Prostate Cancer Treatment in India

Last Modified: June 26, 2020  |   Created on: June 24, 2020
Cancer Treatment, Prostate

Prostate Cancer treatment in India

  • Some men with prostate cancer may require mild treatment, while others may require a more aggressive approach with surgery, radiation, chemotherapy  and other treatment modalities.
  • Indian hospitals offer economical health packages for prostate cancer treatment, staring as low as USD 2800.
  • Prostate surgery cost in India with laparoscopy start with USD 5000 and Robotic prostate surgery cost in India is USD 6500 onwards.   
Prostate-cancer-treatment-cost

Prostate cancer is a common cancer amongst males. It occurs in the prostate, a small gland in men which is responsible for producing the seminal fluid to nourish and transport the sperm. Generally, prostate cancer is known to grow at a slow rate and remain confined to the prostate gland initially, not leading to serious problems. Although, certain types of prostate cancer are slow growing and may need only minimal treatment, there are other types of more aggressive prostate cancer that can spread quickly. 

As with most cancer, the chances of successful treatment are better for prostate cancer when it is detected early and still restricted to the tissues of prostate gland.

Growth in the prostate gland can be benign also, which means it doesn’t invade tissues around them, doesn’t spread to other parts of the body and can be removed. While, the malignant or cancerous growth in the prostate cancer can spread to nearby organs (bladder or rectum) or other body parts and can cause severe health issues, even life-threatening. 

How much does prostate cancer treatment cost in India?

The cost of prostate cancer treatment in India will be determined on the basis of stage of cancer and type of treatment option recommended by the medical experts. The robotic surgery for prostate cancer in India starts from USD 6500 and for laparoscopic surgery cost is USD 5000 onwards. The healthcare packages offered by Indian hospitals are highly affordable, especially for international patients. This is because the overall prostate cancer treatment cost in India is known to be lower than the cost of same treatment in other countries. An international patient can save 50-70% of their money if they choose to have prostate cancer treatment in India.

There are several factors that may influence the health package cost, including:

  • Treatment option: Prostate cancer surgery cost in India varies on the type of surgical procedure and technique used. The cost for chemotherapy and radiation therapy is based on the number of sessions required and the technology for radiation delivery (VMAT, IGRT, or other). HIFU for prostate cancer treatment in India is another option and the price for the procedure will be different. 
  • Technique used: The use of advanced technique offers many benefits to the patient, such as a faster and less painful recovery process. As the length of hospital stay is reduced with minimally invasive surgery, the expense related to it will also be reduced. The cost of robotic surgery for prostate cancer in India is highly reasonable for patients who are suitable for the procedure. Surgery is performed using the latest technique such as da Vinci Robotic system for removal of prostate cancer. 
  • Choice of hospital: The location and quality assurance of the hospital are prime factors. The best hospital for prostate cancer treatment in India are located in major cities such as Delhi, Mumbai, Bangalore, Chennai, Hyderabad and many others. These cities have international airports connected to all the main airlines of the world and it is easy to commute to the hospital from the airport. Also, there will be a number of accommodation options in the metropolitan cities, ranging from budget-friendly guest houses to five or above star hotels. 
  • The prostate cancer treatment hospitals in India, such as Max Hospital, Fortis Hospital, Indraprastha Apollo are certified by national and international accreditation bodies, including JCI and NABH. These certifications provide a mark of clinical excellence and high standard of patient care services, increasing the trust and reliability factor for the hospital. 
  • Surgeon’s experience and credentials: The surgeon’s fee is a part of cost package offered by the hospital. This fee varies on the basis of years of experience the doctor has in the specified field as well as the qualifications and trainings obtained from the top medical institutions. The experienced and highly qualified surgeons are considered to be more reliable as they have a record of positive clinical outcomes.
  • Length of stay at the hospital and in the country: Depending on the type and technique of the treatment procedure, the duration of hospital stay might vary for patients. The hospital room and hotel charges will be counted on the number of days spent. 
  • Room category: Hospitals have a variety of room category options, including single, twin-sharing, triple sharing and deluxe suits. The price range is different for all these types and patients can choose according to their suitability. 

Share your medical reports or contact us at care@lyfboat.com to get precise quotes for the best prostate cancer treatment in India. We will connect with the experts and guide you through the process. Our team provides a detailed treatment plan to all the patients, with a cost estimate from the top hospitals and doctors.

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Symptoms of Prostate cancer

Often, there are no early symptoms of prostate cancer, or the changes experienced by a patient may appear similar to other prostate related disease such as benign prostate hyperplasia.

Males who experience following symptoms should consult a specialist:

  • Problems while urinating – in starting as well as during
  • Frequent urge to urinate, especially at night
  • Presence of blood in the urine or semen (haematuria)
  • Pain during urination
  • Pain during ejaculation may also be experienced by some men
  • Difficulty in achieving or maintaining an erection
  • Pain or discomfort while sitting, due to enlargement of the prostate 

Symptoms for advanced prostate cancer can be noticed as:

  • Fractures or pain in the bone of the hips, thighs, or shoulders
  • Swelling (edema) in the legs or feet
  • Unexplained weight loss
  • Feeling of tiredness and fatigue
  • Weakness or numbness in the legs or feet
  • Loss of bladder or bowel control if cancer starts pressing on the spinal cord
  • Back pain

Screening tests for prostate cancer

Although, the early signs and symptoms of prostate cancer are difficult to notice, there are screening tests that can help detect changes indicating cancer. Screening means testing for cancer in people before they show any symptoms or who are at a high risk of developing cancer. Screening for prostate cancer mainly involves test that measures the levels of PSA in the blood. 

Prostate-specific antigen (PSA) blood test

Prostate-specific antigen (PSA) is a protein secreted by cells of the prostate gland. PSA is mostly detected in semen, but a small amount can also be found in blood. As prostate cancer cells also make PSA, the levels of this protein will increase in the blood. So, the chance of having prostate cancer is more when the PSA level are high. Although, there is no set limit point that can decisively tell if a man have prostate cancer or not, many doctors use a 4 ng/mL or higher as PSA limit to decide if a man might need further testing. Some doctors may recommend more tests starting at a lower level, such as 2.5 or 3. 

High PSA level can be attributed to several other factors as well, such as medical condition called Benign Prostate Hyperplasia (Enlarged prostate), old age, prostatitis (infection), and certain urological conditions. 

The PSA test is also used if a man has already been diagnosed with prostate cancer:

  • In people who are just diagnosed with prostate cancer, the PSA level can also be used in combination with physical exam results and tumor grade (determined on the basis of biopsy results) to help asses patients’ condition and evaluate if other tests such as CT scans or bone scans are further required.
  • PSA level can also be used to determine the stage of cancer, thus affecting the treatment options.
  • Often it is important to check PSA levels to determine how well treatment is working or to access a possible recurrence of the cancer after treatment. 

Other tests 

  • Digital rectal exam (DRE): This test might be less effective than the PSA blood test in screening prostate cancer, but it can sometimes help detect cancers in men with normal PSA levels. During a digital rectal exam (DRE), the doctor inserts a gloved and lubricated finger into the rectum of the patient and feel for any bumps or hard areas on the prostate. As the prostate is positioned in front of the rectum, it can be felt through the rectum. Prostate cancers often start in the posterior region of the gland, and can therefore be felt during a DRE. However, this test might be uncomfortable, especially for men who have condition such as hemorrhoids, but it only takes a short time and isn’t painful.
  • A special types of PSA tests, such as the Prostate Health Index (PHI), 4Kscore test, or percent-free PSA, or other tests for Prostate cancer can also be used for further testing. 
  • Imaging test of the prostate gland using MRI (multiparametric MRI) or transrectal ultrasound (TRUS) may also be recommended. 

Prostate biopsy

A prostate biopsy is done for a decisive diagnosis and staging of the cancer, especially if the initial PSA level is high. A biopsy is a small surgical procedure in which the doctor removes a small tissue samples of the prostate which is then analysed under a microscope. This test is sometimes the best option or the only way to determine if a man has prostate cancer for sure. If prostate cancer biopsy results indicate cancer, this test can also help determine the stage, whether the cancer will grow and spread quickly.

A Gleason score is assigned to the patient who had a prostate biopsy. This score helps classify the grade of prostate cancer cells, which indicates how much the abnormal cells in the prostate look like cancer, and how aggressive their growth appear to be. If a man has a Gleason score of less than six, it means the cells don’t show signs of cancer, and the risk is low. If this score is seven or higher, the medical team will likely assess the score and PSA level to determine the condition.

How can Lyfboat assist you getting Prostate cancer treatment in India?

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Lyfboat is a free advisory platform; we do not charge any fees from patients. In fact, we negotiate the price that Indian hospitals offer. In some cases we are able to reduce the cost by negotiating upto 20% of what Hospitals generally offer. We advise the best treatment from the top hospital/surgeon at best price.

Prostate cancer treatment

A multidisciplinary cancer team will be involved in diagnosing and formulating an appropriate treatment plan for a patient based on their age, general health status, and the stage of prostate cancer. 

Active surveillance: If the cancer is found to be non-aggressive, then watchful waiting is recommended, which is also referred to as active surveillance. The patient will not undergo treatment immediately but have regular check-ups to monitor the cancer. This includes closely monitoring the growth of prostate cancer using tests including prostate specific antigen (PSA), digital rectal exam (DRE) tests and prostate biopsies on a regular interval. The treatment for the cancer will only be suggested if it grows or causes symptoms.

Aggressive types of cancer or those causing health problems may need treated with following options:

Surgery: Prostatectomy is the surgical procedure to remove the prostate cancer cells along with some surrounding healthy tissues. If the prostate cancer hasn’t spread outside the gland, the doctor may suggest radical prostatectomy for treatment. The entire prostate gland will be removed with this procedure. The prostate surgery in India can be performed in different ways and using sophisticated techniques such as robot system. 

For advanced or recurrent cancer, other surgical procedures, such as removal of lymph nodes (Pelvic lymphadenectomy), may also be needed to completely remove the cancer cells in the body. 

Transurethral resection of the prostate (TURP) is a surgical procedure in which the tissue from the prostate are removed using a resectoscope, a thin, lighted flexible tube. This tube along with a cutting tool is inserted through the urethra. Although, this procedure is usually done to treat benign prostatic hyperplasia, it can sometimes help relieve symptoms caused by a tumour. TURP might be suggested for men who have tumour in the prostate only and those who cannot undergo a radical prostatectomy. 

Some patients may also require bilateral orchiectomy which involves surgical removal of both testicles. 

The conventional open radical prostatectomy involves making a large incision in the lower abdomen (retropubic surgery) to access the prostate cancer cells to be removed. Open prostate surgery may also involve removal of prostate tissue through the perineum (perineum prostatectomy), the area between the scrotum and the anus, but this technique is not commonly performed.

The minimally invasive or key hole approaches such as laparoscopic (robotic surgery) radical prostatectomy require a few smaller incisions to be made on the abdomen. Laparoscopic and robot assisted radical prostatectomy have become very popular. These methods have several advantages over the open surgery, including shorter hospital stay, faster recovery, less post-operative pain and chances of complications. 

The robot system allows high precision and eliminate hand related errors during the procedure. The surgeon controls the robot arms during the surgery, and use special surgical instruments to perform the operation. 

Whether open or laparoscopic surgery, prostatectomy is a major operation, with a significant healing process. Depending on the type of technique, the patient may have to stay in the hospital for a few days. Typically, patients go home after the discharge with a catheter to help drain urine for 7 to 14 days. 

Physical therapy may also be recommended to boost the recovery and strength of the patient. It includes Kegel exercises, which help build up pelvic floor muscles and may help patients dealing with persistent incontinence problem. The urologist and oncology tem will discuss the post-discharge instructions in details and assess the recovery during follow-up visits. There will be a gradual increase in the exercise tolerance which can be enhanced with walking more and more distances over the course of recovery period.

Certain physical activities such as calisthenics, weight lifting, golf, and other strenuous work are prohibited for about the 2 months following the surgery. This is to allow proper healing of the abdominal muscles and urethra post operation. 

In some cases, nerve-sparing surgery might be an option, allowing the surgeon to save the nerves that control erection. However, this may not be possible for men who have large tumours or tumours very close to the nerves.

Possible risks of the prostate surgery:

  • Erectile dysfunction 
  • Incontinence or leakage of urine from the bladder 
  • Shortening of the penile size
  • Inguinal hernia: the bulging of part of the small intestine through the weak muscles into the groin

Radiation therapy: This is to eradicate the tumour cells using high-energy rays or X-rays to kill the cancer. It can be administered after the surgery to remove any cancer cells that might be left behind. Radiation may also be suggested when cancer has spread (metastasized) to the bone. There are mainly two types of radiation therapies – 

  • External radiation therapy: In this, a radiation machine outside the body is used to direct the radiation towards the cancer cells. IMRT is a type of external-beam radiation therapy in which images from CT scans are used to form a 3D picture of the prostate prior to the treatment. This information about the size, shape, and location of the prostate cancer is analyzed by the computer system to determine the amount of radiation is needed to destroy it. IMRT offers the benefit of giving high doses of radiation to the prostate without increasing the risk of damaging nearby organs.
  • Internal radiation therapy: The doctor will surgically place radioactive seeds or pellets into or near the cancer cells to destroy them. Brachytherapy is an internal radiation therapy in which small grain sized radioactive seeds are placed in the prostate tissue. 

Proton beam therapy can be used for prostate cancer treatment. Proton beam radiation therapy uses very small particles to kill the cancer cells that haven’t spread.

Nuclear medicine radionuclides based techniques, such as Alpha emitter radiation therapy are also showing effective results in treatment of prostate cancer. It involves the use of a radioactive substance to treat prostate cancer that might have spread to the bone. In Alpha emitter radiation therapy, radium-223, a radioactive substance is injected into the vein, which then collects in areas of bone with cancer and destroys the cancer cells.

Lutetium Prostate Specific Membrane Antigen (Lu-PSMA) therapy is another nuclear medicine based treatment for patients with prostate cancer of advanced stage or refractory to standard treatment approaches. The therapy involves the use of radioactive element to specifically target prostate cancer cells. This high precision treatment help prevent damage to healthy surrounding tissue while delivering a high dose radiation to the tumour cells.

Hormone therapy 

This type of cancer treatment is based on targeting or blocking the action of hormones to stop cancer cell growth. Hormones are substances secreted by certain glands in the body and circulates in the bloodstream. For prostate cancer, male sex hormones can cause the tumour cells to grow. Reducing the amount of male hormones or block them using medication, surgery or other agents may help shrink the tumour.

Chemotherapy

Special anti-cancer drugs are used to shrink or kill the tumour. These drugs can be given as pills or medicines orally or through veins, or both. Systemic chemotherapy is administered by mouth or injected into a vein or muscle; the drugs enter via the bloodstream and reach cancer cells throughout the body. Regional chemotherapy involves directly placing the drug into the cerebrospinal fluid, a particular organ, or a body cavity such as the abdomen. This is to target the cancer cells in those areas. The method of giving chemotherapy depends on the type and stage of the cancer the patient is diagnosed with.

Biological therapy 

This treatment uses the patient’s immune system to help the fight cancer or to control side effects caused by other cancer treatments. In this, biological substances made by the body or in a laboratory are used to boost, target or restore the natural defences of the body to work against the cancer.

Prostate cancer treatment in India may involve other type of therapies that can be an option for select patients (when standard procedures are not effective):

  • High-intensity focused ultrasound: This therapy uses high-intensity focused sound waves (ultrasound) to kill cancer cells. For prostate cancer, an endorectal probe is used to produce the ultrasound waves.
  • Cryotherapy: This treatment involves the use of a special probe that is placed inside or near the prostate cancer to freeze and kill the prostate cancer cells. It is also known as cryosurgery. Ultrasound is used to find the area that will be treated. 
  • Photodynamic therapy: In this type of cancer treatment, a drug and laser is used to destroy the cancer cells. A drug in an inactive form is injected into a vein. It will become active only when exposed to light. The drug is more likely to collect in the cancer cells than in normal cells. Fiber optic tubes are used to emit laser light over the cancer cells containing the drug, it becomes active and kills the cells. This therapy results in minimal damage to healthy tissue and is mainly used to treat tumours on, just under the skin or in the lining of internal organs.
  • Bisphosphonate therapy: The bisphosphonate drugs, such as clodronate or zoledronate, can potentially be used to prevent or slow the growth of bone metastases. As the cancer progresses, it can spread to the bone. Men who have undergone antiandrogen therapy or orchiectomy are at a higher risk of bone loss. In such cases, bisphosphonate drugs can lessen the risk of bone fracture and other bone problems.

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