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Targeted therapy gives hope to cancer patients

 

A new prostate cancer treatment, which uses powerful sound waves to target an area the size of a grain of rice, could provide an alternative to traditional treatment with significantly fewer side effects, according to a trial led by UCLH/UCL.

The results, published in Lancet Oncology, show that 12 months after treatment, none of the 41 men in the trial had urine incontinence and just one in ten suffered from poor erections – both common side effects of conventional treatment. The majority of men (95 per cent) were also cancer-free after a year.

The study, led by Professor Mark Emberton and Dr Hashim Ahmed, is the first to use the treatment known as HIFU (high-intensity focused ultrasound) to treat small areas of cancerous cells just a few millimetres in size (focal therapy).

Dr Hashim Ahmed said: “Our results are very encouraging. We’re optimistic that men diagnosed with prostate cancer may soon be able to undergo a day case surgical procedure for something which, in the past would have meant up to five days in hospital. It means they have fewer side effects and could significantly improve their quality of life.

“This study provides the proof we need to develop a much larger trial to look at whether focal therapy is as effective as the current standard treatment in protecting the health of the men treated for prostate cancer in the medium and long term.”

Prostate cancer is the commonest cancer in men. In the UK, more than 37,000 men are diagnosed each year and the condition leads to approximately 10,000 deaths. However, men with prostate cancer can live for years without their disease getting worse and many are faced with a difficult decision between therapy that may lead to side effects and active surveillance of their condition. Research efforts have therefore centred around reducing the impact of treatment on quality of life.

The standard therapy currently involves treating the whole prostate, either with radiotherapy or surgery (removing it completely). Both cause damage to the surrounding healthy tissue and can lead to substantial side effects.

Men who undergo traditional treatment have a 50 per cent chance of achieving the trifecta status or “perfect outcome” which means no significant side effects and good control of the cancer.  Using HIFU, men have a 90 per cent chance of achieving the same results.

Engineering manager Alan Johnson took part in the trial and is now cancer free. He said: “I did lots of research and this new treatment smacked me between the eyes. It was quick and painless and my sex life is still excellent!

“Best of all it has rid me of the cancerous cells that would have felt like a ticking time bomb inside me.”

The father of two teenage girls, said: “I went into UCH one day and the next I was catching the train back to Leeds. I regularly attend my local hospital for blood tests – but my PSA levels indicate the treatment has been a great success. I have a lot to be grateful for.”

Researchers previously used HIFU to treat the entire half of the prostate where the cancer was situated. That study also showed similar reduction in side-effects and encouraging early cancer control. In this study, they wanted to see if they could reduce damage to healthy tissue even further by treating only the specific cancer sites.

They used two highly sensitive diagnostic techniques – MRI and mapping biopsies – to enable them to pinpoint the exact location of the cancer lesions(s), something which is not possible with a standard diagnostic test (transrectal biopsy),

The researchers then focused high frequency sound waves onto an area the size of a grain of rice. The sound waves cause the tissue to vibrate and heat to about 80 degrees, killing the cells in the target area. The procedure is performed in hospital under general anaesthetic and most patients are back home within 24 hours.

Professor Emberton added: : “Traditional treatments treat the whole prostate regardless of how much cancer there is in the gland and damage to normal tissues can lead to significant side effects. 1 in 2 men have impotence and 1 in 10 need to wear pads because of involuntary urine leak. As men are diagnosed at a younger age, the side effects can have a devastating impact on their quality of life.

“Not only is HIFU less invasive, it’s quick – typically two hours – and the side effects are massively reduced, with results so far indicating an impotence and incontinence rate of just 5%. It enables men to be treated quickly – and then to get on with enjoying the rest of their lives.”

 

Adapted from materials provided by University College London Hospitals

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