Treatments

The Prostate Center has the latest generation technologies allowing a complete multidisciplinary approach and the least invasive possible, whether for the assessment of the location and extent of prostate cancer, its surgical or non-surgical treatment and its follow-up after treatment.

New technologies make it possible to make an accurate diagnosis:  

Imaging : 3 Tesla multiparametric prostate MRI makes it possible to assess several parameters of the tumor such as the increase in its blood supply or its cellularity in order to identify prostate tumors.

Targeted transperineal biopsy: The prostate tumor identified by MRI is integrated by imaging fusion into the endorectal ultrasound navigation software. Thanks to this image fusion, the urologist can accurately take a sample in the area of interest established by the imaging. This mapping of a prostate tumor is essential to offer the patient a tailor-made treatment.

Molecular imaging: Whole-body PET/CT with the prostate-specific membrane antigen (PSMA) radiotracer can effectively detect lesions at a distance of the prostate tumor, in lymph nodes, organs or bones. It is able to detect recurrences after treatment and guide salvage treatments, such as radiotherapy for example.

TREATMENTS

Active surveillance

Some slow-growing prostate cancers may be monitored without surgical treatment or radiation therapy. This active surveillance requires regular clinical check-ups with PSA checks, radiological examinations (MRI) and in the presence of a suspicion of progression a prostate biopsy.

Surgery

• Robotic surgery 

The so-called radical prostatectomy operation involves removing the prostate and associated lymph nodes. The procedure is usually performed minimally invasive and assisted by the DA Vinci robot. It is a high-precision instrument of the latest generation. It allows the urological surgeon to obtain more precision in his surgical gesture and better 3D visibility. This treatment currently represents the 'Goldstandard' for aggressive and localized prostate tumors.

• Focal  treatment

Focal therapy is a new, minimally invasive treatment option with few side effects. It aims to destroy the tumor inside the prostate by cold ( cryotherapy ) or heat (high-frequency ultrasound) without removing the organ. This type of treatment requires precise localization of the tumor performed by a targeted prostate biopsy. This surgical technique is mainly used for non-aggressive tumors.

Radiation therapy

The principle of radiotherapy is to deliver high-energy X-rays, produced by a linear accelerator, which are concentrated on the tumor and any lymph nodes affected. The effect produces DNA damage to tumor cells leading to their immediate and delayed destruction.

Our institute has a latest-generation linear accelerator. It integrates high-performance imaging systems for image-guided radiotherapy (IGRT). We use all available radiological images (MRI or PET/CT) to ensure our patients the best targeting of tumors while preserving the surrounding healthy organs.

The sessions are painless and spread over 4 to 7 weeks. When clinical cases allow, we use short regimens of 20 sessions (moderate hypofractionation). In cases of localized recurrence, we deploy stereotactic radiotherapies that are particularly targeted, highly effective and well tolerated.

Hormone therapy

In most cases, prostate cancer cells need certain hormones (androgens) to proliferate. Hormone therapy is a drug treatment, oral or injection, that decreases the action of these hormones and prevents tumor growth. It can be given alone or with radiation therapy to increase its effectiveness. This anti-hormonal treatment is used both in cases of localized prostate cancer and in case of metastatic disease. In the latter case, we offer patients several other treatments to strengthen hormone therapy, whether through a second last generation hormone therapy, chemotherapy or molecular targeted therapy.

Chemotherapy

This is a treatment, most often given by infusion, that works by destroying cancer cells that are multiplying. In prostate cancer, it is proposed in case of metastatic disease in order to slow its progression and reduce its complications. The complete treatment lasts several months with, after each infusion of chemotherapy, a rest period of 1 to 3 weeks. Adverse reactions are frequent and vary in intensity, but they are transient and their management is controlled. Chemotherapy infusions can, most often, be administered on an outpatient basis in our Oncology Center located in the Parc des Grangettes.

Supportive care

The Prostate Centre team is committed to providing comprehensive and personalized care to patients suffering from prostate cancer. Particular attention is paid to improving quality of life and reducing possible side effects. The Centre has developed partnerships to offer a consultation for pain control, physiotherapy sessions, adapted psychological support, sexology consultation, nutritional follow-up, social assistance, etc.

Protocol care also includes a double appointment with the onco-nutritionist doctor and the psychotherapist at the Center for Preventive & Integrative Medicine. A comprehensive program, including physical rehabilitation and complementary approaches, will then be offered to the patient.