In a nutshell
This study evaluated whether focal Ultrasound-based therapy of individual cancer lesions can minimize the side effects associated with radical therapy that involves the whole prostate gland. Main findings: Focused therapy directed into cancer tissues significantly reduces genitourinary side effects like urine-leakage and impotence.
Some background
The management of localized (confined) prostate cancer remains an issue, with over-diagnosis and over-treatment resulting in potentially long-term damage in urinary and sexual functions. Although surgery and radiotherapy have an established reputation, they are too aggressive for localized disease. This is a problem which prompted urologists and researchers to investigate new methods that would minimize if not eradicate these issues. One promising method of conservative cancer therapy is to target individual cancer lesions while sparing normal tissues.
Methods & findings
In the present study, 42 men, between ages 45 and 80 with low to high-risk prostate cancer received an intense focal therapy (based on Ultrasound waves) delivered selectively to individual cancer lesions.
For 12 months after the therapy, the researchers followed the men and assessed them for both side effects and cancer progression using certified assessment tools and biopsies. The results showed an initially diminished urinary and sexual function, but all men gradually regained pre-treatment functional levels by 12 months. None of the participants experienced urine-leakage and only 1 in 10 reported poor erections. Although not the primary aim of the study, evidence of cancer reduction is promising. After re-treatment of 41 men, 39 showed no clinical evidence of cancer at 12 months.
The bottom line
In this pilot study, focused Ultrasound-based therapy targeting individual prostate cancer lesions, resulted in lower rates of genitourinary side-effects and an encouraging evidence of cancer reduction.
The fine print
The present study was limited by its small sample size (overall 42 men), the employment of various biopsy strategies; and the fact that the nature of focal therapy requires destruction of normal tissues (necessary to cover an adequate margin), which could have contributed to adverse effects some participants experienced.
What’s next?
Discuss with your doctor the possibility of this treatment and weigh the risks and benefits.
Published By :
Lancet oncology
Date :
Jun 01, 2012
