Treatment of advanced prostate cancer is a more challenging task when compared to the therapy of early-stage oncological pathologies. Elaboration of the therapeutic scheme for patients with advanced prostatic malignancies requires the collaboration of urologists, oncologists, surgeons, radiologists, general practitioners, etc. Prostate cancer treatment in Germany combines conventional techniques with innovative medicines (e.g. antiandrogen drug Xtandi) and PSMA therapy with Lutetium-177 and Actinium-225.
Diagnostics – instrumental and lab tests
Comprehensive diagnostics is the basis of treatment scheme elaboration. When a doctor suspects cancer progression, he does not limit the diagnostic plan to the examination of the urinary system, as the disease may affect distant organs, as well. List of the required procedures includes the following:
- The digital rectal examination that is palpation of the prostate through the rectum. DRE can reveal large volumetric formations, but cannot provide information about their composition or degree of malignancy.
- PSA blood test is a laboratory examination that assesses the amount of PSA, the specific protein synthesized by the prostatic tissues. Revealing the PSA level of 4 ng/mL or more, a doctor should suspect prostate cancer.
- Transrectal ultrasound scan, or TRUS, is examining the prostate with the help of ultrasound waves. During the procedure, the specialist assesses the volume of the gland and the presence of additional formations inside it.
- A biopsy is harvesting the tissue sample with the subsequent histological and immunohistochemical examination. Biopsy gives reliable information about tumor type and its sensitivity to different medications. To be more informative, tissue samples are harvested from up to 12 different prostate loci.
- MRI, CT scan, PSMA-PET CT give the doctor information about the state of other organs and allow excluding or confirming metastases presence. A biopsy can be also guided by MRI.
Choosing a suitable treatment option
A number of factors influence the final therapeutic scheme:
- The disease stage and aggressiveness.
- Patient’s age and general state of health.
- Patient’s preferences regarding the treatment technique.
In German hospitals, healthcare professionals apply the whole spectrum of treatments for achieving the most beneficial result:
- Surgery. In patients with advanced cancer, prostatectomy is not a curative option anymore. Nevertheless, prostate removing or resecting can be helpful for restoring urination in urethra compression by the neoplasm.
- Radiation therapy is performed in a number of modes, including the interstitial brachytherapy with radioactive golden seeds, PSMA therapy with Actinium-225 or Lutetium-177. The application of therapeutic radionuclides has also demonstrated effectiveness in metastases fighting.
- Chemotherapy with the administration of prednisone in combination with cabazitaxel (Jevtana) or docetaxel (Taxotere). This scheme is also applied in men with resistance to hormone therapy.
- Androgen deprivation therapy is a kind of hormone therapy. Antiandrogen medications block prostate stimulation by the male hormones and stop the growth of the neoplasm. In Germany, Enzalutamide (Xtandi) is used for this purpose.
- Immunotherapy involves stimulation or reactivation of the patient’s immune system. Currently, Sipuleucel-T (Provenge) is the only vaccine approved for patients with advanced prostate cancer.
- Bone-modifying drugs are administered in bone metastases revealing.
- Symptomatic treatment for pain-alleviation, anemia correction, etc.
Prostate cancer treatment abroad with Booking Health
Looking for treatment of the advanced prostate cancer, one should consider the availability of the medical equipment (e.g. da Vinci robotic system or proton therapy system) in the hospital, skills of the surgeons and oncologists, availability of innovative medications (novel drugs may not be approved for the practical use in your country yet). Treatment of prostate cancer in Germany offers methods and medications that will give the best possible result in each individual clinical case.
International patients can receive medical services in German clinics with the assistance of Booking Health. As the certified international medical tourism provider, Booking Health offers:
- Help in choosing the best medical center and oncologist.
- Booking an appointment without long waiting.
- Help in receiving an invitation for treatment and visa issuing.
- Professional medical reports translation which allows avoiding repeated examination.
- Monitoring of the medical program by independent experts.
- Communication with the clinic after the treatment course completion.
- Control of prices and final calculation, avoiding additional fees (saving up to 50{b3b47b4ce3613a8ae866741a21452b80454d4cde38f39b62399bbbfc1a1a9f3e}).
- Booking tickets, accommodation, transfer.
- Services of the interpreter and personal coordinator.
Please, leave the treatment request on the Booking Health website and be ready to discuss your health problem with the patient case manager the same day.