What are the treatments for prostate cancer

Prostate cancer is a malignant tumor that occurs in the male prostate tissue. It is the result of abnormal and disordered growth of prostate acinar cells. The incidence of prostate cancer has obvious geographical and racial differences. In developed countries and regions such as Europe and the United States, it is the most common malignant tumor in men, and its mortality rate ranks second among all cancers; in Asia, its incidence is lower than that in Western countries, but it has been rising rapidly in recent years.

There are many treatments for prostate cancer, each with its own advantages and disadvantages. Depending on the purpose of treatment, prostate cancer treatments are divided into curative treatments and palliative treatments. Palliative treatments are those aimed at delaying tumor progression and relieving tumor-related symptoms.

Surgery

Surgery is currently the most commonly used curative treatment method, called radical prostatectomy, which completely removes the prostate and tumor. Radical prostatectomy can be performed via the retropubic approach (incision from the umbilicus to the upper edge of the pubic bone), the perineal approach (incision between the scrotum and anus), and laparoscopic or robotic-assisted lower prostatectomy. The appropriate surgical method is selected based on the patient's body shape and disease characteristics, as well as the doctor's technical expertise.

TOMO Radiation Therapy

Radiotherapy is an important treatment for prostate cancer. Radical radiotherapy for early-stage patients has a local control rate and 10-year disease-free survival rate similar to those of radical prostatectomy. The treatment principles for locally advanced prostate cancer are mainly radiotherapy and endocrine therapy. Metastatic cancer can be treated with palliative radiotherapy to relieve symptoms and improve quality of life. In recent years, three-dimensional conformal radiotherapy and intensity-modulated conformal radiotherapy have become the main treatments for prostate cancer. On this basis, CT-guided TOMO radiotherapy not only overcomes positioning errors, but also reduces the radiation dose of normal tissues, thereby increasing the therapeutic dose and achieving better therapeutic effects. Therefore, it has gradually been widely used in clinical practice.

The uncertainty of the prostate position includes both intrinsic and extrinsic factors. The uncertainty of position leads to uneven prostate irradiation dose. Some diseased tissues may not reach the radical dose, increasing the possibility of recurrence. If this factor is taken into account when outlining the target area, the dose to the rectum and bladder will be increased, thereby increasing the incidence of complications.

The main complications of radiotherapy for prostate cancer are acute and chronic urinary tract, digestive tract reactions and sexual dysfunction, which is the main reason hindering the increase of radical dose. The use of TOMO radiotherapy technology can more easily achieve the protection of normal organs while irradiating the prostate and seminal vesicle target areas with high doses, and control the acute and late adverse reactions of the rectum and bladder to below grade 2.

Other treatments

1. Radioactive seed implantation therapy (brachytherapy): Radioactive seeds are implanted into the prostate through the perineal skin, killing prostate cancer through close-range radiation. Because it causes little damage and usually does not require other treatment assistance, it is also one of the curative treatments for prostate cancer. According to the tumor grade, stage, and PSA value, external conformal radiotherapy can be further added after radioactive seed implantation therapy.

2. Cryotherapy: It is a minimally invasive treatment method. Under ultrasound guidance, a probe is inserted into the prostate through the perineal skin, and then liquid nitrogen at minus 96 degrees Celsius is injected into the probe to freeze and kill tumor cells. Currently, cryotherapy is often used as a second-line treatment for prostate cancer patients who have failed external radiation therapy.

3. Chemotherapy: used to treat patients with metastatic prostate cancer that is resistant to endocrine therapy, in order to slow tumor growth and prolong the patient's life. Studies have shown that docetaxel can effectively prolong the survival of patients with endocrine-resistant prostate cancer; and cabazitaxel can further prolong the survival of patients who have failed docetaxel treatment. Many clinical trials are studying new drugs and drug combinations in order to find more effective treatments with fewer adverse reactions. Abiraterone is the most clinically valuable new drug, and it is highly effective for endocrine-resistant prostate cancer.