One in ten prostate cancer is particularly aggressive. For this Form, but also for the less risky, there are now suitable treatments – without the dreaded side effects of impotence and incontinence. FOCUS Online spoke with an expert about the current state of research.
With approximately 64,000 new cases per year, prostate cancer is the most common cancer among men. The cases to take, what is, however, also to the improved and constant checkups. Prostate cancer is discovered earlier.
The good news: “half of the diagnosed tumors are growing so-called low-risk cancers, only very slowly and are not life-threatening,” says Peter Albers, Director of the clinic for urology, University hospital Düsseldorf, Germany.
This means that, even ten years after diagnosis, patients live in a good treatment yet, there are no restrictions, the Tumor must not be treated mandatory, but can be monitored in many cases, also active for some time. “As in the case of breast cancer it is also prostate cancer harmless course,” says the cancer specialist.
Active Surveillance or therapy
In case of non-aggressive prostate cancer, the so-called active Surveillance is, therefore, possible. This means: regular monitoring of the tumor after biopsy, with determination of the PSA value in the blood (prostate specific Antigen), as well as MRIs and repeat biopsies. With the biopsy, the Gleason-Score to determine the ranges from two to ten. Up to six of the Tumor is classified as low-risk cancer, then it can be seen with the therapy under control. Alternatively, in addition to active Monitoring in this group as a new treatment option for focal therapy.
Focal therapy in four variations – suitable for small, limited tumors
Until Recently, requiring special prostate cancer were considered for treatment, the radical prostatectomy (complete removal of the prostate) or radiation therapy as the treatment of choice. Now, there are little aggressive, localized prostate cancer, more sophisticated treatment options, such as Focal therapy. The designation means that only a part of the prostate is treated. For patients, this has the advantage, in comparison to radical SURGERY and radiation, to less frequently with the side effects of incontinence and impotence, are fighting.
Depending on the location of the tumor, different focal therapies are, for example
Focal therapy or wait and see – the advantages and disadvantages of
Since April of 2018, Tookad is approved in Germany and is used in some cancer centers, however, still subject to. The treatment must be in the health insurance applied for. How does cancer expert Albers this new treatment option? “We are still not sure whether this is the optimal therapy,” he says. Because in the end, the focal therapies, is one of the Tookad also are only for Low-risk prostate cancer suitable. And in these cases, the active Surveillance has proven to be very good as the cancer-specific 10-year survival rate. “Only one percent within ten years, the cancer death,” says the expert.
The goal is to keep the Tumor under control, which is achieved with the Monitoring already optimally – without the risks inherent in the principle of any treatment. Because even the so-called can trigger therapies, such as ultrasound, electricity, and Padeliporfin side effects such as impairment of the nervous functions, that is to say problems with potency.
Why will be applied to focal therapy in the first place? “Many patients want to be treated, you will feel uncomfortable, if you know, to have prostate cancer and nothing immediately active, however, will be made”, the expert explains the psychological Background. Every man should decide for himself whether he wants a low-risk prostate cancer therapy, or active Surveillance, is leaving. “According to the current data situation in the long-term effect of focal therapy is not proven,” Peter Albers clearly.
Combination therapy doubled life expectancy in advanced prostate cancer
The situation is different in the case of prostate cancer with metastases in the bone. The hormone therapy was the standard treatment, because testosterone is prostate stimulate cancer. In addition, prostate cancer can form these sex hormones in a more advanced stage, so to speak. It is, therefore, a vicious circle of more Androgens and cancer growth. The hormone therapy can counteract the effects of this history a long time effectively.
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However, studies showed that a combination of hormone therapy plus Antiandrogen therapy plus chemotherapy is more effective. The combination therapy directed against the growth of cancer cells in more advanced stages.
However, many Doctors still are not aware of and would of cancer of your prostate patients rates solely on hormone therapy. “The immediate combination therapy would prolong the life expectancy of these patients significantly, according to data of almost 2 years, the median Survival of patients with bone metastases was only 1.5 years,” says Peter Albers.
Conclusion: The treatment options have improved – both in the case of low-risk carcinomas as well as metastatic prostate cancer. All, which is a little more aggressive prostate cancer was discovered, can now choose, whether you choose a gentle method of treatment within a clinical trial or active wait. And a combination therapy may increase in men who have metastatic prostate cancer, the life expectancy considerably.