Prostate Cancer Treatment Abroad

Prostate cancer occurs in the prostate — a small, walnut-shaped gland — located just below the bladder. It’s the most common cancer amongst men, especially those aged over 60. Although it’s a fairly common occurrence, most prostate cancers grow slowly and in some cases, men pass away of other causes without even knowing they had it. However, in other cases it can develop more severely and catching it early with treatment is extremely important.

Causes and Symptoms of Prostate Cancer

When it comes to the causes behind prostate cancer there are a few different factors that can contribute to this. There are also some potential symptoms to look out for that can indicate the presence of this illness.

Causes

Prostate cancer, like most other cancers, is caused by the presence of abnormal cells. Normal healthy prostate cells undergo mutations and then divide rapidly, ultimately forming a tumour. There are a few factors that can place you at a higher risk of prostate cancer.

• Age: Older men are more at risk. Prostate cancer mainly affects men over the age of 65, accounting for around 60% of the total cases.

• Ethnicity: In the US, black men have been shown to have a higher risk of developing this particular cancer. Researchers don’t fully understand why, but there is evidence that it may be related to genes.

• Location: In Europe, it’s been shown that there’s a differentiation in cases between northern and southern Europe. Prostate cancer cases are higher in the north than in the south.

• Family history: If members of your family have previously had prostate or breast cancer, your chances of getting the illness are generally higher.

Symptoms

In its early stages, prostate cancer tends not to show any symptoms. As it develops, certain symptoms could begin to indicate a cause for concern. These include:

• Increased frequency of urination

• Pain during urination

• Incomplete urination or a weak flow

The above symptoms may also be caused due to other prostate problems, therefore it’s recommended that you undergo diagnostic tests to determine the root cause. In cases where the cancer has already begun to metastasize — spread to other areas of the body — symptoms might expand to include:

• Erectile dysfunction

• Bleeding whilst ejaculating or urinating

• Pelvic, hip, or back pain

Diagnosis and Treatment

If you begin to experience some of the above symptoms, it’s important that you contact your doctor as soon as possible. Catching the cancer at the earliest possible stage gives you the best chance of having effective treatment and a successful recovery.

Diagnosis

There are a few different diagnostic tests that can be carried out to check for prostate cancer.

• Blood test: This is specifically done to measure the amount of the prostate-specific antigen, or PSA, an enzyme produced by prostate epithelial cells.

• Physical or digital examination: These are used to allow your doctor to examine your prostate.

• Imaging scan: This can take the form of a computer tomography (CT) scan, magnetic resonance imaging (MRI) scan, positron emission tomography (PET) scan, bone scan, or an X-ray.

• Biopsy: This may be performed if your surgeon finds unusual tissue in your prostate, or if high levels of PSA are found in your blood.

Prostate Cancer Treatment Abroad: What Options Are Available?

There are various prostate cancer treatment options available. The type of treatment that you undergo will be dependent on your general health, size of the tumour, shape of the tumour, and it’s location. Treatment options include surgery, radiation therapy, chemotherapy, and other hormone-related treatments.

Surgery

The primary surgery for prostate cancer is a radical prostatectomy. This is involves removing the prostate gland and possibly some surrounding tissue. This treatment is most effective in cases where the cancer is localized in the prostate. A radical prostatectomy involves the following steps.

• Anesthesia: Prior to the surgery, the patient is placed under general anesthesia or given an anesthetic numbing for the lower half of your body.

• Incisions: The surgeon starts the prostatectomy by making an incision from the lower abdomen down to the beginning of the pubic bone.

• Removal: Following this, the doctor will carry out the prostate removal, as well as any other affected surrounding tissue.

• Catheter: Next, a catheter will be placed in your penis to help you urinate. This will remain in place for approximately two weeks.

• Closing the incisions: Lastly, your incision will be sutured and dressed.

An alternative surgical option is a pelvic lymphadenectomy. This helps a doctor to assess the risk of a tumour progression. Specifically, there are generally two situations in which a pelvic lymphadenectomy would be carried out.

1. It may be carried out during a radical prostatectomy if there are indications that there could be a high risk of lymph node metastasis. This essentially means if the PSA is higher than 10ng/ml and/or the Gleason Score is high (seven or above). In low risk prostate cancers (e.g. Gleason Score of six and/or PSA < 10ng/ml), a pelvic lymphadenectomy may not be necessary.

2. A pelvic lymphadenectomy is sometimes undertaken as a separate surgery before radiotherapy for patients whose situations are more than low risk (PSA is higher than 10ng/ml and/or the Gleason Score of seven or above)

Radiation Therapy

Radiation therapy works by aiming high energy waves at the cancerous cells. This weakens and destroys the cancerous cells. Although this kind of treatment can also damage healthy cells, they can repair themselves in time. The treatment generally takes place over four weeks, in short sessions of five days per week.

One of the most innovative types of radiation therapy is intensity modulated radiation therapy (IMRT). This method involves 3D imaging of the tumour which then allows the radiation beams to be directed at different sides and angles while attacking the cancerous cells. Ultimately, this more precise direction means that there’s a much lower risk of damaging the surrounding healthy cells.

This treatment is advisable for men who have a localized prostate cancer, or the cancer has only advanced to nearby tissue. Additionally, many patients also undergo hormone therapy prior to undergoing radiotherapy. Hormones ensure a higher success rate by shrinking the size of your prostate.

Other Treatments

Other less common treatments are also available and can be suitable depending on your specific situation.

• Brachytherapy: As opposed to traditional external radiation therapy, this is internal radiation therapy. It involves placing a radiation source inside your body to kill the cancer cells. This can be temporary or permanent.

• High-intensity focused ultrasound: This treatment uses high frequency sound waves to target and kill cancerous cells.

• Hormone therapy: This is often used as a long-term treatment for men with advanced prostate cancer or alongside your main treatment in the early stages. It works by blocking testosterone production in the body or by blocking it from reaching the epithelial prostate cells.

• Chemotherapy: This uses anti-cancer drugs to kill or shrink the cancerous cells. This treatment is mostly recommended for men with advanced prostate cancer.

Alternative Options

• Active surveillance: For localized low-risk prostate cancer, the option of active surveillance is viable. Essentially, it means that patients don’t immediately undergo treatment, but instead defer and monitor their cancer. They undergo regular PSA and other similar tests. This is generally done because low risk, slow moving prostate cancer will not affect a patient’s health and they’ll avoid the aggressive side effects of unnecessary treatment.

• Watchful waiting: Similar to active surveillance, watchful waiting involves a less active and strict follow up routine. It’s more suitable for men who may have other health problems, and aggressive treatments such as chemotherapy may cause more damage than the cancer itself. If men on watchful waiting do have treatment at some point, it’s more geared towards reducing symptoms than as a cure.

What Should I Expect From My Cancer Treatment Abroad?

Prostate cancer is a slow growing cancer and often doesn’t present any symptoms in its early stages. Nowadays, there are a variety of treatments available, ranging from surgery to radiotherapy. It’s important to keep in mind that the treatment will be recommended to you based on how your cancer has progressed. Each treatment comes with it’s own risks and side effects, so it’s important that you can discuss this in detail with your doctor and voice any concerns that you may have before you start your treatment. Your Qunomedical Patient Manager is also available to discuss any worries that you may have at any point during your treatment journey.

Prostate cancer prognosis in the early stages is almost 100%. These odds, along with your mentality and willingness to partake in the treatments fully, will play a major role in pushing you towards a successful recovery.

Popular Doctors and Destinations

It’s become a lot more common for patients to have their prostate cancer treatment abroad. Accessibility to high-quality treatment and much more affordable prices has been the driving force behind this increase in patients travelling abroad. The average price for IMRT treatment In the US for instance, is $111,000. In comparison, the average cost for the same treatment in Germany is between $13,000-$17,000.

Qunomedical also gives the chance to explore specific doctor profiles, allowing you to have a look at a doctor's background, experience, accreditations, and reviews. When it comes to prostate cancer treatment abroad, Dr. Rüdiger Heicappell, MD is one of the most experienced figures in the field. Practising since 1983, Dr. Heicappell has performed around 12,500 treatments. For patients interested in discussing their individual case, Dr. Heicappell, and many other Qunomedical-approved specialists, can be reached via email.

Why Choose Qunomedical?

Qunomedical takes a patient first approach to healthcare, with no exceptions. We strive to find high-quality, affordable healthcare for all, regardless of background. When it comes to prostate cancer treatment abroad, we have done the hard work for you, thoroughly vetting a range of doctors in accordance with our unique scoring system, Qunoscore. Qunoscore takes into 21 unique data points, from qualifications to reviews from past patients. This allows you to choose a doctor based on criteria that matters to you and rest assured knowing that you’ll be receiving the highest quality care possible.