Focused ultrasound offers better treatment for prostate cancer

2 July 2009

An experimental treatment that uses ultrasound waves to kill prostate cancer cells may be able to treat men without surgery, with fewer side effects and with only a short stay in hospital, according to a UK study published in the British Journal of Cancer.

A group of 172 men with prostate cancer that had not spread were treated under general anaesthetic with high intensity focused ultrasound (HIFU) to kill the cancer cells. The trial took place at two centres in London, University College Hospital and the privately owned Princess Grace Hospital.

The men taking part in the trial were discharged on average five hours after receiving the HIFU treatment. Typically men with prostate cancer are treated with either surgery or radiotherapy. Surgery usually requires a two to three day inpatient stay and radiotherapy requires daily treatment as an outpatient for up to one month.

Of the initial group, 159 men were followed up a year later and 92% did not have any recurrence of prostate cancer. Although this was not a comparative study, it would be expected that traditional treatments for early prostate cancer of surgery or radiotherapy would show a similar percentage of men showing no recurrence of their prostate cancer one year on.

Less than 1% — one man of the 159 followed up — had incontinence. And 30-40 % had impotence. None had any bowel problems.

One year following the traditional treatments of surgery and radiotherapy it would be expected that 5-20% of patients would have incontinence and half have impotence. Radiotherapy can also cause side-effects such as diarrhoea, pain and bleeding in 5-20% of people treated.

Dr Hashim Ahmed from UCL's division of surgical and interventional science, who ran the trial, said: "This study suggests it’s possible that HIFU may one day play a role in treating men with early prostate cancer with fewer side effects.

"But we don’t yet know for sure if HIFU is more effective than traditional treatments so it will be important to carry out further studies involving a larger number of patients followed over a longer period of time to truly compare the long term effectiveness of this treatment."

High intensity focused ultrasound uses high frequency sound waves to heat up small accurately-targeted amounts of tissue to a temperature of 80-90°C. It can be used to treat the whole prostate, as in this study, or just the cancer areas.

Professor Peter Johnson, chief clinician at Cancer Research UK, said: "This technique needs careful evaluation to make sure that it can produce the same results as the proven treatments for early prostate cancer. If the treatment can be shown to have less side effects then that will be excellent news, but more research is needed to show this.

"Cancer Research UK is funding a trial to look at this question and we hope that further studies can be carried out to compare HIFU to standard treatments".

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