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Prostate Cancer
Specialist treatments < Cancer < Prostate cancer
MHL is always seeking the best new treatments for prostate cancer as well as outstanding treatment centres to which international patients can apply. Some of the treatments and technologies may not already be well known in some countries so we are pleased to provide an introduction here.
The following list of treatment alternatives is not exhaustive, but includes most of the main methodologies in use today.
Radiotherapy
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 localized advanced tumor 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. We list here a few of these that are in use at the advanced treatment centres today.
Trilogy® radiotherapy
Trilogy stereotactic radiotherapy
With the Trilogy® radiotherapy system, the width of the radiation beam can be adapted to the volume of the tumour and it also has stereotactic abilities in some body areas. This enables it to fix the location of the tumour before and during each treatment session.
The tumour can therefore be targeted more accurately than with conventional radiotherapy. Not only does this reduce damage to surrounding healthy tissue, but it enables greater power to be used, which shortens each treatment session.
TomoTherapy® Hi-Art® system
The ring gantry-based TomoTherapy® platform combines integrated CT imaging with conformal radiation therapy to deliver sophisticated radiation treatments with speed and precision while reducing radiation exposure to surrounding healthy tissue.
The Hi·Art® treatment system delivers helical (continuous 360º) IMRT (image guided radiotherapy that uses tens of thousands of narrow beamlets, all targeting the tumour and individually optimised to contribute to the total required dose.
TomoTherapy HiArt system
CyberKnife can reproduce the conformality for organ coverage achievable with brachytherapy and local control and complication rates are expected to be similar to HDR (high dose rate) brachytherapy. CyberKnife centres may vary in their approach but as a general guideline up to stage 2a tumours, PSA under 10 ng/dl and a negative Cholin PET CT for body metastases.
Brachytherapy
In brachytherapy, the radiation source is placed in direct contact with the tumour. The advantage is that the radiation takes effect directly in the malignant tissue. This means that the fall-off of in the radiation dose in the surrounding tissue is much higher than with external radiotherapy.
Brachytherapy therefore allows a higher radiation dose to be administered in the shortest possible time. The total duration of treatment is, in general, reduced from six weeks to one week. A further advantage is the significantly lower radiation exposure of patients 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.
High Intensity Focussed Ultrasound (HIFU)
HIFU is an option for early stage prostate cancer and may be used to treat part of the gland only, where the tumour or tumours are all on the same side, or to treat the whole organ.
Rather than using radio waves, HIFU uses precision focussed ultrasound waves to locally heat the target area and destroy the tumour.
Medical Oncology
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 my 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.
Treatment Centres
Visit the Prostate Cancer Centres page for details of centres offering all or many of these treatments.
Proton therapy for prostate cancer
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.
Prostate cancer is one of the most common applications of proton therapy, reducing the risk of incontinence and loss of virility sometimes associated with radiotherapy.
MHL currently features the following centres providing proton therapy for prostate cancer
Munich, Germany
Chicago, New Jersey and Oklahoma, USA
To make a treatment enquiry to any of these centres, complete our Proton Therapy Enquiry Form
CyberKnife® radiosurgery for prostate cancer
A1Med currently features the following CyberKnife centres for prostate cancer
Güstrow, Germany
Zurich, Switzerland
Bangalore, India
Lyon, France
Munich, Germany
London, United Kingdom
Radiosurgery uses radiation beams of much higher power and greater precision than radiotherapy, and treatments can be reduced to as little as a single session of 45-90 minutes for some conditions. Others may need to spread over a few days but rarely more than 3-5 days.
The leading system of radiosurgery is CyberKnife. CyberKnife is not suitable for all tumours but it can be the only form of treatment available for complex tumours in sensitive locations and it may offer an alternative to conventional radiotherapy or to open surgery.
The skill of the individual surgeon is still paramount therefore and he controls the movements via a three-dimensional view with a one to ten times magnification.
'Telemanipulation' would be a more accurate term, as this system transfers the hand movements of the surgeon to the instruments that have been inserted through small incisions in the abdomen.
A number of hospitals around the world now use the da Vinci® 'robotic' surgery system to assist surgeons in conducting precisely controlled, minimally invasive surgery for a range of conditions, including prostate cancer.
Surgical removal of the prostate, known as radical retropubic prostatectomy, can be performed manually in the conventional way or as minimally invasive surgery with the da Vinci® 'robotic' surgical system.
'Robotic' Surgery
A1Med currently features the following robotic surgery centres for prostate cancer
Hamburg, Germany
Zurich, Switzerland
To make a treatment enquiry to either of these centres, complete our Specialist Centres Enquiry Form
A1Med currently features the following centre for HIFU prostate cancer treatments
Munich, Germany
Harlaching Hospital, part of Munich Municipal Hospitals Group
To make a treatment enquiry to this centre, complete our Specialist Centres Enquiry Form
For information on CyberKnife radiosurgery generally visit the CyberKnife page. For information on CyberKnife treatments for prostate cancer visit the prostate cancer page of our dedicated web site www.cyberknifeservice.com.
To make a treatment enquiry to any of these centres, complete our CyberKnife Enquiry Form.
It can also reduce distressing side effects which are often associated with radiotherapy for certain types of cancer.
Picture above: Rinecker Proton Therapy Centre, Munich. Video: ProCure, Oklahoma, USA
MHL (Medilux Healthcare Ltd.) promotes individual hospitals or hospital groups which we believe offer high standards of care. We provide you with general information and details of how to make contact with the centre, but we shall not be responsible for the quality of any diagnosis or treatment given or for the failure to diagnose or treat any condition. We cannot advise or enter into correspondence about individual cases and we do not arrange or facilitate treatments.
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