The prostate cancer can be treated with following options which depend on the size and site of the cancer, stage of the cancer and extent to which the disease has spread.

• Radiation Therapy: It comprises of high intensity energy to destroy the cancerous cells and is delivered in 2 ways;
  • External beam radiation therapy: Radiation from outside the body is focused on prostate gland using high powered energy beams like protons or X-ray.
  • Brachytherapy: Radiation is delivered from inside the body. It involves placement of radioactive seeds which are rice-sized that emit the low dose of radiation for long period. The seeds are implanted in the prostate using ultrasound guided needle.
• Hormone therapy: The cancer cells of prostate are dependent on the male hormone testosterone for their growth. Thus, hormone therapy aims at inhibiting the production of testosterone that may stop the growth of the cells or may cause them to die. This therapy includes;
  • LH-RH (luteinizing hormone-releasing hormone) agonists to stop the production of testosterone. The medicines include goserelin, leuprolide, histrelin and triptorelin.
  • Anti-androgens to block the testosterone to reach the cancer cells. These includes flutamide, bicalutamide and nilutamide.
• Chemotherapy: It is used to destroy the fast growing cells by using injectable drugs. It is the treatment of choice for the men whose cancer has advanced to other areas of the body or for the men who have not responded well to the hormone therapy.
• Biological therapy: Also known as immunotherapy in which your own body's immune system is made to fight the cancer. In this some of your immune cells are taken and genetically modified in the lab and are injected back in your body to fight the cancer cells.
• Surgery: The surgery to treat prostate cancer is to remove the prostate gland and is known as Radical prostatectomy. Radical prostatectomy is the surgery done to remove the entire prostate and any nearby tissues i.e seminal vesicles and some nearby lymph nodes that may contain cancer. It is the surgery of choice in men whose cancer is limited to prostate. Following are the different approaches of the prostatectomy;
  • Laparoscopic prostatectomy: This is minimally invasive method in which prostate is removed through small incisions in the abdomen with the help of laparoscope.
  • Robot assisted laparoscopic prostatectomy: The surgical instruments are attached to the robot (mechanical device),and the surgeon uses the controls to direct the device to move the instruments. This surgery is gaining immense popularity as it more precise, less traumatic and minimally invasive procedure. The most popular robotic prostatectomy includes the da Vinci surgical systems which aids to provide dexterity, precision and advanced visualization compared to open and laparoscopic surgery. Using da vinci robotic prostatectomy the surgery can be done through small incision of 1-2 cm.
  • Nerve sparing prostatectomy: It is performed when the cancer is entwined with the nerves to maintain the normal function and structure of the nerve.
  • Radical prostatectomy with retro pubic approach: Traditional open surgery to remove the prostate gland. The prostate is removed through an incision on lower abdomen.
  • Radical prostatectomy with perineal approach: Prostate is reached through an incision between the anus and scrotum.

Men younger than age 75 with limited prostate cancer who are expected to live at least 10 more years tend to get the most benefit from radical prostatectomy.

The ideal candidates for prostate cancer surgery are those whose cancer is limited only to prostate, less than 75 years of age and are otherwise in good health.

The surgery is performed under general or local anaesthesia depending on the choice of surgeon.

The Laparoscopic or robotic assisted or the da Vinci robotic prostectomy in the minimally invasive procedure that provides with the best results in regards of less pain, less scarring and better outcomes after the surgery. The only difference between the laparoscopic and robotic assisted prostatectomy is that the first one is performed at hands of the surgeon using laparoscope whereas the other one is done by the robot which is controlled and manipulated by the controls being operated by the surgeon.

During the surgery 5-6 small keyhole of 1 cm size are made on the mid abdomen and a telescopic lens in put inside that provides the magnified view of the structures like nerves, blood vessel, muscles adjacent to the prostate, thus optimizing the preservation of these structures. Using the miniaturized robotic instrument which are inserted through these keyholes, the prostate gland is cut away from the bladder and removed through one of the key holes.

This surgery has an advantage of less blood loss than the traditional one. The surgery usually take 2-4 hours to complete.

The patient would need to stay at the hospital for 3-4 days after radical prostatectomy. A urinary catheter is inserted which needs to be there for a few days after the surgery. One would feel pain and discomfort which would be controlled with medications. The patient can resume routine activities in about two weeks after the surgery. Strenuous activities, sexual activities need to wait for 8-10 weeks and may take months to return to its maximum level.

It is must to have a regular follow up after radical prostatectomy to make sure that cancer does not come back.

Results of radical prostatectomy are quite good if the cancer is limited to the prostate. The aim of prostate removal surgery is to cure the prostate cancer. Men whose prostate cancer has not spread to other areas have an 85% chance of surviving 10 years after radical prostatectomy.

However, if cancer has spread to the other parts, further treatment like radiation therapy would be required to cure cancer. One should do the regular medical check-ups to make sure that the cancer does not come back.

If the cancer cells are limited to prostate only, th epatient would need to stay at the hospital in India for 2-3 days and can go back home after two weeks. A regular check up with a doctor in local country is must to make sure that cancer does not return.

If the cancer has spread to other parts, the patient would need radiation therapy as well after the prostate removal surgery, which may take few weeks.