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Saturday, 7 December 2019

Ultrasound treatment ‘eliminates’ prostate cancer, study finds (Times)

The Times: Ultrasound treatment ‘eliminates’ prostate cancer, study finds

Date of publication: 3 December 2019

"Scientists using ultrasound to treat some forms of prostate cancer have eliminated the disease in almost two thirds of cases with minimal side-effects, a study has found.

Researchers said that pulses of targeted ultrasound can be used to treat the illness without the need for surgery.

They found that in men with early-stage or less aggressive prostate cancer all signs of the disease were eliminated in 65 per cent of cases within a year.

Note LO: see diagram in Times article

The technique works by sending “precise doses of sound waves to diseased prostate tissue while sparing the healthy nerve tissue surrounding the prostate,” researchers at the University of California, Los Angeles said.

Experts said that ultrasound was unlikely to be as effective as surgery or radiotherapy in eliminating the disease, but it may have fewer side-effects and was less invasive. About 47,000 men in Britain a year have prostate cancer diagnosed. Up to 30 per cent suffer from incontinence and 60 per cent from erectile problems after surgery or radiotherapy.

The new procedure is due to be examined by the National Institute for Health and Care Excellence (Nice) in the coming months to assess whether it is cost-effective for use on the NHS. It has been used in a handful of hospitals as part of trials.

The research will be presented today at the annual meeting of the Radiological Society of North America. Scientists used a rod inserted into the urethra that has ten elements generating ultrasound waves, allowing it to cover the entire prostate gland. This heats and destroys the targeted tissue, controlled by software that can “adjust the shape, direction and shape of the therapeutic ultrasound beam”. The process takes place while the patient is inside an MRI scanner, allowing doctors to monitor the treatment and adjust its heat and aim.

A clinical trial examined 115 men with a median age of 65 whose prostate cancer had not spread. The gland was treated for an average of 51 minutes. The study found that prostate volume decreased on average from 39 cubic centimetres to 3.8 cubic centimetres.

The researchers said: “Clinically significant cancer was eliminated in 80 per cent of the study participants. Seventy-two out of 111 men, or 65 per cent, had no evidence of any cancer at biopsy after one year.” They added that there were “low rates of severe toxicity and no bowel complications”.

The success rate of surgery is high but may carry a higher risk of complications. A 2013 study of more than 10,000 men who underwent a “radical prostatectomy” to remove the gland and surrounding tissue found that 3 per cent died from prostate cancer within 20 years.

The researchers said that the technology had been approved for clinical use in Europe. A Nice spokesman said that it had been notified of the procedure and would examine its safety and efficacy.

Simon Grieveson, of Prostate Cancer UK, said: “Whilst novel treatments like this 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.” "


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