Thousands of men with prostate cancer could be spared incontinence and sex life problems thanks to a highly accurate new way of ‘cooking’ their tumours. At present, many men with early-stage prostate cancer opt to have the whole organ removed, to maximise the chance of being cured. But this approach carries a significant risk of being left incontinent, impotent, or both.
It is a major issue for many of the 47,000 men diagnosed with prostate cancer in Britain every year. Former Rolling Stones bassist Bill Wyman was diagnosed with the disease earlier this year.
An alternative, called High Intensity Focused Ultrasound or ‘HiFu’, kills the tumour alone by using a thin beam of energy to heat up cancer cells to 90C. This leaves the prostate, and vital surrounding tissues, intact. But the technique has never really taken off due to concerns over its effectiveness. Sometimes HiFu misses bits of the tumour, so cure rates have tended to be lower than those achieved by removing the whole prostate. The trouble is that medics have been unable to use HiFu machines, which usually contain steel, at the same time as MRI scanners, which contain huge magnets. They must therefore operate using an MRI scan taken beforehand. Now, HiFu machines are being made without steel, enabling both devices to be used in combination. NHS doctors at St Mary’s Hospital in London are testing the new approach.
Consultant urologist Mat Winkler, part of the study team, explained: ‘At the moment it’s a bit like being an archer who is told he can look and take aim at a target – but only fire after being blindfolded. Using both machines simultaneously is like taking off that blindfold.’ With millimetre accuracy needed for the best results, he said it could make a big difference. ‘By being more precise, we are hoping to achieve higher cure rates with HiFu, with a lower cost to the patient, in terms of reduced quality of life,’ he explained. He cautioned it was suitable only for men with certain types of early-stage prostate cancer but if all went well, he estimated 3,000 to 6,000 men a year could benefit in Britain.
Prostate cancer claims 12,000 lives a year in the UK, killing almost as many men as breast cancer does women. Besides sparing men misery and inconvenience, Mr Winkler said HiFu could save the NHS money if it achieved cure rates which equalled removing the whole prostate. A ‘radical prostatectomy’, as total removal is known, costs £6,500 a time but Mr Winkler said HiFu cost ‘less than half of that’.
Imperial College Healthcare NHS Trust, which runs St Mary’s, hopes to recruit 75 men with early stage prostate cancer, as part of a large international study into the effectiveness of MRI-directed HiFu. Edward Holdbrook, 52, its first patient, had MRI-directed HiFu under general anaesthetic in January. He said: ‘I didn’t feel any pain after I woke up, and have had no side effects.’ A blood test showed his PSA levels – a marker for prostate cancer risk – dropped significantly after the operation. He is due to have a biopsy in August to check if he is cancer-free.
By Stephen Adams, Health Correspondent For Dailymail.com