Focal ablative therapy - a relatively 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 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.
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.
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.
