Prostate Cancer Treatment in Advanced Stages

Although we strive to detect prostate cancer early, we do not always succeed. Thus, in up to 20% of cases, the diagnosis is made with prostate cancer in advanced stages. In addition, we would like to list some more data:

• When symptoms of the disease appear, it is likely that cancer is no longer an initial disease – 95% of the time
• Provided the diagnosis is made in the early stages, the chance of a cure for prostate cancer is about 90%.

However, what do we consider to be advanced stages?

• Tumors that have already spread, that is, are no longer just in the prostate.
• Cases of early diagnosis, submitted to curative treatments, but later returned.

Does advanced stage prostate cancer have treatment?

Once prostate cancer is diagnosed in advanced stages, we must treat it according to your condition. For this, we also have an arsenal to keep the problem under control.

What are the treatment options for Prostate Cancer in advanced stages?

First, urologist in Rohini points out that prostate cancer has the male hormone testosterone as its main “food”. In this sense, the central androgenic block for testosterone reduction, with subcutaneous / intramuscular injections or surgery, is the initial treatment of choice for advanced or metastatic prostate cancer. It is effective in 90% of cases.

However, there are situations in which the tumor cells become resistant to androgenic blockage. Then we can indicate a new line of hormonal treatment orally: drugs like Abiraterone and Enzalutamide. Chemotherapy is also a prostate treatment in Rohini in this situation. Certainly, Docetaxel is the most used chemotherapy in the first line.

In addition, for patients with bone metastases, there are specific medications that help prevent bone fractures and nerve compression. To this end, zoledronic acid is the most widely used.

When do I consider that the Tumor returned, after treatment with a curative intention?

Second, best urologist in Rohini explains what a recurrence of Prostatic Cancer is: “We consider a recurrence or biochemical relapse of prostate cancer when the PSA starts to rise after initial treatment: radical prostatectomy or radiotherapy”.

In order to be more specific, urologist in Pitampura comments that the biochemical recurrence, after a radical prostatectomy, occurs when the PSA is greater than or equal to 0.2ng / ml, confirmed after two collections. Similarly, after radiotherapy, it is defined as an increase in PSA greater than or equal to 2ng / ml after reaching its nadir (lowest PSA value after treatment). Another criterion, used by ASTRO (American Society of Radiology Oncology), is defined as three consecutive increases in PSA, after it reaches its lowest point.

The staging for these cases, however, has no defined pattern, according to urologist in Delhi. So, it can be done with digital rectal examination, transrectal ultrasound and / or prostate magnetic resonance. Bone scintigraphy is indicated in a patient with PSA greater than or equal to 10 ng / ml or when there is bone pain regardless of the PSA level. A new exam has emerged in recent years and can also be used in this situation is PET / CT with PSMA

How is the treatment when Prostate Cancer returns?

Biochemical recurrence is usually treated with hormonal therapy, under the same point of view mentioned by urologist in Pitampura: testosterone as a “food” for the tumor.

In short, prostate cancer treatment in Delhi for the patients with biochemical recurrence after prostatectomy, we usually use radiotherapy with or without associated hormonal therapy. For patients treated primarily with external radiation therapy, we normally use hormonal therapy. However, best urologist in Delhi highlights, the choice of the most appropriate treatment must be individualized.