Prostate cancer treatment in India with cutting-edge technologies with highest success rates.
Prostate cancer is the 4th most prevalent cancer in the world with 1.41 million cases according to WHO. Typically prostate cancer occurs in old age and may not show any signs or symptoms in its early stages.
Detection of cancer itself is a matter of grave concern. However, with the advancement of technologies both in detection and treatment, the survival rates are also increasing.
Let me introduce you, one of our patients Daniel Banda from Ibadan, Nigeria. Daniel is benefitted from prostate cancer treatment in India.
Prostate cancer is the type of cancer that affects the prostate.
The prostate is a small nut-shaped gland in males that produces the seminal fluid that feeds and carries the semen.
Prostate cancer is one of the more prevalent types of cancer. Many prostate cancers develop slowly and limit themselves to the prostate gland, where they may not cause severe damage. However, in some cases, prostate cancer becomes aggressive and spreads quickly to other neighboring body parts.
Prostate cancer in its initial stages, confined to the prostate gland, and the patient has the best chance of success with minimal treatment and complications.
Types of prostate cancer
Types of cancer that may occur in the prostate are
- Adenocarcinoma: Most prostate cancers are adenocarcinoma. These cancers develop from the cells of the gland (the cells that form the liquid in the prostate that is added to the sperm).
- Sarcomas: Soft tissue sarcomas are cancers that develop in the connective and supporting tissues of the body. Muscle, nerves, fat, fibrous tissue, and blood vessels are among these tissues.
- Neuroendocrine tumors (except small cell carcinomas): Neuroendocrine tumors (NETs) are rare tumors that begin in the cells of the nervous system. NETs come in a variety of shapes and sizes. The type you have is determined by the type of cell in which cancer began.
- Small cell carcinoma: Small round cells are responsible for small cell prostate cancer. It’s a type of cancer that affects the neuroendocrine system.
- Transition cell carcinoma: Prostate transitional cell cancer begins in the cells that line the tube that transports urine to the outside of the body (the urethra). This cancer typically begins in the bladder and progresses to the prostate. It can, however, start in the prostate and spread to the bladder entrance and nearby tissues in rare cases.
- There are a few other types of prostate cancer. If you are told that you have prostate cancer, it is quite certain that it is adenocarcinoma.
In some cases, prostate cancers develop and spread rapidly, but in most cases, it develops slowly.
If you experience any of the following symptoms, Please does consult your urologist immediately.
If you are having one or more of these symptoms, don’t conclude on your own that you have cancer. However, don’t take these symptoms lightly as well. Meet the urologist and follow his advice with respect to further investigations.
After the diagnosis of prostate cancer, the doctor will try to figure out the spread of cancer which is known as staging. The stage of prostate cancer refers to the spread of cancer in the body. Your treatment plan also depends upon the stage of prostate cancer.
Before we begin with the staging let’s understand a few terminologies
The most widely used staging system for prostate cancer is the AJCC (American Joint Committee on Cancer) TNM (tumor (T), nodes (N), and metastases (M)) system.
The Grade Group (based on the Gleason score), which indicates how quickly the cancer is likely to grow and spread. The results of the prostate biopsy determine this (or surgery).
Prostate cancer is classified into four stages: I, II, III, and IV. Some stages are further divided (A, B, etc). The lower the number, the less cancer has spread in general. A higher number, such as stage IV, indicates that cancer has progressed further.
Prostate cancer is growing, but it hasn’t spread beyond it.
In most cases, the doctor won’t be able to feel or see the tumor during a DRE or imaging tests.
The tumor covers half of one side of the prostate or less.
- The PSA level is less than 10
- The Gleason score is 6 or less
The prostate cancer is growing, but it hasn’t spread beyond it.
During a DRE, the doctor might or might not be able to feel the tumor or see it on an imaging test. The tumor can affect more than half of one of the prostate’s lobes but not both.
- The PSA level is less than 20
- The Gleason score is 7 or less
The prostate cancer is growing, but it hasn’t spread beyond it.
During a DRE, the doctor might or might not be able to feel the tumor or see it on an imaging test. The tumor can be found in one or both of the prostate’s lobes.
- The PSA level is less than 20
- The Gleason score is 7
The cancer hasn’t spread beyond the prostate. During a DRE, the doctor might or might not be able to feel the tumour or see it on an imaging test. The tumor can be found in one or both of the prostate’s lobes.
- The PSA level is less than 20
- The Gleason score is 7 or 8
In comparison to stage IIB, the cancer cells appear to be more abnormal.
The cancer hasn’t spread outside the prostate. During a DRE, the doctor might or might not be able to feel the tumor or see it on an imaging test. No lymph nodes have been affected by the cancer.
- The PSA level is at least 20
- The Gleason score is 8 or less
The cancer has spread outside the prostate, but it hasn’t reached the lymph nodes or other distant parts of the body.
- The PSA is any level
- The Gleason score is 8, or less
The cancer may or may not have spread outside the prostate. No lymph nodes have been affected by the cancer.
- The PSA is any level
- The Gleason score is 9 or 10
The cancer may or may not have spread to tissues near the prostate. Although the cancer has spread to nearby lymph nodes, it has not spread to other parts of the body.
- The PSA is any value
- The Gleason score is any value
The cancer may or may not have spread to nearby tissues or lymph nodes. The cancer has spread to other parts of the body, including lymph nodes, bones, and organs.
- The PSA is any value
- The Gleason score is any value
Prostate cancer staging is a bit complex. Your oncologist is the best person to conclude what is the stage of your cancer.
The exact cause of prostate cancer is unknown.
According to doctors, Prostate cancer develops when cells in the prostate develop changes in their DNA. The DNA of a cell contains the instructions that tell it what to do. The changes cause the cells to divide and grow at a faster rate than normal cells. When other cells die, abnormal cells continue to live.
The abnormal cells come together and form a tumor, which can spread and invade nearby tissue. Some abnormal cells can break away and spread(metastasize) to other parts of the body over time.
- Old Age: As you get older, your chances of developing prostate cancer increase. After the age of 50, it becomes more common.
- Race: Black people have a higher risk of prostate cancer than people of other races for unknown reasons. Prostate cancer is also more likely to be aggressive or advanced in Black men.
- Family history: If a blood relative has been diagnosed with prostate cancer, such as a parent, sibling, or child, your risk may be increased. Additionally, if you have a strong family history of breast cancer or a gene that increases the risk of breast cancer (BRCA1 or BRCA2), your risk of prostate cancer may be higher.
- Obesity: Obese people may have a higher risk of prostate cancer than people who are considered to be of normal weight, though studies have yielded mixed results. Obese people are more likely to have cancer that is more aggressive and that returns after treatment.
During a DRE, your physician inserts a gloved and lubricated finger into your rectum to examine your prostate, which is next to the rectum. If your doctor becomes aware of any abnormalities, you may need more tests.
A blood sample is taken from a vein in your arm and analyzed for PSA, a substance that is naturally generated by your prostate gland. It’s okay to have a small amount of PSA in your blood. However, if a higher than normal level is found, it can indicate prostate infection or cancer.
If this screening detects an abnormal condition, your doctor may recommend other tests to determine if you have prostate cancer, such as:
In a transrectal ultrasound, a small tube of this size is inserted into the rectum. The catheter uses sound waves to create an image of your prostate gland.
Magnetic Resonance Imaging (MRI)
In certain situations, your doctor may recommend an MRI of the prostate for a more detailed image. MRI images can help your doctor plan a procedure to collect tissue from the prostate.
Collection of a specimen of prostate tissue
To determine if cancer cells are present in the prostate, your doctor may recommend a procedure to collect a sample of prostate cells (prostate biopsy). Prostate biopsies are often done using a fine needle inserted into the prostate to collect tissue. The tissue specimen is analyzed in the laboratory to determine the presence of cancer cells.
Your options for treating prostate cancer depend on multiple factors, like the rate at which your cancer is growing,
if it has spread and your general health, along with the potential benefits or side effects of prostate cancer treatment.
Traditional prostate surgery
Radical Prostatectomy Surgery: The surgical method to remove the prostate gland along with the nearby tissues is called radical prostatectomy surgery.
Surgery is an option to treat cancer that is contained in the prostate. It is occasionally used to treat advanced prostate cancer in conjunction with other prostate cancer treatments.
Advanced prostate surgery
- Robot-Assisted Prostatectomy Surgery: The surgical intervention of the removal of the prostate gland and the adjoining tissues by employing the use of highly advanced – robotic surgical technology is known as Robot-assisted prostatectomy surgery.
- Laser Surgery: An enlarged prostate, also known as benign prostatic hyperplasia, causes moderate to severe urinary symptoms, which can be relieved with prostate laser surgery (BPH). During prostate laser surgery, your doctor inserts a scope into the tube that transports urine from your bladder through the tip of your penis (urethra). Because the prostate surrounds the urethra, it restricts urine flow from the bladder if it is enlarged. A laser passed through the scope delivers energy to the prostate, shrinking or removing excess tissue that is obstructing urine flow.
- Photoselective vaporization of the prostate (PVP): To enlarge the urinary channel, a laser is used to melt away (vaporize) excess prostate tissue: This is a similar procedure to PVP, except that a different type of laser is used to melt away (vaporize) the excess prostate tissue.
- Holmium laser ablation of the prostate (HoLAP): This procedure is similar to PVP, except that the excess prostate tissue is melted away (vaporized) using a different type of laser.
- Holmium laser enucleation of the prostate (HoLEP): The excess tissue that is blocking the urethra is cut and removed with the laser. After that, a morcellator is used to chop the prostate tissue into small pieces that can be removed easily.
External beam radiation for prostate cancer
External radiation is an option for treating prostate-related cancer. It can also be used after surgery to kill cancer cells that may remain if the cancer is at risk of spreading or returning.
Radiation positioned inside your body (brachytherapy).
Brachytherapy refers to placing radioactive sources in your prostate tissues. Most commonly, radiation is contained in radioactive seeds the size of rice that is inserted into the tissues of the prostate. The seeds produce a low radiation dose over a prolonged period. Brachytherapy is an option to treat cancer that did not extend past the prostate.
For more information please visit the brachytherapy for cancer treatment page.
Ablative therapies kill prostatic tissue through cold or heat. Options can include:
Freezing prostate tissue
Cryoablation or cryotherapy of prostate cancer involves using very cold gas to freeze prostatic tissue. Freezing and defrosting cycles kill cancer cells and certain healthy tissues that surround them.
Heating prostate tissue
High-Intensity Focused Ultrasound (HIFU) uses concentrated ultrasound energy to heat the prostate tissue and cause its death.
Hormonal therapy is a treatment to prevent your body from producing male testosterone hormone. Prostate cancer cells are dependent upon testosterone for growth. Cutting down on testosterone supply can cause cancer cells to die or grow more slowly.
Chemotherapy uses medications to kill cells that develop quickly, including cancer cells. Chemotherapy can be given via a vein in your arm in the form of a pill or both.
Immunotherapy uses your immune system in the fight against cancer. The immune system of your body may not attack your cancer, as cancer cells produce proteins that help them hide from the cells of the immune system. Immuno-therapy acts by interfering with this process.
If you want to read more please visit the immunotherapy for cancer treatment page
Targeted drug therapies focus on specific abnormalities in cancerous cells. By blocking these abnormalities, targeted medication treatments can cause the death of cancer cells.
If hormone therapy is not effective, targeted therapeutic medications may be recommended for advanced or recurrent prostate cancer treatment.
If you want to read more please visit the targeted therapy for cancer treatment page
A cancer treatment that uses a drug and a certain type of laser light to kill cancer cells. A drug that is not active until it is exposed to light is injected into a vein. The drug collects more in cancer cells than in normal cells.
Fiberoptic tubes are then used to carry the laser light to the cancer cells, where the drug becomes active and kills the cells. Photodynamic therapy causes little damage to healthy tissue. It is used mainly to treat tumors on or just under the skin or in the lining of internal organs.
Radiofrequency ablation is an innovative treatment used to kill cancerous tissues using high-frequency radio waves and heat.
Prostate cancer is classified into 4 stages and your doctor chooses the treatment protocol according to the cancer progression and patient’s condition. The typical approach of doctors based on the different stages is as follows.
Treatment options for stage I prostate cancer may include:
Active surveillance: Your PSA levels are monitored by your doctor. If those numbers rise, it could indicate that your cancer is progressing or spreading. Your doctor will then be able to alter your treatment.
Radiation therapy: This either kills or prevents prostate cancer cells from growing and dividing.
This condition can be treated in two ways.
- A machine is used to aim a beam of radiation at your tumor in the “external” type.
- A doctor uses “internal radiation” to treat a tumor by inserting radioactive pellets or seeds into or near it (this procedure is also known as brachytherapy).
Radical prostatectomy: This procedure involves removing your prostate as well as some of the surrounding tissue.
Ablation therapy: To kill cancer cells, this treatment uses freezing or high-intensity ultrasound.
Treatment options for stage II prostate cancer may include:
Active surveillance: It’s usually used at this stage if you’re a much older man or have other serious health issues.
Radiation therapy: Your doctor may give you a combination of radiation therapy with hormone therapy. These are drugs that prevent testosterone from promoting the growth of cancer cells in your body. For some patients, radiation therapy in the form of external beam and/or brachytherapy is used.
Radical prostatectomy: Surgically removing your prostate and possibly some lymph nodes around it.
Treatment options for stage III prostate cancer may include:
- External radiation plus hormone therapy
- External radiation plus brachytherapy and possible hormone therapy
- Radical prostatectomy: Radiation therapy and/or hormone therapy may be used after a radical prostatectomy, which usually includes the removal of the pelvic lymph nodes.
Because of the risk of disease progression without treatment, active surveillance is usually not an option for stage 3 disease.
Treatment options for stage IV prostate cancer may include:
- Hormone therapy: Hormone therapy is frequently used in combination with surgery, radiation, or chemotherapy.
- Radical prostatectomy: Prostate removal surgery is performed to relieve symptoms such as bleeding or urinary obstruction, as well as to remove cancerous lymph nodes.
- Radiation therapy: External radiation with or without hormone therapy
- Chemotherapy: If standard treatments fail to relieve symptoms and cancer progresses, chemotherapy may be used. Cancer cells will shrink and grow more slowly as a result of the drugs.
- Palliative care: Palliative care provides relief from symptoms such as pain and difficulty peeing.
The typical approach of doctors to treat prostate cancer
The most common treatment for prostate cancer is surgery. Surgery, on the other hand, must be combined with other treatments such as radiation therapy, brachytherapy, chemotherapy, external beam therapy, and hormone therapy. The majority of the time, it’s a multi-modality approach.
Stage I: In stage I where cancer hasn’t spread. The usual sequence of treatment that doctor typically follows is surgery followed by external and internal radiation therapy.
Stage II: In stage II where cancer is growing and hasn’t spread beyond the prostate. The sequence of the treatment is your doctor may give you a combination of radiation therapy with hormone therapy after the surgery. The sequence may change as per the particular case.
Stage III: In Stage III the three possibilities are there cancer hasn’t spread outside the prostate, spread outside the prostate, and may or may not spread outside the prostate.
The sequence of treatment, Surgery (which usually includes the removal of the pelvic lymph nodes) is followed by radiation therapy and/or hormone therapy.
Stage IV: In Stage IV two possibilities are first cancer has spread to nearby lymph nodes, it has not spread to other parts of the body. Second cancer has spread to other parts of the body, including lymph nodes, bones, and organs.
The sequence of the treatment is Hormone therapy is frequently used in combination with surgery, radiation, or chemotherapy. The patient is also given palliative care.
How to choose the best oncologist for your prostate cancer treatment?
The most recent and unique approach enlists the multidisciplinary services of medical, surgical, and radiation oncologists to create a comprehensive treatment plan that ensures the best possible outcome.
A team of highly qualified cancer experts known as a ‘Tumour Board’ will present a comprehensive evaluation of your medical case and recommend the best treatment approach, which may include a combination of treatment protocols such as chemotherapy, radiation therapy, and/or surgery.
Tumour board reviews are a multidisciplinary approach to cancer treatment that enlists the help of doctors from various specialties to assess and treat patients’ medical conditions and diagnoses in order to achieve the best possible results.
MedicoExpert’s tumor board approach to zero down the right treatment plan for you in India
How to choose the best hospital and best country for prostate cancer treatment?
Look for a hospital that provides world-class healthcare services when choosing a hospital for your prostate cancer treatment.
MedicoExperts can assist you in locating hospitals that are NABH and JCI accredited and provide world-class health care.
Although the United Kingdom and the United States provide prostate cancer treatment, the costs maybe a little too high.
The cost of treatments and surgeries in India, however, is nearly half that of western and other developed countries.
The availability of world-class treatment at a reasonable cost has enticed many international citizens to seek treatment in India.
The Indian healthcare system has well-trained doctors as well as specialized and well-trained operative and post-operative care teams that can handle complex cases at a reasonable cost.
Listen to Dr. Pankaj Maheshwari speak about prostate enlargement, prostate cancer, and all you need to know is to be cautious.
He also answers all commonly asked questions regarding prostate enlargement, prostate cancer, and its treatment.
Dr. Pankaj Maheshwari is a renowned urologist and has over 23 years of expertise in handling urological cases.
He is one of the pioneers to initiate therapeutic flexible ureteroscopy in India.
The cost for prostate cancer treatment in India varies on the size of the tumor, stage of cancer, and also the treatment option is chosen according to the condition of the patient. A cancer evaluation will reveal the extent of the spread and the best-suited treatment to restrict and cure it.
The cost for cancer evaluation starts from 500 USD (38000 INR).
After the initial evaluation, the oncologist will be able to gauge if cancer can be treated by therapy alone or if surgery is recommended. The cost for prostate cancer surgery in India starts from 4200 USD (319856 INR).
Thanks to advancements in technology and innovation, newer and safer surgical options are also possible. Advanced cutting-edge surgery like Focal Laser Ablation and robot-assisted prostatectomy surgery is also available for an additional 10-20% of the standard surgery cost.
However, it is to be noted that not every patient is eligible for this treatment option. The onco-surgeon will suggest the best-suited treatment plan based on the patient’s case.
In certain cases, surgery is also to be combined with other treatments like chemotherapy and radiation therapy to ensure a complete cure. The cost of chemotherapy starts from 400 USD / cycle (30462 INR).
A study in Mumbai showed that patients who underwent surgical prostate cancer treatment had a better survival rate (91%).
These results show that although prostate cancer treatment can save a life or extend the number of years of survival, awareness, and prevention of the disease have become vital in our time.
Frequently Asked Questions and patient concerns:
1. At what age does prostate cancer occur?
Prostate cancer is rare among men under the age of 40, but the probability of having prostate cancer increases rapidly after the age of 50. About 6 in 10 men over the age of 65 have prostate cancer.
2. What is the best fruit for the prostate?
Strawberries, blueberries, raspberries and mulberries are recommended for an expanded prostate diet. The prostate is controlled with potent hormones called sex hormones, including testosterone.
3. Is a PSA of 6.5 Bad?
PSA concentrations lower than 4 ng/ml are generally considered normal, while concentrations higher than 4 ng/ml are considered abnormal.
PSA levels of 4 to 10 ng/ml indicate a higher-than-normal risk of prostate cancer. When PSA levels are more than 10 ng/ml, the risk of prostate cancer is much higher.
4. How long do you normally live with prostate cancer?
Nearly 100 percent of men with local or regional prostate cancer will survive more than five years after diagnosis. Few men (approximately 7%) have more advanced prostate cancer when diagnosed.
5. Can prostate cancer make itself go away?
Simply put, yes, prostate cancer can be cured when it is detected and treated quickly. The vast majority of prostate cancer cases (over 90%) are discovered early, making tumors more susceptible to response to prostate cancer treatment.