Best Prostate Cancer treatment in Delhi India | Metastatic prostate cancer treatment | दिल्ली में प्रोस्टेट कैंसर का इलाज
The best prostate cancer treatment in Delhi India by gold medalist (AIIMS) cancer specialist. 12+ years of experience in AIIMS New Delhi, safe and effective prostate cancer immunotherapy, targeted therapy (cancer tablets), hormone therapy and chemotherapy, treatment with surgery and radiation for prostate cancer cure. Stage 4 (metastatic) prostate cancer treatment. More information here.
What is prostate cancer? What is prostate adenocarcinoma?
The prostate is a gland present in all men. Normally it helps in semen production.
Cancer is a disease where normal cells change into uncontrollably dividing and spreading cells. Prostate cancer is cancer that starts in the prostate gland. It is one of the most common cancers among men in India.
What are the causes of prostate cancer?
The vast majority of prostate cancer cases have no apparent cause. A few risk factors for prostate cancer are:
- Older age
- Family history
- Ethnic group
However, many prostate cancers occur without any apparent reason.
What are the symptoms of prostate cancer?
In early stages, prostate cancer causes no symptoms. As prostate cancer grows, the pressure from the tumor leads to difficulty in urination, such as dribbling, hesitation, poor stream etc. More advanced stage may lead to local spread of tumor causing pain and bleeding.
Prostate cancer can also spread to other organs like bone, liver and lungs causing symptoms like bone pain, jaundice, abdominal pain and breathlessness. This is called stage 4 (or metastatic) prostate cancer.
What is prostate-specific antigen (PSA)? What to do if I have high PSA?
Prostate cells produce a chemical called prostate-specific antigen (PSA). PSA is normally present in the blood in small amounts. These amounts can increase (sometimes dramatically) in prostate cancer. However, small increases in PSA can also happen without cancer (for example, due to infection or benign natural growth of prostate). To interpret a high PSA report it is suggested to meet an oncologist or an urologist.
What tests are needed before treatment of prostate cancer?
Generally, the following tests are needed:
- Blood tests including PSA
- Biopsy which can be done from the prostate by a urologist or from any other easily accessible site. Note that biopsy is safe and does not cause spread of cancer
- Scans which may include PSMA-PET scans, bone scans, CT scans and/or MRI scans. The exact scan needed varies from person to person.
- Other tests if needed
What is Gleason score?
Prostate cancer biopsies are graded using gleason score which contains two numbers. The maximum score is 5+5=10. The higher the score, the more aggressive the cancer.
What is the treatment of prostate cancer in Delhi, India? Is prostate cancer curable?
Prostate cancer is curable.
The majority of prostate cancers are discovered at a curable stage. Generally prostate cancer is treated by:
- Prostate cancer surgery: Radical prostatectomy consists of removing the entire prostate gland. It is a highly sophisticated surgery that is preferably done in expert hands. Learn more
- Prostate cancer radiotherapy: Invisible beams of energy can be used to destroy cancer cells
- Prostate cancer hormone therapy: Manipulation of the body’s own hormone system to kill cancer cells.
- Prostate cancer chemotherapy: Chemicals that attack and kill cancer cells directly
- Prostate cancer Immunotherapy: Harnessing the body’s own immune system to kill cancer cells
- Prostate cancer targeted therapy: Killing prostate cancer by using technologies that target and kill only cancer cells
You can learn more about each modality below.
What is metastatic prostate cancer? What is the best metastatic prostate cancer treatment in Delhi, India?
Metastatic (or stage 4) prostate cancer refers to cancer that has spread beyond the prostate gland to involve other sites in the body. The most common sites of spread are lymph nodes and bones.
Even stage 4 cancer can be cured in a subset of patients. Even in the patients with incurable cancer, proper therapy can control the disease for many, many years, sometimes even a decade or more. Prostate cancer is usually a slow disease.
The main treatment modalities used in stage 4 prostate cancer are hormone therapy, immunotherapy and chemotherapy.
What is hormone therapy/ADT? How is it used in prostate cancer?
Prostate cancer is very sensitive to hormone therapy. Cancer cells increase and reduce with changes in testosterone levels in the body. Therefore, by eliminating testosterone from the body, we can control and treat prostate cancer.
This can be done in two ways:
- By using injections that temporarily reduce blood testosterone
- By surgical removal of the testes (orchiectomy) for permanent reduction
What are abiraterone acetate and enzalutamide?
Abiraterone (Zytiga, many other names) and enzalutamide (Xtandi, many other names) are tablet-form hormone therapies used commonly in metastatic prostate cancer treatment. These therapies are highly effective and can control prostate cancer for long durations, sometimes years.
What is chemotherapy? Is it useful in prostate cancer?
Chemotherapy is drugs that directly kill cancer cells. Chemotherapy is very effective in prostate cancer. In fact, just a few months of chemotherapy can sometimes control stage 4 prostate cancer for many years. Prostate cancer chemotherapy generally does not have many side effects and is safe and effective even for elderly men.
What is prostate cancer immunotherapy? Is prostate cancer immunotherapy available in Delhi, India?
Immunotherapy is a new revolution in cancer treatment. Immunotherapy works by stimulating the body’s own immune system to kill cancer cells. This allows it to exert powerful action with minimum side-effects. Thus one can produce dramatic results even in hopeless cases. This is an area of furious research in prostate cancer. At present immunotherapy is generally used in patients with limited options. This is expected to change rapidly in future.
What is PSMA therapy?
PSMA is a marker expressed only on prostate cells and absent in normal cells. It is possible to design special radioactive chemicals that specially go and kill only prostate cancer cells. This is called PSMA therapy. It is often used in patients who exhaust other options.
What is the cost of Prostate cancer treatment in Delhi, India?
In the current era, there are numerous options at every stage for prostate cancer. A good medical oncologist can help you obtain cost-effective treatment at every stage. For example, a good medical oncologist can help identify patients who are candidates for active surveillance (which might cost just a few thousand rupees per year) who can avoid prostatectomy (which often costs a few lakhs). Similarly, hormone therapy can be given by injections (which have to be given again and again) or by surgery (which is a small, one-time expense). Many new drugs are costly but not more effective than older drugs that are extremely cheap. Thus, guidance by an ethical medical oncologist can help you get the most cost-effective treatment of prostate cancer.
Why is it important to consult a prostate cancer specialist in Delhi, India?
Delhi is one of the best cities in India for the treatment of prostate cancer, with great availability of surgical specialists and infrastructure for the treatment of this complex disease. The treatment for prostate cancer requires significant expertise and a strong team. Some patients may require treatment for multiple years with many drugs. Improper frontline treatment can lead to disease relapse which is difficult to cure. Recently, there has also been a massive influx of new drugs, genetic tests and personalized therapy. An expert is needed to navigate this complexity.
Dr Vineet Govinda Gupta is a medical oncologist based in Delhi NCR with expertise in the treatment of ovarian cancer. He is gold medalist from AIIMS New Delhi where he has previously worked for more than 12 years. He has received numerous awards and published research in cutting-edge journals. More information here
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- Breast cancer, another tumor treated commonly with hormone therapy
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