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Prostate cancer treatment is always designed individually according to the characteristics of the disease. The choice of treatment is influenced by other possible diseases, possible references to so-called high-risk prostate cancer, the results of prevalence studies and, of course, the patient's own wishes.
After developing prostate cancer, many patients face a challenging situation with different treatment options. When weighing different treatments, it is important that diagnostic tests and treatment recommendations are based on the latest medical research evidence and perceived data. At Docrates Cancer Center, the patient and relatives are always given special consideration when discussing different treatment options, their advantages and disadvantages.
Local or locally advanced prostate cancer can be increasingly cured with radiation therapy. Radiation therapy has established itself as an effective treatment for prostate cancer in the 21st century. Surgery can also be curative if the cancer is completely localized.
Leaving prostate cancer to active monitoring is controversial in local low-risk prostate cancer in light of current knowledge.
Indeed, individual studies, such as cancer gene profiling, may provide indications of new cancer therapies worth experimenting with. At Docrates Cancer Center knowledge on cancer gene profiling has been utilized already for a long time.
Depending on the characteristics of prostate cancer, radiation therapy can be tailored in many different ways. There are several different techniques to choose from in external radiotherapy, and radiotherapy can also be given as intracorporeal HDR brachytherapy. In aggressive cancers, the best treatment outcome is most likely to be obtained by combining external beam radiotherapy with intravenous high-dose HDR therapy. Based on risk factors, radiotherapy can also be combined with cancer drugs.
To minimize the side effects of radiotherapy for prostate cancer, we at Docrates are utilizing a new product called SpaceOAR Hydrogel as part of the standard care for every prostate cancer patient receiving radiotherapy. SpaceOar of the prostate and the rectum injectable gel that moves the rectum off the prostate immediate vicinity. During radiotherapy, the radiation dose to the rectum is significantly reduced, which means that men, for example, do not develop long-term diarrhea, which is quite common in the past.
Depending on the individual’s needs, the patient may also be advised to visit a urotherapist, physiotherapist or, for example, a specialist in nutrition or sexual therapy. They can provide home care instructions, for example, for recovery exercises and general well-being.
Most commonly, drug treatment is given in advanced prostate cancer, but also in high-risk local cancers as adjunctive therapy.
New drugs are often also suitable for elderly patients, with other diseases, and for use as part of combination therapies. These new prostate cancer drugs are often both more effective and better tolerated than previous drugs, and can also be effective when previous drugs have already lost their effectiveness. New drugs can relieve symptoms, slow the progression of the disease, especially in the bones, and prolong life.
Advanced prostate cancer can be treated effectively, and treatment should always be individually planned. First-line treatment always includes drug therapy, most commonly hormonal therapy and chemotherapy, or a combination, and often a bone-strengthening drug if the cancer has spread widely to the bone.
In addition to traditional prostate cancer therapies, we use isotope therapies such as radium-223 and samarium therapy. As the newest entrant, we started lutetium PSMA treatments in early 2017. Lutetium-PSMA treatment also allows for the effective destruction of extra-skeletal metastases without serious side effects, whereas isotope treatment with a radiopharmaceutical applied to the skeleton (radium or samarium) has been shown to be effective and safe when the metastases are only in the skeleton.
Lutetium PSMA is still an experimental, Fimea-licensed drug treatment. International randomized comparative studies of lutetium-PSMA therapies are already underway in their third phase, after which more specific formal routine treatment recommendations are likely to be issued for cancer cases selected for treatment. However, results were already presented at the ESMO2018 meeting in October, which showed that in a dose escalation study, up to three times the dose of Docrates that was shown to be effective proved to be safe and well tolerated without the occurrence of dose-limiting toxicity.
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