New prostate cancer treatment with fewer side effects
Written by Robert Smith
Monday, 16 April 2012
A new technique to treat early prostate cancer may have far fewer side-effects than existing therapies, say experts.
A 41-patient study in the journal Lancet Oncology suggests targeted
ultrasound treatment could reduce the risk of impotence and
Researchers say it could transform future treatment if the findings are repeated in larger studies.
The Medical Research Council (MRC), which funded the study, welcomed the results, which it said were promising.
Each year 37,000 men in the UK are diagnosed with prostate cancer.
Many face a difficult dilemma: the disease kills about 10,000 men every
year, but for some it may not get worse if left untreated.
Standard treatment with surgery or radiotherapy involves treating the
whole prostate gland, and can harm surrounding tissue, with a serious
risk of side-effects, including urinary incontinence and impotence.
Doctors at University College Hospital in London have carried out the
first trial using high-intensity focused ultrasound (HIFU) aimed at
small patches of cancer cells on the prostate.
This was a "proof of concept" study involving 41 patients.
They used a probe, placed close to the prostate, which emits sound waves
that heat the targeted cells to 80C, while causing minimal damage to
surrounding nerves and muscles.
Hashim Ahmed, a urological surgeon at the trust who led the study, says
the results, 12 months after treatment, are very encouraging.
"We've shown in this study that focal therapy - by targeting the
individual areas of cancer - can avoid the collateral damage. We've
shown that nine in 10 men had no impotence and none of the men in the
study had incontinence of urine."
Mr Ahmed says the early evidence on cancer control is also very good.
But he says this needs to be evaluated in much larger studies.
"This could offer a transformation of the way we treat prostate cancer.
It could offer a cost-effective treatment for the NHS, and offer men
with early prostate cancer an opportunity to treat their disease, but
with very few side-effects."
A patient on the trial, 72-year-old Robert Page, from Croydon, says his treatment, two years ago, was a great success.
"The outcome was very good," he said. "I was very pleased with the
treatment and very happy with the lack of side-effects, particularly
when I contrast that with what might have been the case if I'd had one
of the other, alternative, treatments."
The study was funded by the Medical Research Council, the Pelican Cancer Foundation and St Peter's Trust.
Professor Gillies McKenna, director of the Gray Institute for Radiation
Oncology and Biology, a joint collaboration between the MRC and Cancer
Research UK, welcomed the findings.
"If these promising results can be confirmed in a randomised controlled
trial, focal therapy could soon become a reasonable treatment choice for
prostate cancer alongside other proven effective therapies."
The chief executive of the Prostate Cancer Charity, Owen Sharp, also emphasised the importance of further research.
"We welcome the development of any prostate-cancer treatment which
limits the possibility of damaging side-effects, such as incontinence
and impotence. These early results certainly indicate that focal HIFU
has the potential to achieve this in the future.
"However, we need to remember that this treatment was given to fewer
than 50 men, without follow-up over a sustained period of time.
"We look forward to the results of further trials, which we hope will
provide a clearer idea of whether this treatment can control cancer in
the long term whilst ridding men of the fear that treating their cancer
might mean losing their quality of life."