Overview
Prostate cancer treatment varies depending on the stage and aggressiveness of the cancer, as well as the patient’s overall health and preferences. Common treatment options include surgery, such as a prostatectomy, which involves removing the prostate gland. Radiation therapy uses high-energy rays to target and kill cancer cells. Hormone therapy aims to reduce or block the production of testosterone, which can fuel the growth of cancer cells. Chemotherapy involves using drugs to kill rapidly growing cancer cells.
About Prostate Cancer Treatment
Prostate cancer is a type of cancer that occurs in the prostate gland, which is a small, walnut-shaped gland in males responsible for producing seminal fluid that nourishes and transports sperm. It is one of the most common types of cancer among men. Untreated HPV as well as having genital whitening procedures may increase the chances of developing prostate cancer.
Signs of prostate cancer
Prostate cancer often develops slowly and may not show any signs or symptoms in its early stages. However, as the cancer progresses, several signs and symptoms may become apparent, including:
One of the most common symptoms is difficulty urinating. This can include a weak or interrupted urine flow, the need to urinate more frequently, especially at night (nocturia), or difficulty starting and stopping urination. Some men may also experience pain or burning during urination.
Another potential sign of prostate cancer is the presence of blood in the urine or semen. This can be alarming and should prompt immediate medical attention. Additionally, men with advanced prostate cancer may experience pain in the pelvic area, hips, or back. This pain can be persistent and may worsen over time.
Erectile dysfunction is another symptom that can be associated with prostate cancer. Men may find it difficult to achieve or maintain an erection. This can be due to the cancer itself or as a side effect of treatments such as surgery or radiation therapy.
In some cases, prostate cancer can cause swelling in the legs or feet. This is often due to the cancer spreading to the lymph nodes, which can block the normal flow of lymphatic fluid. Similarly, if the cancer spreads to the bones, it can cause bone pain and fractures.
It’s important to note that these symptoms can also be caused by other conditions, such as benign prostatic hyperplasia (BPH) or prostatitis. Therefore, experiencing these symptoms does not necessarily mean that a man has prostate cancer. However, it is crucial to seek medical evaluation to determine the cause of the symptoms and to receive appropriate treatment.
Stages of Prostate Cancer
Prostate cancer is typically classified into stages based on the extent of the cancer’s spread. The staging system helps determine the most appropriate treatment and predict the patient’s prognosis. Understanding the stages of prostate cancer is crucial for determining the most appropriate treatment plan.
Stage I prostate cancer: Is the earliest stage. At this stage, the cancer is confined to a small area of the prostate and is not detectable through a digital rectal exam (DRE) or imaging. It is usually found incidentally during surgery for another condition or through a prostate-specific antigen (PSA) test. The cancer cells look similar to normal cells and are considered low-grade.
Stage II prostate cancer: Is more advanced than Stage I but is still confined to the prostate. This stage is divided into two sub-stages: IIA and IIB. In Stage IIA, the cancer is detectable through a DRE or imaging but is still confined to one-half or less of one side of the prostate. In Stage IIB, the cancer may be present in more than one-half of one side of the prostate but has not spread outside the prostate. The cancer cells may be more abnormal and higher grade than in Stage I.
Stage III prostate cancer: Has spread beyond the outer layer of the prostate and may have invaded nearby tissues, such as the seminal vesicles. However, it has not spread to the lymph nodes or distant organs. This stage is also known as locally advanced prostate cancer. The cancer cells are typically more abnormal and higher grade, indicating a more aggressive form of the disease.
Stage IV prostate cancer: Is the most advanced stage. At this stage, the cancer has spread to nearby lymph nodes, distant organs, or bones. This stage is divided into two sub-stages: IVA and IVB. In Stage IVA, the cancer has spread to nearby lymph nodes but not to distant organs. In Stage IVB, the cancer has spread to distant organs, such as the bones, liver, or lungs. The cancer cells are usually very abnormal and high-grade, indicating a highly aggressive form of the disease.
Prostate Cancer Treatment Process
Diagnosing Prostate Cancer
Diagnosing prostate cancer involves a combination of screening tests, diagnostic procedures, and imaging studies to accurately identify the presence and extent of the disease.
The process often begins with a prostate-specific antigen (PSA) test, which measures the level of PSA in the blood. Elevated PSA levels can indicate prostate cancer, but they can also be caused by other conditions such as benign prostatic hyperplasia (BPH) or prostatitis. Therefore, a high PSA level alone is not definitive for prostate cancer, but it can prompt further investigation.
Another common screening method is the digital rectal exam (DRE), where a healthcare provider inserts a gloved, lubricated finger into the rectum to feel the prostate for any abnormalities, such as lumps or hard areas. While the DRE can help detect prostate abnormalities, it is not as sensitive as the PSA test and may miss early-stage cancers.
If either the PSA test or DRE suggests the possibility of prostate cancer, the next step is often a prostate biopsy. During this procedure, a urologist uses a thin needle to remove small samples of prostate tissue, usually guided by transrectal ultrasound (TRUS). The tissue samples are then examined under a microscope by a pathologist to determine if cancer cells are present and to assess the aggressiveness of the cancer using the Gleason score.
In addition to the biopsy, imaging studies may be used to further evaluate the extent of the cancer. Magnetic resonance imaging (MRI) can provide detailed images of the prostate and surrounding tissues, helping to identify the location and size of the tumor. Computed tomography (CT) scans and bone scans may be used to check for the spread of cancer to other parts of the body, such as the lymph nodes or bones.
Multiparametric MRI (mpMRI) is an advanced imaging technique that combines different MRI sequences to provide a more comprehensive assessment of the prostate. This technique can help identify areas of the prostate that are more likely to harbor significant cancer and guide targeted biopsies.
In some cases, additional tests such as genomic testing may be performed on the biopsy samples to provide more information about the genetic characteristics of the cancer. These tests can help predict the behavior of the cancer and guide treatment decisions.
Treatment Options for Prostate Cancer
Treatment options for prostate cancer vary based on the stage of the cancer, the patient’s overall health, and personal preferences. The main treatment options include active surveillance, surgery, radiation therapy, hormone therapy, chemotherapy, targeted therapy, and immunotherapy.
Active surveillance: Is often recommended for men with low-risk, slow-growing prostate cancer. This approach involves closely monitoring the cancer with regular PSA tests, digital rectal exams (DRE), and biopsies. Treatment is initiated only if the cancer shows signs of progression. This option helps avoid or delay the side effects of more aggressive treatments.
Surgery: Is a common treatment for localized prostate cancer. The most common surgical procedure is a radical prostatectomy, which involves removing the entire prostate gland and some surrounding tissue. This can be done through traditional open surgery or minimally invasive techniques such as laparoscopic or robotic-assisted surgery. Surgery aims to remove the cancer completely, but it can have side effects such as urinary incontinence and erectile dysfunction.
Radiation therapy: Uses high-energy rays to kill cancer cells. It can be delivered externally through external beam radiation therapy (EBRT) or internally through brachytherapy, where radioactive seeds are implanted directly into the prostate. Radiation therapy can be used as a primary treatment for localized prostate cancer or in combination with other treatments for more advanced stages. Side effects may include fatigue, urinary problems, and bowel issues.
Hormone therapy: Also known as androgen deprivation therapy (ADT), aims to reduce or block the production of testosterone, which can fuel the growth of prostate cancer cells. This treatment is often used for advanced or recurrent prostate cancer. Hormone therapy can be administered through medications or surgical removal of the testicles (orchiectomy). Side effects may include hot flashes, reduced libido, and bone thinning.
Chemotherapy: Involves using drugs to kill rapidly growing cancer cells. It is typically used for advanced prostate cancer that has spread to other parts of the body and is not responding to hormone therapy. Chemotherapy can help shrink tumors, relieve symptoms, and prolong life. Common side effects include nausea, hair loss, and fatigue.
Targeted therapy: Focuses on specific molecules involved in cancer growth and progression. These drugs can block the growth and spread of cancer cells while minimizing damage to normal cells. Targeted therapy is often used for advanced prostate cancer with specific genetic mutations.
Immunotherapy: Harnesses the body’s immune system to fight cancer. One type of immunotherapy used for prostate cancer is the cancer vaccine sipuleucel-T (Provenge), which stimulates the immune system to attack prostate cancer cells. Immunotherapy can be an option for advanced prostate cancer that has not responded to other treatments.
Prostate Cancer Treatment in Iran
Equipped hospitals, and advanced specialized centers with experienced doctors and specialists are available in all medical treatment areas in Iran. Also, good hotels and entertainment centers have made Iran an appropriate choice for patients who are struggling with prostate cancer and need treatment.
Prostate Cancer Treatment Process in Iran
The treatment process for prostate cancer in Iran involves a combination of modern medical practices and personalized care tailored to the patient’s specific condition.
The journey typically begins with a thorough diagnosis, which includes a prostate-specific antigen (PSA) test, digital rectal exam (DRE), and imaging studies such as MRI or CT scans. If these tests indicate the presence of prostate cancer, a biopsy is performed to confirm the diagnosis and determine the cancer’s aggressiveness.
Once diagnosed, the treatment plan is developed based on the stage of the cancer, the patient’s overall health, and personal preferences. Active surveillance is often recommended for men with low-risk, slow-growing prostate cancer. This approach involves regular monitoring through PSA tests, DREs, and periodic biopsies to track the cancer’s progression without immediate intervention.
For localized prostate cancer, surgery is a common treatment option. The most frequently performed surgical procedure is a radical prostatectomy, which involves the removal of the entire prostate gland and some surrounding tissue. This can be done through traditional open surgery or minimally invasive techniques such as laparoscopic or robotic-assisted surgery. These advanced surgical methods are available in several specialized hospitals in Iran, providing patients with access to high-quality care.
Radiation therapy is another primary treatment for prostate cancer in Iran. It can be delivered externally through external beam radiation therapy (EBRT) or internally through brachytherapy, where radioactive seeds are implanted directly into the prostate. Radiation therapy is often used as a standalone treatment for localized cancer or in combination with other treatments for more advanced stages.
For advanced or recurrent prostate cancer, hormone therapy is commonly used. This treatment aims to reduce or block the production of testosterone, which can fuel the growth of cancer cells. Hormone therapy can be administered through medications or surgical removal of the testicles (orchiectomy). In some cases, chemotherapy may be recommended, especially if the cancer has spread to other parts of the body. Chemotherapy involves using drugs to kill rapidly growing cancer cells and can help shrink tumors, relieve symptoms, and prolong life.
Iran also offers targeted therapy and immunotherapy for prostate cancer patients. Targeted therapy focuses on specific molecules involved in cancer growth and progression, while immunotherapy harnesses the body’s immune system to fight cancer. These advanced treatments are available in specialized cancer centers across the country.
Prostate Cancer Treatment Cost in Iran
The cost of prostate cancer treatment in Iran can vary significantly depending on the stage of the cancer, the type of treatment, and the healthcare facility. Patients face a combination of direct medical costs, direct non-medical costs, and indirect costs, which can lead to substantial financial burdens. This includes both direct medical costs, such as surgery, radiation therapy, and medications, as well as indirect costs, such as transportation and lost productivity.
For early-stage prostate cancer, the costs are relatively lower. However, as the cancer progresses to more advanced stages, the costs increase significantly. The increase in cost is due to the need for more intensive treatments, such as hormone therapy, chemotherapy, and targeted therapy, as well as the management of complications and side effects.
