Prostate Cancer Treatment at IEO
The Program was born from the desire to achieve a multidisciplinary and translational approach in the management of patients with prostate cancer, moving quickly and efficiently scientific discoveries into clinical practice, through the identification and validation of new diagnostic, prognostic and therapeutic biomarkers. The program according to ongoing development of well-timed prevention and individual therapy-planning, aims to build an integrated approach to urological cancer patients’ care, reducing the risk of “overdiagnosis” or drug toxicity, improving quality of life without a deep impact on the health budget.
At the European Institute of Oncology, we have a specialized team for the diagnosis and treatment of prostate cancer that integrates medical and nursing competencies to guarantee 360° disease management to the patient, who is at the center of the therapeutic process with an active role at each step. In order to select the appropriate treatment, the patient diagnosed with prostate cancer is evaluated by considering the prognostic factors related to
cancer. Localized prostate cancer can be treated with:
At IEO, we had a great development of robotic surgery, as it was the more frequent surgical treatment for prostate cancer. Robotic surgery offers better perioperative outcomes: blood loss, catheterization, surgical time, comparing to the open surgery. Being between pioneers of functional imaging studies gave us the opportunity of developing a state-of-the-art techniques in Magnetic Resonance as the Multi-parametric Magnetic Resonance Imaging (mp-MRI) in Prostate, which is the current most advance technique in the study of this organ. It has shown the potential to influence the decision to preserve neurovascular bundles and the extent of surgical margins in robotic prostatectomy.
If required, Lymphadenectomy could be done during the same surgery according to the surgeon advise. Radiotherapy course consists of 3-5 fractions, the Division has the latest equipment available for the highprecision radiotherapy like Intensity Modulated Radiotherapy (IMRT, including dynamic arc IMRT using RapidArc technology. In case with Prostate Cancer, treatment could be performed with:
· Cyberknife System - This is a miniature linac dedicated to robot-assisted radiosurgery i.e. delivery of a single high dose of radiation, stereotactically directed to the target. Robotic arm enables the system to deliver radiation from many different directions, verifying instantaneously the target position. This non-invasive, frameless, high precision (submillimetric accuracy) approach
allows delivery of the ablative dose to any part of the human body.
· Vero System - This is the world's first real-time dynamic tracking irradiation system that is capable of accurately tracking the position of tumors that move inside patient's body due to respiration, for example, and thereby enables highly precise, uninterrupted X-ray irradiation to the targeted tumor. In a short time irradiation can be precisely delivered to several moving targets.
Pharmacological and Hormonal therapy
Testosterone produced by the male testes stimulates the growth of prostate cancer. Hormone therapy tries to counteract this action by slowing down or blocking the testosterone synthesis (androgen deprivation). Hormonal treatment can be carried out with different strategies:
· Surgical removal of both testicles (bilateral orchiectomy). It allows to achieve the best results in the shortest time, permanently reducing the circulating testosterone levels. Obviously, from a psychological point of view, this approach is difficult for the patient to accept, which is the reason that nowadays, unless the patient himself prefers this drastic solution for avoiding to constantly receive treatments, surgery is reserved for urgent cases, where it is necessary to quickly lower testosterone levels in order to reduce bone metastases compression on the spinal cord (spinal compression).
Bones are the predominant and sometimes the only sites of distant metastases of prostate cancer. Therefore specific treatment of bone metastases in prostate cancer plays a very important role, and aims at controlling pain, and preventing skeletal complications. The treatments of bone disease use drugs such as bisphosphonates.
· Pharmacological therapy with different types of drugs that can reduce testosterone levels in the blood. The treatment may be continuous or with short interruption periods (intermittent therapy), to reduce the impact of side effects.
Physicians at the IEO have developed and validated the most widely used and effective techniques in surgical care through integration with radiotherapy and pharmacology procedures adopted today worldwide.
IEO offers a comprehensive program for the prevention, determining risk factors, early detection, as well as surgical
and medical treatment with the latest technology available. It is performed at:
IEO – Division of Urology; Division of Radiotherapy
The Program performed by:
· Urology Surgeons
· Radiation oncologist
The patient has the possibility to choose the referent surgeon.
Required Time and Plan
The average hospitalization time is of 3 nights, the discharge is expected on the 4th day in the morning. Other 3-5
additional days should be added if radiotherapy is required. Also, IEO suggests to stay 5 additional days in Milan after, in case if it will be required to make additional tests and procedures.
Standard Services For The Patient
· Facilitating the consultations
· Assistance scheduling the first visit
· Pre-arrival assistance (Flight, Visa, Accommodation…)
· Cultural Mediation Service
· Assistance with banking and business services
· Liaison between the patient and hospital staff
· Assistance during inpatient stay and after discharge
· Assistance with medical reports
· Future Appointment Scheduling
· Transportation Service (with extra charge)
For more information about Prostate Cancer Treatment options at IEO Milan, Italy, feel free to contact us right away!