Prostate cancer: Lasers cut risk of side effects
BLASTING away prostate cancer with ultrasound is just as successful as more gruelling treatments with a far lower risk of side effects, a new study suggests.
Although survival rates for the most common type of male cancer are high, some patients suffer distressing and permanent consequences brought on by radiotherapy or surgery.
Incontinence and erectile dysfunction are among the most common. Now a new technique using high-intensity focused ultrasound (HIFU) to target tumours has scored highly in tests.
The treatment is similar to a lumpectomy for other cancers – where doctors remove only tumour cells, leaving as much healthy tissue as possible – but it is less invasive.
In the largest trial to date, 625 men with prostate cancer underwent the treatment at six UK hospitals. Their average age was 65 and although some had mediumto high-risk cancer, it had not spread to other organs.
Doctors found that HIFU resulted in the same 100% survival rate as more invasive treatments, but with fewer side effects. Professor Hashim Ahmed of Imperial College London said it could improve men’s quality of life.
He added: ‘Although prostate cancer survival rates are very good, the side effects of surgery or radiotherapy can be life-changing. Some patients are left requiring multiple incontinence pads every day, or with severe erectile dysfunction. We need to now focus on improving the quality of life for these men following treatment.’
There are 3,500 new cases of prostate cancer every year in Ireland – the second most common cancer in men after non-melanoma skin cancer, with just over 6,000 cases here annually.
Although surgery to remove the walnut-sized prostate or radiotherapy that attacks the whole gland is effective, they can result in incontinence in up to a third of men, and a 30% to 60% greater risk of erectile dysfunction.
The new method lets surgeons target a tumour with high-energy ultrasound beams with millimetre accuracy while a patient is under general anaesthetic, with less risk of damage to surrounding tissue.
The study found that HIFU treatment reduced the risk of incontinence after five years to only 2% , while erectile dysfunction fell to 15%.
About 10% of patients needed further treatment, such as surgery or radiotherapy, to treat cancer cells that returned. This was a similar rate to those who had conventional treatments.
More trials are planned to track progress after ten years, as well as those to directly compare HIFU with surgery and radiotherapy, says the study report, published in the journal European Urology.
Dr Caroline Moore of the UCL Faculty of Medical Sciences in the UK called the results ‘very encouraging’.
She added: ‘We treat the cancer but not the entire prostate. This means that men are much more likely to preserve urinary and sexual function, compared to traditional surgery or radiotherapy.’