AI Summary Overview
How is Prostate Cancer Diagnosed?
A urologist often evaluates prostate cancer using a prostate-specific antigen blood test, digital rectal examination and multiparametric MRI. A digital rectal examination is performed to detect any hard spots in the gland. A raised PSA level does not confirm cancer because benign prostate enlargement and prostatitis may also increase it.
A prostate biopsy is generally required in most cases to confirm the diagnosis and determine the cancer stage. PSMA PET/CT, CT, MRI or bone scanning may also be used by doctors in selected patients to identify whether the cancer has spread and subsequently, assist in treatment planning.
How is Prostate Cancer Treated Based on Stage and Risk?
Prostate cancer treatment depends on the risk group and how far the cancer has spread. The table below summarises the usual treatment approach:
| Risk or Disease Extent | Usual Treatment Approach |
| Very Low or Low Risk | Active surveillance is commonly preferred. Surgery or radiotherapy may be considered when surveillance is unsuitable or the cancer progresses. |
| Favourable Intermediate Risk | Active surveillance may be suitable for selected patients. Other options include radical prostatectomy, external-beam radiotherapy or brachytherapy. |
| Unfavourable Intermediate Risk | Radical prostatectomy or radiotherapy, often combined with a limited course of androgen deprivation therapy. |
| High Risk or Locally Advanced | Radiotherapy combined with long-term androgen deprivation therapy, sometimes with an additional hormone-blocking medicine, or radical prostatectomy in selected patients. |
| Metastatic Hormone-Sensitive | Androgen deprivation therapy combined with an androgen-receptor pathway medicine, chemotherapy or selected three-drug combinations. |
| Metastatic Castration-Resistant | Hormone-pathway medicines, chemotherapy, PARP inhibitors for eligible genetic alterations, radioligand therapy for PSMA-positive disease, radiopharmaceuticals or supportive treatment. |
Stages of Prostate Cancer and Their Treatment
Prostate cancer is staged from I to IV. Treatment is adjusted for each stage.
| Stage | Common Treatment Approach |
| Stage I | Active surveillance is often suitable for low-risk cancer. Surgery or radiotherapy may be considered based on risk, age, health and preference. |
| Stage II | Active surveillance may remain appropriate for selected lower-risk cases. Surgery, external-beam radiotherapy or brachytherapy may be recommended for cancers requiring treatment. |
| Stage III | Radiotherapy with androgen deprivation therapy is commonly used. Radical prostatectomy with possible additional radiotherapy or hormone therapy may be considered for selected patients. |
| Stage IV with Regional Lymph-Node Involvement | Radiotherapy combined with hormone therapy may be considered, depending on disease extent and overall health. |
| Stage IV with Distant Metastases | Systemic treatment using androgen deprivation therapy combined with other medicines is the main approach. Radiotherapy or other procedures may also relieve symptoms or treat selected disease sites. |
Surgery and Local Treatments for Prostate Cancer
Local therapies are used to treat cancers that are limited to the prostate and cure localised cancers. These procedures include:
-
Active Surveillance Active surveillance involves scheduled PSA tests, examinations, MRI scans, and repeat biopsies, with the start of curative treatment if the cancer shows signs of progression.
-
Radical Prostatectomy Radical prostatectomy removes the prostate gland and seminal vesicles and sometimes nearby lymph nodes, through open, laparoscopic or robot-assisted surgery.
-
External-Beam Radiotherapy External-beam radiotherapy directs high-energy radiation at the prostate and surrounding tissues over a planned course of treatment.
-
Brachytherapy Brachytherapy delivers radiation from radioactive sources placed temporarily or permanently within the prostate.
-
Focal Therapy High-intensity focused ultrasound or cryotherapy destroys a selected tumour area and may be considered for carefully selected localised cancers or within specialist programmes.
-
Salvage Treatment Surgery, radiotherapy, hormone therapy or focal treatment may be considered when cancer returns after initial treatment.
Other Treatments for Prostate Cancer
Other options often considered for prostate treatment are:
-
Androgen Deprivation Therapy Androgen deprivation therapy lowers testosterone or blocks its action to slow the growth of prostate cancer.
-
Androgen-Receptor Pathway Therapy Medicines, such as abiraterone, enzalutamide, apalutamide and darolutamide, provide stronger suppression of androgen-driven cancer growth.
-
Chemotherapy Docetaxel or cabazitaxel may be used for advanced or metastatic prostate cancer, depending on previous treatment and fitness.
-
Targeted Therapy PARP inhibitors may be used in selected patients whose tumours have eligible DNA-repair gene alterations.
-
Radioligand Therapy Lutetium-177 PSMA treatment is used to deliver targeted radiation to PSMA-positive metastatic prostate cancer cells.
-
Radiopharmaceutical Therapy Radium-223 may be used for selected patients with symptomatic prostate cancer that has spread mainly to the bones.
Oral Medications for Prostate Cancer Treatment
Oral medicines are commonly combined with ongoing androgen deprivation therapy in advanced prostate cancer. These include:
-
Abiraterone: Reduces androgen production and is usually given with a corticosteroid.
-
Enzalutamide: Blocks androgen-receptor signalling in hormone-sensitive or castration-resistant prostate cancer.
-
Apalutamide: Used in selected non-metastatic castration-resistant or metastatic hormone-sensitive cases.
-
Darolutamide: Used in selected non-metastatic castration-resistant or metastatic hormone-sensitive cases.
-
Olaparib: A PARP inhibitor used for eligible cancers with specific DNA-repair gene alterations.
-
Other PARP inhibitors: May be used alone or in approved combinations for selected biomarker-positive cancers.
Ayurvedic and Alternative Treatments for Prostate Cancer
Ayurvedic and alternative treatments complement, and do not replace, the medical treatment for prostate cancer. These include:
-
Yoga and Breathing Exercises: May support flexibility, sleep, stress management and general well-being.
-
Meditation and Counselling: May help manage anxiety and treatment-related emotional distress.
-
Acupuncture: May help selected patients manage pain, hot flushes or nausea when provided by a qualified practitioner.
-
Herbal Supplements: Should not be used without approval from the oncology team because they may cause side effects or interact with cancer medicines.
-
Ashwagandha: It might help alleviate treatment-related fatigue.
-
Ayurveda: Individualised ayurvedic herbal formulations prescribed by a qualified AYUSH practitioner can be helpful for overall well-being.
Note: These prostate cancer treatments should only be considered after consultations with the oncologist.
Home Care for Managing Prostate Cancer
Effective home care aids in the process of recovery from prostate cancer and provides comfort. These include:
-
Attend scheduled PSA tests, imaging appointments and oncology follow-ups.
-
Take all medicines exactly as prescribed.
-
Perform pelvic-floor exercises under the guidance of a physiotherapist or clinician.
-
Follow catheter and wound-care instructions after surgery.
-
Report fever, heavy bleeding, inability to urinate, severe pain or leg swelling promptly.
-
Maintain adequate nutrition, hydration and regular physical activity as tolerated.
-
Seek medical support for urinary, bowel, sexual or emotional difficulties.
-
Use counselling, rehabilitation or cancer-support services when required.
Latest Treatment for Prostate Cancer
PSMA radioligand therapy is a newer treatment option for some patients with advanced prostate cancer. It uses a radioactive medicine that attaches to PSMA-positive cancer cells and delivers radiation directly to them. Lutetium-177 PSMA therapy may help slow cancer growth and improve survival in selected patients whose cancer has spread and no longer responds well to standard hormone treatment.
This therapy is available only at specialised nuclear medicine centres in India. Genetic testing may also help identify patients who can benefit from targeted medicines such as PARP inhibitors.
How Long Does Prostate Cancer Treatment Take?
Prostate cancer treatment duration depends on its type and stage. The table shows approximate timelines:
| Treatment | Approximate Duration |
| Active Surveillance | Continues for years with scheduled PSA tests, examinations, MRI scans and repeat biopsies. |
| Radical Prostatectomy | Surgery usually requires a short hospital stay, followed by approximately 4 - 6 weeks of initial recovery. |
| External-Beam Radiotherapy | May range from about 5 sessions to several weeks, depending on the selected radiation schedule. |
| Brachytherapy | Usually completed as one procedure or a small number of planned sessions. |
| Hormone Therapy | May continue for several months, 1 - 3 years, or indefinitely, depending on disease risk and extent. |
| Chemotherapy | Usually given in repeated cycles over several months. |
| Radioligand Therapy | Commonly administered at intervals of about 6 weeks, for up to 6 planned doses when appropriate. |
| Targeted Therapy | Continues while it remains effective and side effects are manageable. |
Prostate Cancer Treatment Side Effects
Prostate cancer treatment may have some side effects. These include:
-
Urinary incontinence, retention, frequent urination or painful urination
-
Erectile dysfunction, reduced libido, reduced fertility or dry orgasm
-
Bowel irritation or rectal bleeding
-
Fatigue, hot flushes, weight gain or muscle loss
-
Anaemia, low white blood cell count, low platelet count or increased infection risk
-
Kidney problems or liver abnormalities
-
Severe allergic reaction (rare)
-
Secondary cancer after radiotherapy (rare)
Lifestyle Changes for Managing Prostate Cancer
Healthy practices help with the treatment and recovery of prostate cancer. These may also decrease the chances of recurrence. Some of these measures are:
-
Eat a balanced diet containing vegetables, fruits, whole grains and adequate protein.
-
Maintain a healthy body weight.
-
Perform aerobic, resistance and weight-bearing exercise as medically appropriate.
-
Stop smoking.
-
Limit alcohol intake.
-
Follow pelvic-floor rehabilitation after surgery when advised.
-
Discuss bone-density monitoring during long-term hormone therapy.
-
Take calcium or vitamin D supplements only when recommended.
-
Seek support for urinary, sexual, emotional or relationship-related concerns.
Triggers That Can Worsen Symptoms of Prostate Cancer
Some of the triggers that can worsen prostate cancer symptoms include:
-
Cancer spread to the bones or nearby organs
-
Urinary blockage caused by an enlarged tumour
-
Delayed or interrupted treatment
-
Poor response to hormone therapy
-
Urinary tract infection
-
Dehydration
-
Constipation, which can increase pelvic discomfort
-
Prolonged physical inactivity
-
Uncontrolled pain
-
Smoking and excessive alcohol intake
Prostate Cancer Treatment Cost
The treatment cost of prostate cancer in India varies with the hospital, location, stage and method. While a radical prostatectomy generally costs ₹1.5 lakh to ₹2.5 lakh, robotic surgery costs range from ₹5 lakh to ₹14 lakh. Similarly, radiation therapy ranges from ₹2.5 lakh to ₹7 lakh for a full course. On the other hand, hormone therapy injections cost ₹30,000 to ₹1 lakh per cycle. Moreover, advanced targeted and radioligand therapies are far more expensive.
Does Health Insurance Cover Prostate Cancer Treatment in India?
Several health insurance plans cover medically necessary hospitalisation, prostate surgery, radiotherapy, chemotherapy and certain advanced treatments for prostate cancer. These are subject to policy terms, exclusions, waiting periods and pre-authorisation requirements.
Critical illness insurance or cancer insurance plans provide a lump-sum benefit on the diagnosis of prostate cancer. Outpatient medicines, advanced targeted therapies and radioligand treatment may have separate limits or require additional coverage. Patients should review the policy wording, disclose their medical history accurately and obtain insurer approval before planned treatment.
FAQs
-
Q1. Can prostate cancer be cured?
Ans: Localised prostate cancer can often be treated with curative intent using surgery or radiotherapy. Metastatic prostate cancer is generally not curable, but treatment can help control the disease, relieve symptoms, and extend survival. -
Q2. Which treatment is best for prostate cancer?
Ans: There is no single best treatment for every patient. The choice depends on factors such as the stage of cancer, PSA level, biopsy results, age, overall health, life expectancy, and personal treatment preferences. -
Q3. How long does prostate cancer treatment take?
Ans: Recovery after prostate cancer surgery usually takes several weeks, while radiotherapy may be completed over a few sessions or several weeks. Hormone therapy and other systemic treatments may continue for months or even years based on treatment response.
-
References
-
https://www.maxhealthcare.in/our-specialities/cancer-care-oncology/conditions-treatments/prostate-cancer
-
