemotherapy.
Depending upon the age and condition of the patient, not all cancers need to be treated immediately.
Treatment may be avoided or delayed by the use of hormomal therapy. Testosterone has a marked effect on the development of prostate cancer, so this may be reduced by medication.
Drug based therapies may also be used to attack the tumour(s), either as a stand-alone treatment or as a prelude to radiotherapy or radiosurgery.
Drugs known as LHRH analogues are injected monthly or quarterly under the skin, which lead to a complicated mechanism that halts production of testosterone in the testes.
Although this is unlikely to cure the cancer, it can slow or halt the growth of the tumour.
Often another 'anti-androgen' drug is added, which blocks the testosterone uptake into the prostate itself.
Hormone deprivation therapy, which can also be done surgically by removal of the hormone-producing testicular tissue, is the best treatment for a prostate cancer that has metastasised.
Hormone withdrawal treatment is also used concomitantly with radiation treatments, over approx one year, as it can improve the healing rates of radiation treatment.
Similarly in case of a localised tumour, androgen deprivation may be used, pending decision on the best form of treatment or as a pretreatment before surgery.
If the tumour continues to grow, despite exhausting all possibilities of surgery and hormone deprivation, chemotherapy may be employed.
Options include minimally invasive surgery, CyberKnife radiosurgery, particle beam therapy (proton beam or the latest ion beam) and a range of treatments at leading university and specialist cancer hospitals.
Particle beam therapy (proton or ion beam) and CyberKnife radiosurgery offer much greater precision however and they cause fewer side effects compared to radiotherapy, especially where the tumour is comparatively small and localised.
As the tumour grows larger and more diffuse, the benefits of these systems reduces and in the most advanced tumours patients may be advised that radiotherapy close to home would be the most appropriate treatment for their case.
The da Vinci 'robotic' surgery system displays internal images at up to ten times magnification and relays the surgeon's hand movements.