Other Treatment Options For Prostate Cancer
There are several other prostate cancer treatment options that are available for the patients. Chemotherapy is one of the other popular treatment modality that may be used after surgery for patients with the cancer of the prostate.
The following table highlights the average cost of chemotherapy for prostate in some of the top medical tourism destinations in the world:
- Hormone therapy
- External beam radiotherapy
Thus, the total cost of prostate cancer treatment varies greatly from one individual to another, depending on the individual medical case.
Explore Best Hospitals for Prostate Cancer Treatment
Fusion Guided Focal Laser Ablation Of Prostate Cancer
|The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. Read our disclaimer for details.|
|Recruitment Status : Enrolling by invitationFirst Posted : May 3, 2016Last Update Posted : July 14, 2021|
- Study Details
Prostate cancer is the most common non-skin cancer in U.S. men. Treatments for early or less aggressive disease are limited. Researchers want to test a device that destroys cancerous tissue with laser energy. They want to see if using it with ultrasound is more comfortable than using it with magnetic resonance imaging .
To test a cooled laser applicator system to treat prostate cancer lesions. To see if ultrasound imaging is a practical and feasible treatment with laser ablation for focal prostate cancer treatment.
Men at least 18 years old with prostate cancer seen on MRI that has not spread in the body.
Participants will be screened with standard cancer care tests. These can include physical exam, lab tests, and MRI. For the MRI, they lie in a machine that takes pictures. Participants will have a prostate biopsy. Needle samples will be taken from 12 places in the prostate. This will be guided by MRI and ultrasound, which is obtained through a coil in the rectum.
The cooling catheter will be removed. A different catheter will be put in the urethra to keep the bladder emptied.
Who Are Good Candidates For Focal Therapy
When focal therapy for prostate cancer first began to be used in about 2007, it was only as an alternative to active surveillance in very low-risk patients. Since then, the use of focal therapy has expanded to include those with favorable intermediate risk disease . The best candidates have a prostate gland of about 40cc in size or a tumor in the lower half of a larger gland, a single visible tumor on MRI, and the absence of cancer elsewhere in the gland .
In each case, the doctor will consider the patients general health and mental outlook, the size and location of the tumors present, and their chances of spreading more. Use of tests such as MRI, ultrasound, and biopsy can help decide if a patient will benefit more from focal therapy or from traditional treatments.
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The Role Of Mri For Target Identification
Focal ablation is based on the premise that clinically significant prostate cancer can be identified and localized prior to intervention. Ultrasonography, computed tomography imaging, and T1/T2-weighted MRI lack adequate sensitivity and specificity for detecting clinically significant prostate cancer. As mentioned above, mpMRI, which incorporates diffusion-weighted imaging and dynamic contrast enhancement, is emerging as a useful modality to reliably detect and even characterize clinically significant prostate cancer., A meta-analysis reported that the sensitivity and specificity of DWI for prostate cancer detection are 0.69 and 0.89, respectively, compared to the sensitivity and specificity of T2-weighted imaging alone .
Several studies support the utility of mpMRI for detecting the site of clinically significant prostate cancer.
Haffner and colleagues were the first to demonstrate the utility of mpMRI for directing prostate biopsies. A standard 12-core TRUS random guided biopsy was performed in all 555 cases. Of the 351 cases with a positive mpMRI result, additional tissue cores were directed into the focal abnormalities using visual estimation, or cognitive co-registration. Visual estimation identified virtually all of the clinically significant cancers while failing to detect many of the clinically insignificant cancers
About The Southwest Prostate Cancer Symposium
The Southwest Prostate Cancer Symposium is a multi-day conference that seeks to educate urologists, radiation oncologists, medical oncologists, and other healthcare professionals involved in the treatment of prostate cancer. The topics focus on current technical aspects of diagnosis and treatment of localized and advanced disease, particularly regarding imaging, technology, and training in the related devices. Dr. Marks presented this lecture during the 24th SPCS in 2019. In 2020, the 25th SPCS will also offer training sessions involving imaging, scanning, and prostate cancer treatment-related devices on site. Please visit this page in order to register for future SPCS meetings.
Selected Key References
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Vascular Targeted Photodynamic Therapy
Vascular targeted photodynamic therapy combines mechanical and chemical treatment to achieve non-thermal tissue ablation. VTP uses laser activation of a photosensitizing compound to generate free radicals and microvascular thrombosis, within the treatment zone. Laser activation is achieved through transperineal interstitial prostate laser fibers. VTP treatment zones can be carefully contoured and result in minimal thermal dispersion, offering potential advantage in side-effect profile. Treatment across the prostate capsule may be limited, as well as across intraprostatic calcifications. The treatment is further subject to the limitation involving injection of a photosensitizer and achieving treatment confluency.
Our Workup Treatment And Follow
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Is There A Role For Focal Ablation Of Prostate Cancer
One of the unique characteristics of prostate cancer is the spectrum of the disease as it relates to disease aggressiveness, age range of those affected, and treatment priorities. The age range in a large personal series of approximately 5000 RP performed by one of the authors of this review is 36 to 81 years. The risk and extent of disease ranges from men with a single biopsy core with 1-mm GGG 1 cancer to all biopsies showing GGG 4 and 5 disease. The priority of some men is to cure the disease whereas others are motivated to preserve quality of life. It is reasonable to propose that the optimal management of prostate cancer should include AS, whole-gland treatment, and an alternative offering potential for oncological control with preservation of quality of life. We believe this option is FA of prostate cancer.
Focal Laser Ablation: The Casit Approach
Focal laser ablation achieves oncologic control by inducing hyperthermic conditions throughout the target lesion. Successful treatment requires accurate guidance of the laser fiber to the target lesion as well as real-time monitoring. Both of these tasks can be achieved with magnetic resonance imaging, however, this method is time consuming and expensive. We are developing an alternative approach in which ultrasound and interstitial probes are used for laser fiber guidance and treatment monitoring respectively .
Figure 2: A Setup during focal laser ablation. Ultrasound is used to guide a laser fiber to a target lesion with the resulting ablation monitored via four interstitial thermal probes. B Thermal data acquired by the interstitial thermal probes for two laser activations at different locations in the prostate. Note that the probe monitoring the laser tip exceeds 60°C while safety probes outside the target treatment zone remain relatively cool. C The treated tissue appears as a dark region on post-operative MRI. The location of each probe is indicated with the probe at the laser tip lying inside the treatment zone and all safety probes positioned in untreated tissue.
This project is a multi-disciplinary effort involving urologists, radiologists, pathologists, engineers and industry collaborators. The video below outlines our journey which started with the development of targeted biopsy for prostate cancer diagnosis.
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Selecting Candidates For Focal Ablation
There is no consensus how to optimally stratify men with localized prostate cancer to RP, RT, FA, or AS. A consensus statement recommends that all candidates for FA should undergo an MRI, MRFTB, and SB., An alternative would be to perform transperineal saturation biopsy to map the disease. We offer FA to men with a single MRI lesion without gross extracapsular extension who have high-volume GGG 1 or any volume GGG 2-3 and very select cases of GGG 4. Generally, we do not exclude cases with low-volume contralateral GGG 4 .
The Mri Focal Laser Ablation Procedure
The following illustrations show the steps involved in MRI Focal Laser Ablation:
Advantages of MRI Focal Laser Ablation
- Outpatient procedure
- Repeatable if necessary
- All future treatment options still open if necessary
Or to complete a detailed contact form, .
You will be contacted by the Scionti Prostate Center.
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Prostate Cancer Patients Are Paying Hefty Price For Controversial New Treatment
Men hoping to avoid some side effects of prostate cancer treatment are shelling out tens of thousands of dollars for a procedure whose long-term effects are unknown and insurers, including Medicare, wont pay for.
Proponents say high-intensity focused ultrasound can have fewer negative side effects than surgery or radiation, while giving some patients another option between actively watching their cancer and those more aggressive steps. Critics, however, say the procedure is being oversold, leading some patients to get a treatment they dont need.
Device makers are busy selling the $500,000-and-up machines to doctors around the country and offering training courses. Billboards advertising this new non-invasive treatment for prostate cancer are springing up, while treatment center websites promise a safer method with benefits such as no erectile dysfunction and no incontinence, although studies show those side effects can occur, but less often than with other types of more aggressive treatments. The treatment can range in cost from $15,000 to $25,000.
HIFU is the latest treatment to prompt concerns over whether there should be limits such as requiring tracking of results placed on expensive new technology while additional data is gathered.
In the U.S., advisory committees to the Food and Drug Administration twice turned down applications from manufacturers to market HIFU devices as a treatment for prostate cancer, citing not enough long-term evidence.
How Does It Work
Hear Dr. Michael Bedecs FLA story
Sperling Diagnostic Group, in conjunction with Sperling Prostate Center has developed a simple, proprietary 4-step treatment protocol utilizing our advanced technological capabilities and expertise.
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The Nyulmc/sperling Prostate Cancer Center
Between April 2013 and April 2014, 21 men underwent focal laser ablation as part of a collaboration between the NYULMC Smilow Comprehensive Prostate Cancer Center and the Sperling Prostate Cancer Center. All candidates for this collaborative focal laser ablation of the prostate study signed informed consent to participate in a longitudinal outcomes study.
The selection criteria for focal laser ablation included a 10-year life expectancy, between one to two focal abnormalities on mpMRI consistent with prostate cancer, no Gleason pattern 4 disease on random TRUS-guided biopsies of the normal appearing prostate on mpMRI, focal abnormality on MRI < 15 mm, and no Gleason score over 7. In most cases, preservation of potency was a very high priority. Candidates are extensively counseled regarding the very limited short-term and lack of long-term oncologic outcomes data with focal prostate cancer laser ablation.
Fiber placement T2-weighted axial sequence.
Temperature-sensitive fast spoiled gradient-recalled echo images.
Postablation gadolinium-enhanced T1-weighted axial sequence.
To date, there has been no significant change in the mean AUASS, IPSS, or SHIM between 3 to 6 months and baseline . Incontinence has not been reported by any patient in the perioperative or postoperative setting. The mean preoperative PSA value was 5.40 . Among the 12 patients in whom the 6-month PSA was available, the mean PSA value decreased from 5.10 at baseline to 3.69 at 6-month follow-up .
Other Factors Affecting Prostate Cancer Treatment Cost
Apart from the type of surgery or treatment and the choice of technology, the following are some of the factors that affect the overall prostate cancer treatment cost:
Type of Hospital
There are several hospitals around the world that provide world-class medical treatment to patients. The greater the number and quality of services offered by the hospital, the expensive is the treatment at the hospital.
Therefore, the total cost of prostate cancer treatment that you have to pay actually depends on the level of services that you expect from the hospital. To be able to receive five-star services from the hospital, you must be willing to pay lavishly for it.
Experience of the Surgeon
Expertise and skills of the treating doctor matter a lot when it comes to successful treatment of any cancer type. It takes a lot of patience, courage, and knowledge to treat a cancer patient and this is the reason why the most experienced surgeons tend to charge a greater fee for their services.
However, that does not mean that all the experienced and qualified surgeons charge fees that an average patient cannot afford. There are many highly educated and skilled doctors for prostate cancer treatment that offer their services with an equal compassion at a reasonable rate. Therefore, one must try to find a credible doctor with required credential who charges a fee that a patient can afford.
Length of Stay at the Hospital
Cost of Accommodation, Food, and Local Travel
|Cost per Day|
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The Average Cost Of Prostate Cancer Treatment: Top Countries
Like any other cancer, prostate cancer treatment is delivered with the help of different modalities. Thus, the total treatment package cost differs from one patient to the other. The selection of treatment modalities that are best expected to work in the case of patients further depends on certain factors, including the following:
- Age of the patient
There are several other types of prostate cancer surgeries apart from prostatectomy and TURP. Two of the other types of surgeries include CyberKnife treatment , high intensity focused ultrasound , cryosurgery, and orchiectomy. However, these two forms of surgeries are less common and largely depend on the preference of the surgeon and the condition of the patient.
The exact prostate cancer surgery cost depends on several factors. The following are some of the factors that dictate the overall prostate cancer surgery cost:
- The type of incision and its location
- The type of technology used
- Type of procedure
Minimal Urinary Erectile Problems Say Investigators
May 01, 2019
Focal laser ablation for prostate cancer shows “promising early oncologic results” and “acceptable morbidity” in men with low- to intermediate-risk prostate cancer, concludes a new single-center study of the experimental treatment method.
However, outcomes from this series of 120 patients, which is the largest data set published to date, indicate that nearly 20% of the men needed some form of re-treatment after one year.
Also, an expert not involved with the study, who congratulated the authors for collecting and publishing data, believes the study has important limitations.
The new study appeared in the March issue of the Journal of Vascular and Interventional Radiology
“There’s a huge untapped population of men who don’t want to undergo surgery this gives them an alternative,” lead author Eric Walser, MD, an interventional radiologist at the University of Texas Medical Branch in Galveston, told Medscape Medical News.
Walser is one of the first practitioners in the US to use FLA to treat prostate cancer.
With FLA, the prostate is accessed via the rectum. The laser fiber and rectal probe are guided to the tumors using an interventional magnetic resonance imaging system.
The investigators report that, 1 year after FLA, study patients had “no significant changes in quality of life,” and 83% were free from re-treatment.
Walser predicts that the rate of cancer recurrence will drop to around 10% because his team modified its technique.
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