Prostate Cancer Treatment in Hyderabad | Surgery and Cost

Physical Examination – Doctor will first take the medical history, health habits, past illness and treatments then will do the physical examination of the body to check the lump or any other signs of disease

Digital rectal examination (DRE) - The doctor inserts a gloved, lubricated finger into the rectum and feels the prostate through the rectal wall to check for abnormal areas or lumps.

Prostate-specific antigen (PSA) test: Prostate-specific antigen, is a protein produced by the prostate gland. The Prostate-specific antigen test measures the level of PSA in a man’s blood. The blood level of PSA is often elevated in men with prostate cancer, apart from this other non-cancerous conditions such as prostatitis, benign prostatic hyperplasia or enlargement of the prostate can cause an elevation in PSA level.

Transrectal magnetic resonance imaging (MRI): A transrectal MRI is done to find out if the cancer has spread outside the prostate into nearby tissues. This procedure is also called nuclear magnetic resonance imaging (NMRI). 

Transrectal ultrasound: Transrectal ultrasound is used to look for abnormalities in the rectum and nearby structures. An ultrasound probe is inserted into the rectum to check the prostate. The probe bounces sound waves off body tissues to make echoes that form a sonogram of the prostate. It is also called as endorectal ultrasound.

Transrectal Biopsy: A transrectal biopsy is used to diagnose prostate cancer and determine Gleason score in addition to stage to help plan treatment. This procedure performed either by using transrectal ultrasound called as transrectal ultrasound guided prostatic biopsy or by MRI called as transrectal MRI guided biopsy.

A transrectal biopsy is the collection of tissue samples from the prostate by inserting a thin needle through the rectum wall and into the prostate. Sometimes a biopsy is done using a tissue sample that was removed during a transurethral resection of the prostate (TURP) to treat enlarged prostate.

TRUS prostatic biopsy performed in men with a rapidly increasing PSA level and a palpable abnormality on a digital rectal examination (DRE). TRUS is a highly sensitive diagnostic modality for rectal wall involvement in patients with locally advanced prostate cancer.

Prostate cancer treatment options and recommendations depend upon level of PSA in blood, Gleason score, Grade, first time detected or recurrent, such as - medical management, radiation therapy, hormone therapy, minimally-invasive procedures, and surgical management. The choice or selection of the prostatic carcinoma treatment depends upon the other health conditions, past treatment for prostate cancer and severity of the symptoms.

Most prostate cancers are found in the early stages, when they are growing slowly. These are different types of treatment by stage of prostate cancer for patients:

If prostate cancer is in an early stage, is growing slowly, and treating the cancer would cause more problems than the disease itself, a doctor may recommend watchful waiting and active surveillance.

During watchful waiting, routine PSA test, digital rectal examination, and prostate biopsy are not usually done. In case of urine blockage due to prostate cancer then treatment would be initiated to relive symptoms.

Further treatment plan can be discussed based on the patient’s life expectancy and other illnesses to determine whether watchful waiting and active surveillance is appropriate.

During prostatectomy surgery, the prostate gland and, or surrounding lymph nodes will be removed to treat prostate cancer. A urologist or urologic oncologist (surgical oncologist) perform surgery to remove the tumor from the prostate gland or remove complete gland. If the cancer spread outside the prostate gland, then systemic treatment required to destroy the cancer cells. The following types of surgery are used, and it depends on the stage and grade of the disease, the patient’s health condition, and other factors.

• Open radical prostatectomy: removing prostate gland through open procedure
• Radical laparoscopic prostatectomy: removing prostate gland through laparoscopic instruments
• Robot-assisted laparoscopic radical prostatectomy: removing prostate gland through robot-assisted laparoscopic instruments
• Transurethral resection of the prostate (TURP): It is most often used to relieve symptoms of a urinary blockage in patients with prostate cancer
• Pelvic lymphadenectomy
• Bilateral orchiectomy

How effective is hormone treatment for prostate cancer?

Hormone therapy or androgen suppression therapy is used for reducing levels of male hormones (androgens - testosterone and dihydrotestosterone (DHT)), in the body, or to stop them from stimulating prostate cancer cells. Hormone therapy is effective in slowing down the cancer growth or shrink them.

Hormone therapy does not cure alone the prostate cancer, it can be used:

• If the prostate cancer has spread too far and surgery or radiation can’t be used
• If the prostate cancer comes back or remains after radiation therapy or surgery
• To make radiation therapy more effective 

How much does prostate cancer treatment cost in India?

Prostate cancer treatment recommendations depend upon level of PSA, Gleason score, Grade, co-morbid conditions of the patient. Average cost of prostate cancer treatment in India would vary from Rs. 4,50,000 to Rs. 7,50,000 (four lakh fifty thousand to seven lakh fifty thousand). Prostate cancer treatment cost in India vary in different hospitals at different cities. These are different surgical treatment options and their cost:

• Radical Laparoscopic Prostatectomy cost in India - Rs. 4,80,000 to Rs. 5,50,000 (four lakh eighty thousand to five lakh fifty thousand)
• Robot-assisted laparoscopic radical prostatectomy cost in India - Rs. 7,00,000 to Rs. 7,50,000 (seven lakh to seven lakh fifty thousand)
• Open radical prostatectomy cost in India - Rs. 3,00,000 to Rs. 4,00,000 (three lakh to four lakh)