Researchers from UCLA say they’ve found a less-invasive procedure than those commonly used now to treat prostate cancer — and it comes with fewer side effects.
The procedure, called “MRI-guided transurethral ultrasound ablation” (TULSA), “would be a major advance [because] it’s less invasive, incidence of side effects is very low, and you can do it as an outpatient procedure in under an hour,” Dr. Ethan Halpern, co-director of the Prostate Diagnostic Center at Jefferson University Hospitals and researcher at the Sidney Kimmel Cancer Center in Philadelphia, tells SurvivorNet.
Read MoreThe Procedure
The goal of the procedure is to “ablate” the prostate, or cause prostate cells to die, presumably killing the cancer as well. In the past, this has most frequently been done using needles while the patient is under anesthesia. More recently, researchers have begun using high-frequency ultrasound to ablate the tissue. In this study, ultrasound treatment was guided using an MRI.The study involved 115 men, median age 65, with localized low- or intermediate-risk gland-confined prostate cancer. They received the treatment to the entire gland. It took an average of 51 minutes each.
After the treatment, cancer was eliminated in 80% of the patients. Seventy-two out of 111 men, or 65%, had no evidence of any cancer at biopsy after one year. Patients saw blood levels of prostate-specific antigen (PSA), a marker of prostate cancer, fell by a median of 95%.
This procedure requires a rod-shaped device which is inserted into the urethra. The device delivers precise doses of sound waves to the diseased prostate tissue, while sparing healthy tissue.
Fewer Side Effects
Traditionally, one of the most challenging side effects when talking about ablating the prostate is impotence, according to Dr. Halpern. “There are neurovascular bundles on the back of the prostate, and they are responsible for erection,” he says. If those bundles are destroyed in the ablation process, impotence will occur.
The other potential side effect when dealing with prostate ablation is problems with the urethra. If the urethra is damaged in the process, patients can experience problems with urination, Dr. Halpern says.
The new treatment could eliminate these problems.
Information about High-Intensity Focused Ultrasound (HIFU)
While the new procedure includes MRI guidance, high-intensity focused ultrasound (HIFU) alone has been used recently to heat and kill cancer cells in the prostate. This relatively new treatment is usually only offered to men with early stage, localized cancer that is in one area of the prostate.
Dr. Patrick Swift, radiation oncologist at Stanford and Clinical Professor of Radiation Oncology-Radiation Therapy, on high intensity focused ultrasound treatments
It's important to note that prostate cancer is often what's called a "multi-focal disease," so it’s rare that a patient has cancer confined just to one area of the prostate. If patients have cancer confined to one area, HIFU can "reset the time clock on the cancer so they can avoid the full treatments until a later date," says Dr. Patrick Swift, a radiation oncologist and clinical professor of Radiation Oncology at Stanford Medicine in Palo Alto, Calif.
The downside? The long-term effectiveness of the treatment is still being determined. Also, HIFU is not widely available. It's mostly offered through clinical trials, and can be very expensive.
Learn more about SurvivorNet's rigorous medical review process.
