Managing Stage 4 Prostate Cancer: German Medical Approaches

Stage 4 prostate cancer involves nearby organs and tissues and metastasizes to the lymph nodes, spine, or internal organs.

This form of the disease is considered incurable. Doctors usually do not perform surgery, but there are still options for long-term control of the malignant process. You can undergo stage 4 prostate cancer treatments in Germany: not only standard, but also innovative methods are used here, allowing you to achieve excellent therapeutic results even in the most severe cases.

Principles of Prostate Cancer Treatment

In the first three stages, prostate cancer is curable: the tumor can be removed (prostatectomy) or destroyed by radiation. In Germany, laparoscopic and robotic (da Vinci robot) surgeries are used to remove tumors.

However, if metastases are found, surgery cannot cure the cancer. In this case, the patient receives systemic treatment. This differs from local (topical) treatment in that the drugs used affect all tumors and cancer cells at the same time – even those not detected by medical imaging or other tests.

Hormonal therapy is considered the main systemic treatment for stage 4 prostate cancer. Androgen deprivation aims to suppress hormone production. It is mainly drug-based, although it can also be surgical (bilateral removal of the testicles).

Doctors use one or two drugs that suppress testosterone production. Since the tumor needs hormones to grow, it stops growing and even shrinks. The PSA level in the blood drops.

Hormone therapy works for 12-18 months, longer in some patients. Then the cancer becomes castration-resistant and you have to switch to other types of treatment. Chemotherapy is usually the second-line treatment. When that stops working, doctors in most countries with poor medical care turn to symptomatic treatment, assuming that nothing more can be done. But if you are undergoing treatment of prostate cancer in Germany, there are still options to control the tumor in other ways.

Targeted and Immunotherapy

Some patients with prostate cancer are eligible for targeted therapy with PARP inhibitors. Additional tests are needed to determine if this treatment is right for you.

Immunotherapy may include a dendritic cell-based cancer vaccine. It helps to prolong life. It works by activating the anti-cancer immune response. The vaccine is prepared individually for each patient. A total of three doses are required at 2-week intervals.

For some patients, doctors prescribe immune checkpoint inhibitors. These block molecules that help cancer cells evade the immune response. Additional testing is needed to select candidates for such therapy.

Some clinics in Germany are using innovative prostate cancer drugs based on dendritic cells and oncolytic viruses. This is a worthwhile option when other treatments no longer work.

Radiotargeted Therapy with Lutetium-177

Significant progress in the treatment of castration-resistant metastatic prostate cancer has been made with the introduction of Lutetium-177 PSMA therapy. This is a radionuclide that, after intravenous administration, accumulates in tumor tissue and destroys pathological cells with radiation.

The ability to accumulate in cancer cells is based on the presence of a ligand in the composition of the drug. It delivers the radionuclide to those cells that contain a large number of prostate-specific membrane antigen (PSMA) molecules. Healthy tissues do not have this protein and are therefore not damaged by the drug.

Lutetium-177 therapy is given every 6 weeks. The course consists of an intravenous injection, after which the person must spend three days in the hospital while the radionuclide is eliminated from the body.

The drug shows excellent results. In some patients, it can put the disease into remission for years. When successful, tumors may not only shrink, but may even disappear.

Radionuclide Therapy with Radium-233

In the case of metastatic bone lesions, modern prostate cancer hospitals in Germany use Xofigo. The radionuclide accumulates in the bones and destroys the metastases.

There are other radionuclides for the treatment of metastatic bone lesions, but they are all more toxic and less effective. Radium-233 is characterized by its shorter and more powerful radiation. As a result, cancer cells are more effectively destroyed and the surrounding tissue in the area where the radionuclide has accumulated is virtually unaffected.

If you want to get treatment in Germany or find out prices, visit Booking Health website. Here you can choose a clinic, compare the cost of procedures in different medical centers, make an appointment for treatment at convenient dates and get services to organize your trip abroad.