Prostate cancer: Cure through surgery?
DO YOU KNOW THE “NUMBER NEEDED TO TREAT”?
For prostate cancer, removal of the prostate (radical prostatectomy – RPE) is considered “curative” – curative. So men assume that you are “cured” after the operation. Is that really so?
The “Number Needed to Treat – NNT” provides information. It describes the effectiveness of a treatment. For prostate removal, the NNT is151 in most cases. This means that out of 15 operated men, only one (!) man lives longer than men who did not have the prostate removed. The remaining 14 men live exactly the same length of time after RPE as men who were not treated at all. Thus, RPE confers a survival advantage on one in 15 men, and 14 in 15 men only experience the disadvantages of men who were not treated at all. Thus, RPE confers a survival benefit on one in 15 men, and 14 in 15 men experience only the disadvantages of surgery, such as impotence and incontinence, with no survival benefit.
Read this and more in the S3 Guideline Prostate Cancer of the German Society of Urology 20212 and ask your urologist – or let us advise you on the alternatives to radical prostatectomy.
The body’s own immune system – the best therapy for cancer
The body’s immune system is so far the only way to cure cancer. This is because even after the removal of a locally occurring tumor – e.g. a prostate carcinoma – tumor cells are present throughout the patient’s body.
These microscopic cells cannot be visualized by imaging and have not yet been treated. They can remain inactive in the body for years and decades and form the basis for the later growth of metastases and larger clusters of tumor cells. The vast majority of men with prostate cancer die from metastases rather than their primary tumor in the prostate.
Nevertheless, established therapies for prostate cancer are focused on treating the primary tumor. Surgery, radiation and chemotherapy damage the immune system instead of supporting it. Treatment of cancer cells scattered throughout the body has not routinely taken place.
Immunotherapy supports the body’s own immune system in fighting tumor cells
However, it has been known for many years that there are also treatment fractions for cancer that support the body’s own immune system in fighting tumor cells. These procedures have in common the way they kill tumor cells, namely by apoptosis and necrosis. These include procedures such as irreversible (IRE) and reversible electroporation (ECT = electrochemotherapy), but also photodynamic therapy (PDT), a much older procedure that has been well studied scientifically in terms of its antitumor immune effects.
Making prostate cancer “visible” to the immune system
Tumors are recognized by the immune system via tumor antigens, recognition molecules that are located, for example, on the surface of tumor cells. During treatment with tissue ablation procedures such as IRE, ECT and PDT, these tumor antigens are released en masse and recognized by the immune system – just like a vaccination in which inactive viruses are injected.
In this way, tumors that are difficult for the immune system to recognize, such as prostate carcinoma, can be made “visible”.
Enhancement of the immune response by immunotherapy
It has been known for about 100 years that inflammation occurring concurrently with tumors can lead to spontaneous remission 3.
For bladder tumors, inducing infection with the tubeculosis vaccine bacillus Calmette-Guerin (BCG) is established as standard therapy. Oncolytic viruses4, dendritic cells, cytokines such as interleukin-6, and suppression of T-regulatory cells by low-dose cyclophosphamide may also enhance the immune response against tumor cells.
VITUS Immunotherapy
Pioneering integrated therapy concepts for better survival in prostate cancer
It has been known for about 100 years that inflammation occurring concurrently with tumors can lead to spontaneous remission 3.
For bladder tumors, inducing infection with the tubeculosis vaccine bacillus Calmette-Guerin (BCG) is established as standard therapy. Oncolytic viruses4, dendritic cells, cytokines such as interleukin-6, and suppression of T-regulatory cells by low-dose cyclophosphamide may also enhance the immune response against tumor cells.
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