Prostate Cancer Ultrasound Treatment as Effective as Surgery or Radiotherapy

Source: Imperial College London

Summary: Researchers found that using a high energy ultrasound beams to destroy prostate cancer tumours may be as effective as surgery or radiotherapy, but with fewer side effects.

Prostate cancer is the most common cancer in men in the UK, with around 47,000 cases every year. Treatments include surgery to remove the gland, or radiotherapy, which uses radiation to the entire prostate. However, these treatments can cause collateral damage to surrounding sensitive tissues like nerves, muscles, urine passage, bladder and rectum. The prostate is roughly the size of a walnut and sits between the bladder and the penis. Surgery and radiotherapy to the entire prostate are effective treatments but can lead to a long-term risk of urinary problems, like incontinence, of between 5-30%. They also carry a risk of erectile dysfunction between 30-60%. Radiotherapy can also cause rectal problems like bleeding, diarrhoea and discomfort in 5% of patients. Researchers found that using a high energy ultrasound beams to destroy prostate cancer tumours may be as effective as surgery or radiotherapy, but with fewer side effects. The findings were published in the journal European Urology.

High intensity focused ultrasound

The study tracked 625 men with prostate cancer who received a type of treatment called high-intensity focused ultrasound (HIFU) (pictured). Credit: SonaCare Medical LLC

High intensity focused ultrasound (HIFU) is a newer treatment, performed under general anaesthetic, which delivers beams of high energy ultrasound directly into the prostate gland, via a probe inserted up the back passage. There are no needles or cuts to the skin. This allows a surgeon to precisely target tumour cells within the gland to millimeter accuracy, with less risk of damage to surrounding tissues. In the new HIFU study, conducted on men with an average age of 65 and whose cancer hadn’t spread, the risk of urine incontinence at five years after the treatment was 2%, and the risk of erectile dysfunction was 15%. The team says the results include patients with medium to high-risk cancer. Further follow-up trials are needed to track the progress of the patients after ten years, as well as trials that directly compare HIFU with surgery and radiotherapy.

Dr. Caroline Moore, Reader in Urology from the UCL Faculty of Medical Sciences said: “The registry-based data from over 600 men is very encouraging. We started the HIFU programme at UCLH in 2003, and now principally use it as a focal treatment, where we treat cancer but not the entire prostate.”

More Information: Stephanie Guillaumier et al, “A Multicentre Study of 5-year Outcomes Following Focal Therapy in Treating Clinically Significant Nonmetastatic Prostate Cancer”, European Urology (2018). DOI: 10.1016/j.eururo.2018.06.006

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