A pioneering treatment for prostate cancer rids nine in
10 sufferers of the disease without debilitating side effects, a British
study shows today (Tuesday).Researchers at
University College London used intensive ultrasound to produce the "perfect"
outcome for patients with the most common cancer in men.
The treatment can be completed during a one-off visit
to hospital, with patients walking out within hours, compared with the long
stays on wards associated with radiotherapy and surgery.
The ability of the ultrasound therapy to destroy
tumours while avoiding side effects made it twice as effective as
traditional methods, researchers said.
The treatment is expected to be approved as safe and
effective next week by the National Institute for Health and Clinical
Excellence (Nice), which will say that further trials should go ahead before
it is approved for use on the NHS.
Scientists said the treatment could be used routinely
within five years.
Researchers, who were funded by the Medical Research
Council, described clinical trials as "very encouraging" and said they
offered hope to the 37,000 people diagnosed with prostate cancer every year.
More than 10,000 men die annually from the disease.
If caught early enough, radiotherapy and surgery can
stop the spread of prostate cancer, but the side effects severely damage the
quality of life of the patient.
Of the men given the traditional treatments, up to 20
per cent suffer incontinence and half experience impotence. Radiotherapy
also causes other side effects in up to one in five patients, including pain
and bleeding.
The new technique, High Intensity Focused Ultrasound
(Hifu), focuses powerful soundwaves on an area about a 10th of an inch
across. It effectively boils cancerous cells to death, killing tumours, and
does far less damage to surrounding tissue, minimising side effects.
In the study by University College London, published
in Lancet Oncology,
41 men were treated with high intensity ultrasound. The vast majority - 95
per cent - were free of cancer after 12 months, with none suffering
incontinence and just one in 10 suffering impotence. While the disease could
return, the researchers said they were hopeful of developing the therapy
further. Dr Hashim Ahmed, who led the study at University College London and
University College London Hospitals Trust, said: "This changes the paradigm.
By focusing just on the areas of cancer we reduce the collateral damage to
surrounding tissue. 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, which can
be safely repeated once or twice, to treat their condition with very few
side effects.
"That could mean a significant improvement in their
quality of life."
Dr Ahmed said he expected other doctors to consider
using the treatment after the Nice guidance is issued next week.
He added: "These results will encourage more
physicians to look at it more carefully. If men are interested in this
concept they should speak to their cancer doctor or their GP. The next step
is a large scale randomised controlled trial. This needs to be evaluated in
a timely way so men can benefit."
Prof Gillies McKenna, the director of the Medical
Research Council and the Cancer Research UK Gray Institute for Radiation
Oncology and Biology, said: "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 research was funded by the MRC, the Pelican
Cancer Foundation and St Peter's Trust. Jacqui Graves, the interim head of
health care at Macmillan Cancer Support, said: "Significant reduction in the
likelihood of common side effects, such as incontinence, will enable men to
recover better and go on to lead good quality lives. We hope that a larger
trial will be supported to ensure that the UK achieves the best outcomes for
men affected by prostate cancer."
Owen Sharp, the chief executive of the Prostate
Cancer Charity, said: "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."
