According to the statistics of World Health Organization, prostate cancer is the most widespread cancer type among the European men. Prevention and early diagnosis of the prostatic neoplasms stay in the focus of attention, as in timely start of therapy 5-year survival rate reaches 100%.
Recent research has demonstrated that the prostate-specific antigen (PSA) blood test is helpful, but cannot provide doctors with the reliable information. In Germany, several more accurate tests, like Progensa, the phi, and the 4Kscore test are being implemented into the clinical practice. Curative treatment options are also supplemented by robotic surgical techniques, Lutetium-177 and Actinium-225 PSMA therapy, immunotherapeutic methods.
How does the prostate cancer reveal itself?
At the early stages the disease does not have any clinical manifestations. Only regular check-ups and screening tests give a chance to detect oncological changes in the prostate tissues. Typically, tumor causes complaints only when it is large enough to hamper the urine flow or when it spreads to the neighboring or distant organs.
Early symptoms include the following:
- Frequent urination.
- Difficulties with beginning or ending urination.
- Intermittent urinary stream.
- Unpleasant feelings during the urination or ejaculation.
- Visible blood in the urine.
Nevertheless, early signs of the prostate cancer are not specific. They can be also present in patients with urological infections, benign hyperplasia of the prostatic gland, urolithiasis, etc. Only thorough examination can confirm or exclude the diagnosis reliably.
Which diagnostic tests are obligatory for the precise diagnosis making?
As a rule, a doctor starts examination from the anamnesis taking. Clarifying the information about cancer cases in relatives, concomitant disorders and duration of experiencing symptoms is essential for elaboration of the individual diagnostic plan. Further steps include:
- Digital rectal examination is palpation of the prostate through the wall of the rectum.
- Transrectal ultrasound creates images of the prostate gland with the help of sound waves. Color Doppler ultrasound provides a doctor with the additional information about state of blood vessels.
- PSA blood test reflects activity of the atypical cells multiplication and probability of the disease relapse after the treatment completion.
- Biopsy is investigating a part of the neoplasm under the microscope in order to reveal atypical cells. As a rule, samples for the histological examination are taken from up to 12 different loci.
- MRI, CT scan, PSMA-PET CT show comprehensive picture of the prostate and surrounding organs state. In addition, MRI can help guide the biopsy procedure.
- Osteoscintigraphy is performed in order to detect bone metastases.
Based on the results, a doctor determines the disease stage and proceeds to the treatment planning.
Individual approach to the treatment planning
Basically, there are three main therapeutic modes for the prostatic malignancies treatment. These are the surgical removing of the neoplasm, radiation therapy and medications intake. None of the methods is superior to other ones, as different disease stages require different approaches.
Surgery shows excellent results at the early cancer stages, when the tumor can be removed completely. In addition to removing atypical tissues, surgery aims to preserve nerves and blood vessels, so that a patient is able to control the bladder and have sex. The intervention can be performed in few modes:
- conventional open prostatectomy;
- minimally invasive radical prostatectomy with da Vinci robot (nerve-sparing surgery);
- transurethral prostate electroresection.
Radiation therapy may follow the surgery and kill the residual atypical cells, or be an independent treatment technique. Depending on the tumor size and presence of metastases, radiation is applied in different forms:
- conventional radiation therapy;
- radioactive seeds implantation (interstitial brachytherapy);
- intensity-modulated radiation therapy (IMRT);
- Actinium-225 PSMA therapy;
- Lutetium-177 PSMA therapy.
Medications include drugs for stopping cancer progression and improving patient’s general state. These are:
- androgen deprivation therapy;
- bone-modifying drugs in bone metastases;
- symptomatic treatment.
A doctor will explain you benefits and risks of each therapeutic scheme, so you will make the decision after the discussion.
Choosing the hospital and treating physician
Searching the information about clinics and doctors who specialize in the prostate cancer treatment, one should pay attention to independent statistics (e.g. number of correct diagnoses and successful surgeries per year), availability of the innovative equipment (e.g. da Vinci robotic system, proton therapy system), and qualifications of healthcare professionals.
As a rule, the most beneficial results are demonstrated by European clinics that combine active clinical practice and scientific research, e.g. university and academic hospitals of Germany. Fortunately, specialized oncological centers of most European countries admit foreign patients and offer them full package of the medical services.
Planning the prostate cancer treatment in Germany is more convenient and safe with assistance of Booking Health. Booking Health is the certified international medical tourism operator. Patients from over 75 countries can receive professional help of the Booking Health specialists, including:
- Choosing most appropriate clinic and doctor.
- Preparing basic medical program in advance.
- Financial control, providing favorable costs without overpricing (saving up to 50%).
- Booking the appointment on the necessary date, arranging the inpatient treatment.
- Help in buying and forwarding of medicines, if necessary.
- Communication with the clinic after treatment completion, help in assessment of the control examinations.
- Booking hotels and plane tickets, transfer organization, services of interpreter.
To start planning treatment you should leave the request on the official website of Booking Health. The same day, patient case manager or medical advisor will contact you to discuss all the details.