Non-surgical treatment of prostate cancer covers every option other than removing the prostate: active surveillance, external beam radiotherapy, brachytherapy, hormone therapy, focal therapies such as HIFU and cryotherapy, and drug and radioligand treatments for advanced disease. Which of these apply depends on the risk group of the cancer, defined by PSA, Gleason grade group, MRI and stage.
For cancer confined to the prostate, radiotherapy offers cancer control comparable to surgery in long-term trials, with a different pattern of side effects. Low-risk cancers may need no treatment at all. Focal therapies are less proven over the long term. No option is free of trade-offs.
What Non-Surgical Prostate Cancer Treatment involves
Assessment involves PSA, multiparametric MRI, targeted biopsies and, for higher-risk disease, a PSMA PET-CT. External beam radiotherapy is planned on CT, often after tiny gold markers or a rectal spacer gel have been placed, and is delivered in 20 daily sessions over 4 weeks, or in 5 sessions of stereotactic treatment; older schedules used 37 to 39 sessions. Low-dose-rate brachytherapy implants 60 to 100 radioactive seeds through the perineum under anaesthetic in a single sitting. High-dose-rate brachytherapy places temporary catheters for one or two treatments, often as a boost. Hormone therapy, given as injections or tablets that lower or block testosterone, accompanies radiotherapy for 6 months up to 2 to 3 years in intermediate and high-risk disease. HIFU destroys part of the gland with focused ultrasound through the rectum.
Who is a good candidate for Non-Surgical Prostate Cancer Treatment?
The right option depends on the risk group, the size of the prostate, urinary symptoms, age, other health conditions and what matters most to you.
- Low-risk cancer: active surveillance with PSA tests, MRI and repeat biopsy
- Intermediate-risk cancer: radiotherapy with or without short-course hormone therapy, or brachytherapy
- High-risk localised or locally advanced cancer: radiotherapy with long-course hormone therapy
- Men unfit for, or preferring to avoid, surgery
- A single visible MRI lesion of intermediate risk, for focal therapy within a centre that audits its results
- Metastatic disease: hormone therapy with newer hormonal agents, chemotherapy or lutetium PSMA therapy
Es ist normalerweise nicht die richtige Wahl, wenn:
- Severe pre-existing urinary obstruction, which radiotherapy and brachytherapy can aggravate until treated
- Inflammatory bowel disease or previous pelvic radiotherapy, which count against radiation
- A very large prostate for brachytherapy, unless it is first shrunk with hormones
- Multifocal or high-grade disease for focal therapy
- Men who are unable to commit to PSA follow-up for years
Technikoptionen
- Active surveillance: Monitoring with the intention of curative treatment if the cancer progresses. It avoids side effects for many men with low-risk disease.
- IMRT or VMAT radiotherapy: Image-guided external beam treatment over about 4 weeks.
- Stereotactic body radiotherapy: Five high-dose sessions over 1 to 2 weeks, on a linac or CyberKnife, for low and intermediate risk.
- Brachytherapy: Permanent seeds or temporary high-dose-rate sources placed inside the prostate.
- Androgen deprivation therapy: Injections or tablets that lower testosterone; combined with radiotherapy or used for advanced disease.
- HIFU, cryotherapy and other focal ablation: Treat only the affected part of the gland. Medium-term data are encouraging, long-term data are limited, and re-treatment is common.
Was passiert während Ihrer Behandlung
Each radiotherapy session takes 10 to 20 minutes, and you feel nothing; you are asked to arrive with a comfortably full bladder and an empty rectum. Brachytherapy and HIFU take 1 to 3 hours under spinal or general anaesthetic as a day case or with 1 night in hospital, and a catheter stays in for a few days afterwards. Hormone injections are given every 1, 3 or 6 months.
Vorbereitung auf Ihre Reise
A 5-session stereotactic course can be completed in about 2 weeks, including planning. Conventional 20-session radiotherapy needs 5 to 6 weeks in the city. Brachytherapy or HIFU needs about a week. Hormone therapy and PSA monitoring continue for years, so they must be arranged with a urologist or oncologist at home. Active surveillance is best run locally, though a second opinion with MRI review is a reasonable reason to visit.
- Informieren Sie den Arzt über Medikamente, Allergien, Schwangerschaft oder Stillen und eine Vorgeschichte von Fieberbläschen, Keloidnarben oder Autoimmunerkrankungen
- Vermeiden Sie Alkohol, Aspirin und entzündungshemmende Schmerzmittel für ein paar Tage im Voraus, wenn Ihr eigener Arzt zustimmt, um Blutergüsse zu reduzieren
- Kommen Sie ohne Make-up auf dem Behandlungsbereich an und vermeiden Sie zwei Wochen vorher Sonnenliegen und starke Sonne
Genesung und Ergebnisse
Towards the end of radiotherapy and for several weeks afterwards, expect more frequent and urgent urination, some burning, looser bowels and tiredness. These settle in most men within 2 to 3 months. Erectile function can decline gradually over 1 to 3 years. Hormone therapy causes hot flushes, low libido, fatigue, weight gain and bone thinning for as long as it lasts; exercise helps considerably. PSA falls slowly after radiotherapy, reaching its lowest point after 18 months or more, and may bounce temporarily.
- Back to everyday activity: Little; side effects peak around the end of treatment
- When results show: PSA falls over 6 to 24 months
- How long they last: Monitored with PSA for life
Sicherheit, Risiken und Revisionspolitik
Side effects differ from those of surgery: less leakage of urine, more bowel and irritative urinary symptoms.
- Urinary frequency, urgency or a weak stream, and occasionally retention needing a catheter
- Bowel urgency or rectal bleeding from radiation proctitis, long-term in a few percent
- Erectile dysfunction developing over months to years
- Hormone therapy effects: hot flushes, loss of libido, fatigue, bone loss, and metabolic and cardiovascular effects
- Urethral stricture, and rarely a fistula between rectum and urethra after HIFU or salvage treatments
- A small increase in the long-term risk of bladder or rectal cancer after radiotherapy
- Cancer recurrence requiring salvage treatment, which carries higher risks
Jeder schriftliche Vorschlag wird durch Clinic-Y gibt an, was die Klinik abdeckt, wenn eine Korrektur erforderlich ist. Fragen Sie danach, bevor Sie buchen, nicht danach.
Cost of Non-Surgical Prostate Cancer Treatment in Türkiye
Clinic-Y does not publish a single price for Non-Surgical Prostate Cancer Treatment, because the honest figure depends on your case. What moves it:
- The modality: surveillance, radiotherapy schedule, brachytherapy or focal therapy
- MRI, PSMA PET-CT and biopsy work-up
- Rectal spacer and fiducial markers
- Type and duration of hormone therapy
- Length of stay in the city
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Häufig gestellte Fragen
Is radiotherapy as effective as surgery?
For localised prostate cancer, a large long-term trial found very similar survival at 15 years with surgery, radiotherapy and monitoring, with different side effects. The choice is personal.
Can I have surgery later if radiotherapy fails?
Salvage surgery is possible but difficult, and carries higher complication rates. Other salvage options exist. Discuss this before choosing.
Is HIFU a proven alternative?
It is an option for carefully selected men. Follow-up data beyond 10 years are limited, and a proportion need repeat or whole-gland treatment.
Do I need treatment at all?
Many men with low-risk prostate cancer never do. Active surveillance is the preferred approach in most guidelines for that group.