Sound waves treat prostate cancer with fewer side effects

British Journal of Cancer

An Experimental cancer therapy for prostate cancer may be able to treat men without surgery and offer fewer side effects according to the results of a UK study published in the British Journal of Cancer* today (Wednesday).

A group of 172 men with prostate cancer that had not spread were treated under general anaesthetic with High-Intensity-Focused Ultrasound (HIFU) - which uses sound waves to kill cancer cells. The trial took place at two centres - University College Hospital in London and the privately owned Princess Grace Hospital, also in London.

The men taking part in the trial were discharged on average five hours after receiving the HIFU treatment. Typically men with prostate cancer are treated with either surgery or radiotherapy. Surgery usually requires a two to three day inpatient stay and radiotherapy requires daily treatment as an outpatient for up to one month.

Of the initial group, 159 men were followed up a year later. Three quaters of those followed up showed no biochemical recurrence of prostate cancer one year later.

The number of patients reporting bowel problems and incontinence appeared to be low. Eight out of 12 patients for whom data was available after one year were potent.

This was not a comparative study but one year following the traditional treatments of surgery and radiotherapy it would be expected that 5-20 per cent of patients would have incontinence and half have impotence. Radiotherapy can also cause side-effects such as diarrhoea, pain and bleeding in 5-20 per cent of people treated.

Dr Hashim Ahmed from UCL's division of surgical and interventional science, who ran the trial, said: "This study suggests it’s possible that HIFU may one day play a role in treating men with early prostate cancer with fewer side effects. But we don’t yet know for sure if HIFU is more effective than traditional treatments so it will be important to carry out further studies involving a larger number of patients followed over a longer period of time to truly compare the long term effectiveness of this treatment."

High-Intensity-Focused-Ultrasound or HIFU uses high frequency sound waves to heat up small accurately-targeted amounts of tissue to a temperature of 80-90?C. It can be used to treat the whole prostate, as in this study, or just the cancer areas.

Professor Peter Johnson, chief clinician at Cancer Research UK, said: "This technique needs careful evaluation to make sure that it can produce the same results as the proven treatments for early prostate cancer. If the treatment can be shown to have less side effects then that will be excellent news, but more research is needed to show this. Cancer Research UK is funding a trial to look at this question and we hope that further studies can be carried out to compare HIFU to standard treatments".

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References

 Ahmed, H. et al (2009). High-intensity-focused ultrasound in the treatment of primary prostate cancer: the first UK series British Journal of Cancer, 101 (1), 19-26 DOI: 10.1038/sj.bjc.6605116

Notes to Editor

The senior investigator for this trial was Dr Mark Emberton, clinical director for cancer services at University College London Hospitals NHS Foundation Trust (UCLH).

To search for UK cancer trials visit Cancer Research UK's clinical trials database on our patient information website CancerHelp UK (www.cancerhelp.org.uk) or call Cancer Research UK’s specialist information nurses on freephone 0808 800 4040. Lines are open from 9am to 5pm, Monday to Friday.

About HIFU

HIFU doesn't pass through either solid bone or air so it can not treat every type of cancer. It has been tested on prostate cancer, kidney cancer, primary and secondary liver cancer, pancreatic cancer and bladder cancer. NICE guidelines in 2008 state that HIFU is only available through clinical trials, or provided the treatment data is put into a national urology registry.

UKHIFU Ltd is the exclusive UK distributor of the Sonablate ®500 HIFU device which is used at UCLH. The team of technologists at UKHIFU are available to answer technical treatment related questions from doctors, patients and other interested parties on 01761 415570 or info@ukhifu.co.uk, or go to the website for more information www.ukhifu.co.uk

About University College London Hospitals NHS Foundation Trust (UCLH)

University College London Hospitals NHS Foundation Trust (UCLH), situated in the West End of London, is one of the largest NHS trusts in the United Kingdom and provides first class acute and specialist services.

The new state-of-the-art University College Hospital which opened in 2005, is the focal point of the trust alongside five cutting-edge specialist hospitals.

The Trust is committed to research and development and forms part of UCL Partners which in March 2009 was officially designated as one of the UK's first academic health science centres by the Department of Health.

About UCL (University College London)

Founded in 1826, UCL was the first English university established after Oxford and Cambridge, the first to admit students regardless of race, class, religion or gender, and the first to provide systematic teaching of law, architecture and medicine. UCL is the seventh-ranked university in the 2008 THES-QS World University Rankings, and the third-ranked UK university in the 2008 league table of the top 500 world universities produced by the Shanghai Jiao Tong University. UCL alumni include Marie Stopes, Jonathan Dimbleby, Lord Woolf, Alexander Graham Bell, and members of the band Coldplay. UCL currently has over 12,000 undergraduate and 8,000 postgraduate students. Its annual income is over £600 million.