Daily Telegraph - Tuesday 17th April 2012

“Perfect” prostate cancer therapy

Scientists hail pioneering ultrasound treatment that destroys tumours in nine out of ten cases without side effects

By Rebecca Smith, Medical Editor

A pioneering treatment for prostate cancer rids nine out of ten sufferers of the disease without debilitating side effects, a British study shows today.

Researchers at University College London used intensive ultrasound to produce the “perfect” outcome for patients with the most common cancer in men.

The treatments can be completed during a one-off visit to hospital, with patients walking out within hours, compared to the long stays on wards associated with radiotherapy and surgery.

The ability of ultrasound 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 that 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 treatment, up to 20 percent suffer incontinence and half suffer 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 sound waves on an area about a tenth 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 ten 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 safely be 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.

We look forward to the results of further trials, which we hope will provide a clearer idea of whether this treatment can control cancer in the longer term.”