Blasting prostate cancer with sound waves eliminates tumours in nearly two thirds of patients, a study suggests.
The technique – which uses precise pulses of ultrasound to attack tumours in a session lasting less than an hour – could mean many men avoid surgery.
Researchers from the University of California at Los Angeles, who tested the technology on 115 men with prostate cancer, saw tumours destroyed in 80 per cent of men they treated.
And 65 per cent of patients were still clear of cancer a year later. Some 47,000 men each year develop prostate cancer in the UK.
The technique – which uses precise pulses of ultrasound to attack tumours in a session lasting less than an hour – could mean many men avoid surgery
The Daily Mail is campaigning for an urgent improvement of prostate cancer treatments and diagnosis, which are lagging years behind other diseases such as breast cancer.
Despite rapid advances in other cancer types, which have resulted in falling death rates, the number of men who die from prostate cancer is still going up, with 11,800 men in Britain lost each year to the disease.
And of those who do survive, many are left with severe side effects as a result of surgery, including incontinence and impotence.
The new treatment, called MRI-guided transurethral ultrasound ablation – or TULSA – comes with few of those side effects, the researchers said.
TULSA works by delivering precise doses of sound waves to diseased prostate tissue while sparing surrounding healthy nerve tissue.
It works using on a rod-shaped device, inserted into the urethra, which sends out sound waves from 10 ultrasound-generating elements.
The elements are controlled automatically by a software algorithm that can adjust the shape, direction and strength of the therapeutic ultrasound beam.
The procedure takes place in an MRI scanner so that doctors can closely monitor treatment and assess the degree and location of heating.
Research leader Professor Steven Raman said: ‘Unlike with other ultrasound systems on the market, you can monitor the ultrasound ablation process in real time and get immediate MRI feedback of the thermal dose and efficacy.
‘It’s an outpatient procedure with minimal recovery time.’
The treatment, which took an average of 51 minutes, saw prostate volume decreased on average from 39 cubic centimeters 3.8 cubic centimeters a year after treatment.
Blood levels of ‘prostate-specific antigen’, or PSA, a marker of prostate cancer, fell by an average of 95 per cent.
There were low rates of severe toxicity and no bowel complications.
‘We saw very good results in the patients, with a dramatic reduction of over 90 per cent in prostate volume and low rates of impotence with almost no incontinence,’ Professor Raman said.
The device, which is already approved for clinical use in Europe, is an advance on another technique that has been used on the NHS for several years called ‘HIFU’, or high-intensity focused ultrasound.
TULSA could also be used to treat men with non-cancerous enlarged prostate – a condition known as benign prostatic hyperplasia or BPH – which affects half of all men over the age of 50, and 60 per cent of those over 60.
‘There are two very unique things about this system,’ Professor Raman said.
‘First, you can control with much more finesse where you’re going to treat, preserving continence and sexual function.
‘Second, you can do this for both diffuse and localised prostate cancer and benign diseases, including benign hyperplasia.’
TULSA also has the benefit of allowing further treatment if needed, he said.
If it fails, then the procedure can be repeated, and more aggressive invasive approaches like surgery and radiotherapy can still be used.
Simon Grieveson, head of research funding at Prostate Cancer UK, said: ‘Over 47,000 men are diagnosed with prostate cancer each year in the UK and many face a difficult decision about what treatment they should have.
‘Current treatments for localised disease, such as surgery or radiotherapy, can be very effective, but they are not without a risk of side effects.
‘In addition, many men with low-risk prostate cancer may be able to avoid radical treatments like this altogether, and instead have their cancer monitored under active surveillance.
‘Whilst novel treatments like this one could potentially cause fewer side effects, we cannot tell from these results alone whether this could be as effective as the treatment options that are currently available and if so, which men could benefit the most.’
WHAT IS PROSTATE CANCER?
How many people does it kill?
Prostate cancer became a bigger killer than breast cancer for the first time, official statistics revealed last year.
More than 11,800 men a year – or one every 45 minutes – are now killed by the disease in Britain, compared with about 11,400 women dying of breast cancer.
It means prostate cancer is behind only lung and bowel in terms of how many people it kills in Britain. In the US, the disease kills 26,000 each year.
Despite this, it receives less than half the research funding of breast cancer – while treatments for the disease are trailing at least a decade behind.
How quickly does it develop?
Prostate cancer usually develops slowly, so there may be no signs someone has it for many years, according to the NHS.
If the cancer is at an early stage and not causing symptoms, a policy of ‘watchful waiting’ or ‘active surveillance’ may be adopted.
Some patients can be cured if the disease is treated in the early stages.
But if it diagnosed at a later stage, when it has spread, then it becomes terminal and treatment revolves around relieving symptoms.
Thousands of men are put off seeking a diagnosis because of the known side effects from treatment, including erectile dysfunction.
Tests and treatment
Tests for prostate cancer are haphazard, with accurate tools only just beginning to emerge.
There is no national prostate screening programme as for years the tests have been too inaccurate.
Doctors struggle to distinguish between aggressive and less serious tumours, making it hard to decide on treatment.
Men over 50 are eligible for a ‘PSA’ blood test which gives doctors a rough idea of whether a patient is at risk.
But it is unreliable. Patients who get a positive result are usually given a biopsy which is also not foolproof.
Scientists are unsure as to what causes prostate cancer, but age, obesity and a lack of exercise are known risks.
Anyone with any concerns can speak to Prostate Cancer UK’s specialist nurses on 0800 074 8383 or visit prostatecanceruk.org