Modern Trends in the Treatment of Prostate Cancer

Greater awareness among people and better access to diagnostic screenings have contributed to increased detection of prostate cancer,” says Dr. Sandeep Bafna, Consultant Urologist & Genito Urinary Reconstructive Surgeon, Apollo Hospitals, Greams Road, Chennai. He says increased incidence of prostate cancer is due to lifestyle changes such as unhealthy diet, lack of physical activity, obesity, smoking , family history and genetic mutations.

Time for a Doctor Visit

• A visit to a urologist is warranted if the following symptoms are observed:
• Frequent or urgent need to urinate, especially at night
• Difficulty in passing urine
• Pain or blood in the urine or semen
• Unexplained weight loss
• Unexplained pain in the lower back, hips or thighs

Diagnosis

After a physical examination, a prostatespecific antigen (PSA) test is the common initial screening tool. In case of elevated PSA, digital rectal exam (DRE) is done to feel the prostate for abnormalities. The next step is Multiparametric MRI of the prostate that creates detailed images of the prostate and helps doctors in detection, localization and staging of prostate cancer or other conditions such as infection or enlargement. Detection of abnormalities in MRI warrants PSMA-PET-CT scan, a more effective imaging technique to detect the spread of cancer to other parts of the body. Further confirmation is done through a biopsy. Transperineal prostate biopsy, which involves taking tissue samples through the skin of the perineum is an advanced technique where infections are grossly reduced in comparison to the conventional transrectal approach, which uses a probe into the rectum to create an image of the prostate.

“Prostate cancer is curable and early detection through regular check-up is the key. If identified early, modern treatment approaches offer fantastic curative results, greater life expectancy and a good quality of life.”

Dr. Sandeep Bafna, Consultant Urologist & Genito Urinary Reconstructive Surgeon, Apollo Hospitals, Greams Road, Chennai

AI in the Diagnosis and Treatment

AI plays a significant role in the diagnosis and treatment of prostate cancer. Through precise analysis of images and data from various diagnostic tests, AI improves detection and grading accuracy. Also, by predicting outcomes, it helps doctors categorize patients as early, intermediate or high-risk and guides in developing personalized treatment plans based on patient’s specific data.

Conventional surgery for advanced prostate cancer has been bilateral orchiectomy, to remove both testicles. Open prostate surgery or open prostatectomy for advanced prostate cancer removes the prostate gland through a single, large incision i the lower abdomen or perineum. Risks in this surgery such as extensive bleeding, infection and damage to the surrounding organs and longer recovery time have shifted focus to newer techniques such as robotic prostatectomy. This is a minimally invasive surgical procedure that removes the prostate gland using a robotic system controlled by the surgeon. It leads to faster recovery, lesser blood loss, shorter hospital stay and better outcomes.

AI has enhanced patient outcomes in robotic prostatectomy, improving surgical precision. AI analyses real-time data and helps surgeons navigate complex anatomy accurately, enabling a nerve-sparing approach and leads to negative surgical margins. Immunotherapy stops the spread of cancer and has shown better results than chemotherapy. PSMA is a targeted treatment for prostatecancer ( Lutetium-177 PSMA therapy) that uses a radioactive substance to destroy cancer cells through radiation. It improves survival rates and quality of life for patients with advanced, metastatic prostate cancer. 

Focal therapy or high-intensity focused ultrasound (HIFU) uses high-frequency ultrasound waves to heat and destroy cancer cells with minimal damage to the surrounding healthy tissue, preserving urinary and sexual function. Proton beam therapy uses a precise, high-energy beam of protons to destroy cancer cells , sparing the healthy tissue. Doctors offer various options and guide the patient to select a treatment of choice.

Featuring insights from Dr. Sandeep Bafna, Consultant Urologist & Genito Urinary Reconstructive Surgeon, Apollo Hospitals, Greams Road, Chennai

📞 For appointments, call Apollo Hospitals Chennai at 044 4040 1066