Thousands of NHS prostate cancer patients could soon benefit from an experimental form of radiotherapy that blasts tumours with pinpoint precision.
By avoiding ‘collateral damage’ to surrounding healthy tissues, the hope is that the high-tech proton-beam therapy will save scores of men from nerve and blood vessel damage that leads to erectile dysfunction and incontinence – two of the most feared complications for those suffering the disease.
The surgical removal of the prostate – the walnut-size gland that sits below the bladder in men – is still the gold standard treatment. But some doctors believe proton-beam therapy shows huge promise, and one NHS hospital will begin treating patients this year.
The new radiotherapy technique reduces the collateral damage caused by the existing form of treatment which uses multiple beams of radiation
One of the few Britons to have already received the pioneering treatment has revealed how his sex life is ‘completely back to normal’ just months after undergoing the therapy. Father-of-four Timon Colegrove was diagnosed with the illness in December 2017 after a routine check.
Although Timon had no symptoms – typically, a need to urinate more frequently or problems with urination are signs of prostate disease – his worst fears were realised when a biopsy confirmed he did indeed have cancer. The 57-year-old former chief executive from Woodstock, Oxfordshire, said: ‘I was horrified. I was relatively young, very active and felt well.’
Timon, whose own father had suffered from prostate cancer in his 80s, was equally concerned about possible complications following treatment. He was offered surgery to remove the prostate, but this carried up to a 40 per cent risk of impotence and urinary incontinence. Conventional radiotherapy carried similar risks.
‘My fiancee Rebecca and I will be getting married this year, so that was devastating,’ says Timon. ‘I expected my consultant to tell me what to do but I was given options and supposed to decide for myself, which I felt unqualified to do. That made me start my own research.’
In conventional radiotherapy, which is used to treat about 150,000 patients with all kinds of cancer each year, high-energy beams of radiation destroy cancerous cells. But to reach a tumour, the rays must pass through healthy tissue, and they also carry on moving through the body. Burns to the skin and damage to muscle and internal organs are often unavoidable
A year on, Timon is focusing on the couple’s big day once more, having undergone proton-beam therapy, which he paid for privately. He went to the Rutherford Cancer Centre South Wales – the couple relocated for the duration of his treatment – every weekday for four weeks, with his final session happening last October.
‘Each session lasted just a few minutes and by the end I was in and out of hospital within an hour,’ says Timon. Throughout this time, he was able to have erections.
However, hormone drugs given to help shrink the prostate and boost the chances of the radiotherapy working dampened his libido temporarily. Now he says: ‘Our sex life is completely back to normal.’ And as for continence, he says: ‘For a while I did find that when I needed to go, I really needed to go. That is returning to normal now.’
In conventional radiotherapy, which is used to treat about 150,000 patients with all kinds of cancer each year, high-energy beams of radiation destroy cancerous cells. But to reach a tumour, the rays must pass through healthy tissue, and they also carry on moving through the body. Burns to the skin and damage to muscle and internal organs are often unavoidable.
Proton-beam therapy works by bombarding tumours with protons, the centres of atoms. The millimetre-accurate treatment is claimed to be less destructive to surrounding tissue, so less likely to cause post-treatment complications. Protons are not absorbed into the tissue they pass through, so they don’t damage it while killing the tumour.
Since 2015, the Government has ploughed more than £250 million into providing NHS hospitals with proton-beam technology. The investment was made after the British parents of an eight-year-old boy with a brain tumour were detained in Spain after fleeing with him in a bid to secure the treatment abroad. Ashya King was set to have chemotherapy and radiotherapy at Southampton General Hospital, but his parents Brett and Naghemeh feared the treatment could leave him badly brain-damaged. They were locked up in Madrid for 72 hours on child cruelty charges.
Ashya did later receive the radical treatment – in Prague rather than Spain – and three years on, he has been cleared of cancer.
The Christie Hospital in Manchester announced recently it was due to offer its first NHS patients the technology. University College Hospital London also plans to provide a service from 2020 and NHS Wales has agreed to fund treatments at the Rutherford.
ALTHOUGH there is growing evidence for the use of proton-beam therapy for brain tumours, there is less proof it is effective for prostate cancer, a disease that affects some 50,000 British men a year.
Dr Jason Lester, who treated Timon, said: ‘We don’t yet know if it improves survival but we know that by delivering a lower-radiation dose, we can reduce the chances of complications.’
However, Professor Roger Kirby, consultant urologist and director of The Prostate Centre, is more circumspect. ‘We know it works well for children with brain tumours,’ he says. ‘It has potential for prostate cancer, but it’s still unproven as a treatment.’
Timon is aware the treatment is experimental but says: ‘At my support group, I spoke to a couple of chaps who had surgery, and their sex life ended overnight. If I were in my 80s, I might find that acceptable, but it’s not something I want to contemplate right now.’