A new non-invasive treatment for prostate cancer is the ‘single biggest change in 20 years’ and can prevent side-effects related to surgery, a new study found.
Researchers from Imperial College London studied the results of over 500 patient given the treatment – named focal therapy – to track its effectiveness.
Prostate cancer is the most common form of cancer among men in the UK, with around 48,500 new cases every year and traditional treatments come with life changing side effects including sexual dysfunction and incontinence.
Focal therapy uses ultrasound or cryotherapy to specifically target cancer cells in the prostate gland without damaging surrounding tissue.
The team say hospitals also stand to benefit, as the treatment can be delivered in a self-contained area and most patients can recover at home.
However, the treatment comes at a hefty price, with specialised machines costing around £500,000.
Researchers from Imperial College London studied the results of over 500 patient given the treatment – named focal therapy – to track its effectiveness. Picture: Stock
FOCAL THERAPY: TARGETED TREATMENT OF PROSTATE CANCER
Focal therapy specifically targets cancer cells in the prostate gland without damaging surrounding tissue.
This results in fewer side-effects, the ability to recover at home and so allows for those treated to live a normal life.
There are a number of different types of focal therapy but they all have the same basic principle – a high dose of targeted energy to kill cancer cells.
This was the first type of focal therapy and involves rapidly cooling the cancerous tissue to -40F and trigger hypothermia in the cancer cells.
High Intensity Focused Ultrasound
This technique uses high temperatures of over 140F generated by high energy sound waves to burn cancer cells.
Instead of sound, heat to kill cancer cells comes from light – laser beams activate a light-sensitive drug that kills prostate cancer cells.
While focal therapy has been available privately and on the NHS for several years, only 0.5 per cent of prostate cancer patients use it.
This is because few public hospitals are equipped to administer the novel treatment and doctors have remained sceptical due to the lack of long-term data.
Imperial College researchers gathered enough evidence to support what has been described as the ‘single biggest change’ in treating prostate cancer in 20 years.
Senior author Dr Matt Winkler said: ‘As a prostate cancer surgeon I know far too well the devastating impact of erectile dysfunction or urine incontinence on the lives of many men after prostate cancer surgery.
‘We are proud to provide colleagues and affected men with information that may make it easier to avoid radical prostate removal or radiotherapy.’
There are two kinds of focal therapy depending on the size and location of the tumour in the prostate – a small gland which sits below the bladder.
One uses a high intensity ultrasound (HFIU) to heat up cancer tissue with millimetre precision, while the other uses cryotherapy to cool it down.
420 patients who were treated with HIFU and 81 with cryotherapy and in both cases the risk of sexual dysfunction and incontinence was much lower than with traditional treatments.
Professor Hashim Ahmed, a leading prostate cancer expert from Imperial, said focal therapy carries up to ten-fold reductions in urine leak and sexual problems.
‘Importantly, for the first time we have shown that it has similar cancer control at radical prostatectomy, at five to eight years after treatment,’ he added.
Focal therapy specifically targets cancer cells in the prostate gland without damaging surrounding tissue, allowing those treated to live a normal life. Stock image
‘While focal therapy is not suitable for all patients, there are thousands every year who are suitable and they should be fully informed about it.’
Equipping the NHS to provide focal therapy for every man who chooses this option is the next hurdle, the researchers say.
Looking to overcome this challenge, the charity Prost8 UK has launched a campaign to fund six new focal therapy suites at hospitals around the country.
Each suite costs £500,000, which is much less than the millions needed for surgical and radiotherapy equipment.
Prost8 UK’s founder Paul Sayer chose focal therapy when he was diagnosed with prostate cancer in 2018 at the age of 62 and said ‘i am all but unchanged from my pre-cancer self’.
‘As a result, I am now driven to make sure as many men as possible know about focal therapy and, more importantly, can access it when needed.’
The findings could improve quality of life for the 12,000 men who are diagnosed with prostate cancer early every year and 10,000 who return for treatment after radiotherapy.
Promoting focal therapy when possible would also free up hospital beds, which have been in short supply during the pandemic, the researchers say.
Dr Winkler said: ‘After diligently collecting data over the last 10-years, we can now for the first time provide comparative evidence of equivalent cancer control rates for up to five to eight years.
‘While our method does not provide the highest level of evidence, a randomised controlled trial, it is as good as it gets at this point in time.’
The findings were published in the journal Nature.
WHAT IS PROSTATE CANCER?
How many people does it kill?
Prostate cancer became a bigger killer than breast cancer for the first time, official statistics revealed last year.
More than 11,800 men a year – or one every 45 minutes – are now killed by the disease in Britain, compared with about 11,400 women dying of breast cancer.
It means prostate cancer is behind only lung and bowel in terms of how many people it kills in Britain. In the US, the disease kills 26,000 each year.
Despite this, it receives less than half the research funding of breast cancer – while treatments for the disease are trailing at least a decade behind.
How quickly does it develop?
Prostate cancer usually develops slowly, so there may be no signs someone has it for many years, according to the NHS.
If the cancer is at an early stage and not causing symptoms, a policy of ‘watchful waiting’ or ‘active surveillance’ may be adopted.
Some patients can be cured if the disease is treated in the early stages.
But if it diagnosed at a later stage, when it has spread, then it becomes terminal and treatment revolves around relieving symptoms.
Thousands of men are put off seeking a diagnosis because of the known side effects from treatment, including erectile dysfunction.
Tests and treatment
Tests for prostate cancer are haphazard, with accurate tools only just beginning to emerge.
There is no national prostate screening programme as for years the tests have been too inaccurate.
Doctors struggle to distinguish between aggressive and less serious tumours, making it hard to decide on treatment.
Men over 50 are eligible for a ‘PSA’ blood test which gives doctors a rough idea of whether a patient is at risk.
But it is unreliable. Patients who get a positive result are usually given a biopsy which is also not foolproof.
Scientists are unsure as to what causes prostate cancer, but age, obesity and a lack of exercise are known risks.
Anyone with any concerns can speak to Prostate Cancer UK’s specialist nurses on 0800 074 8383 or visit prostatecanceruk.org