The aim of metastatic prostate cancer treatment is to extend life expectancy and improve the patient’s quality of life. Four treatment options have proven their efficiency in metastases treatment. These are hormone therapy, chemotherapy, immunotherapy and targeted PSMA therapy with Lutetium-177.
Some of these treatments are available worldwide while others are applied only in a limited number of countries. Today, Germany offers all approved international plans in combination with (in-country only) developments.
Hormone therapy – decreasing level of androgens
Under normal circumstances, male hormones (i.e. testosterone) stimulate prostate growth. Unfortunately, hormones have the same effect on prostate cancer cells – they stimulate growth. Thus, suppressing testosterone synthesis prevents the tumor from further growth and spreading.
Main androgen-depriving techniques include:
♦ Gonadotropin– releases hormone analogues that directly suppress hormone production in testicles.
♦ Enzalutamide suppresses the hormone production both in testicles and adrenal glands.
♦ Antiandrogens (e.g. flutamide, bicalutamide) block action of testosterone.
♦ Surgical castration (removing of testicles). The intervention is irreversible and used as the last-line measure.
Chemotherapy – suppressing atypical sells
Patients with metastatic prostate cancer may demonstrate poor response to hormone therapy administration. Diverse tumor types have diverse hormonal sensitivity. As a result in some cases doctor may propose chemotherapy for treatment.
The first option is administration of docetaxel. Docetaxel prevents atypical cells from growing and dividing. Action of the medication may be enhanced by the simultaneous prednisone administration. It has been the standard scheme of the chemotherapeutic treatment in Germany since 2004.
If the disease progresses against the background of docetaxel receiving, a specialist considers administration of cabazitaxel. This is a newer medication that has been used as the second line therapy since 2011.
Immunotherapy – retraining patient’s immunity
Another option of prolonging the survival in patients with resistant to hormonal therapy metastatic prostate cancer is vaccines application. Immune cancer treatment in Germany includes administration of sipuleucel-T.
Sipuleucel-T is made of patient’s own immune cells (leukocytes). During the procedure called leukapheresis leukocytes are collected from blood for further processing and activation. This means that each dose of sipuleucel-T is manufactured for the patient individually.
Leukocytes undergo genetic modification and become capable of fighting cancer. During the therapy patient needs to visit clinic three times as the vaccine is given in three intravenous infusions fortnightly. The medication is remarkably safe and causes few side effects.
Lutetium-177 PSMA therapy – looking for the smallest metastases
PSMA therapy with Lutetium-177 is the targeted systemic radionuclide therapy. The technique is efficient in patients with metastatic castration-resistant prostate cancer.
Being connected with a specific carrier (molecule PSMA-617), therapeutic radionuclide Lutetium-177 fixates on the superficial PSA-receptor of the cancer cells. Prior to the therapy, patient undergoes diagnostic PSMA-PET CT to be sure that expression of the required receptor is sufficient.
Lutetium-177 emits medium-energy beta-particles. This irradiation type does not damage the nearby healthy tissues, as its action is strictly localized. PSMA therapy with Lutetium-177 is safe and well tolerated. It is applied even in patients with a kidney insufficiency against the background of single functioning kidney.
Treatment of the advanced cancer abroad
For patients without strong international experience, receiving treatment of metastatic prostate cancer in Germany will be easier and safer with services of Booking Health. Booking Health is the international medical tourism provider, official partner of German clinics with the ISO 9001:2015 certificate in the relevant field.
Services of Booking Health include assistance in making the informed choice between best hospitals, consultation on the preliminary diagnostic and therapeutic programs, making urgent appointment and facilitating visa issuing. While medical experts concentrate on health aspects of the program, travel experts and coordinators take care about booking tickets and accommodation, transfer, services of interpreter and medical reports translation.
In addition, financial experts will double-check the final calculation, excluding additional fees and reducing therapy cost. Leave the treatment request on the Booking Health website and wait for a call from a medical adviser within 24 hours. Your medical journey starts after you discuss the details.
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