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Ultrasound May Permit Prostate Lumpectomies, Study Says

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High-intensity focused ultrasound
may offer prostate cancer patients a treatment option with fewer
side effects by targeting tumors better, according to a study
published in the medical journal The Lancet Oncology.

The technology enables doctors to preserve the prostate by
aiming only at the cancerous area in contrast to standard
treatment, such as irradiation or surgical removal of the gland,
which may cause impotence and leakage of urine or feces,
researchers in London said in the study published today. The
technique, also called HIFU, may provide men with an alternative
similar to the lumpectomy, in which doctors remove tumors rather
than the whole organ in breast-cancer patients, they said.

“The signal from this study is quite strong,” Hashim
Ahmed, a urologist at the University College London who was the
report’s lead author, said in a phone interview. “When you look
at the current standard of care, there’s a 1-in-3, or 1-in-2
chance of having the perfect outcome. In this study, after 12
months, it’s a 9-in-10 chance.”

None of the 41 men in the trial reported urine incontinence
and only one in 10 suffered from poor erections 12 months after
the treatment, the researchers said. About 95 percent of the men
were cancer-free after a year, meaning most had a “perfect
outcome” in terms of disease progression and side effects, the
authors said.

Larger Trial

The study was carried out in London and funded by the U.K.
Medical Research Council, the Pelican Cancer Foundation and St.
Peter’s Trust for Kidney, Bladder Prostate Research. Ahmed
said he’s recruiting patients for a larger trial in the U.K. and
is looking for funding.

HIFU is a narrow, focused beam of high-energy sound waves
directed at a cancerous area the size of a grain of rice.
Doctors using magnetic resonance imaging and mapping biopsies to
identify targets and aim the sound waves at affected tissue,
causing it to vibrate and heat to about 80 degrees Celsius (176
degrees Fahrenheit) to kill cells, according to the study.

The procedure was performed in the hospital under general
anesthesia and most patients were home within 24 hours, the
researchers said.

The men in the study were all medium- to high-risk patients
whose cancer was likely to spread within a few years and who
would have faced surgery or radiotherapy and side effects, Ahmed
said. Men who had already received chemotherapy, hormone
treatment or radiation therapy were excluded from the trial.

Smaller Tumors

The technology is “very good for smaller tumors, and it
preserves nerves and blood vessels, which is important for
sexual function,” said Malcolm Mason, a spokesman on prostate
cancer for Cancer Research UK and head of oncology and
palliative medicine at Cardiff University.

HIFU may offer better quality of life for low-risk patients
who, while not needing surgery or radiation, may be anxious
about their condition, Mason said. In these cases, standard
treatment isn’t given unless there’s a change in test results
such as levels of prostate-specific antigen, or PSA. Low-risk
patients may not see their cancer spread for many years.

“Certainly within the prostate field it’s a very
encouraging step,” Mason said. “It doesn’t mean that HIFU is
better and that men should demand HIFU over any other
treatment.”

Cause of Death

Prostate cancer is the sixth most-common cause of cancer
death in men worldwide, according to Cancer Research UK. Other
treatments being used include cryotherapy, where prostate cancer
cells are frozen and destroyed, as well as hormone therapy and
chemotherapy.

HIFU may be cheaper than the standard treatment, Ahmed
said. The cost of the MRI and mapping was an estimated 1,500
pounds ($2,400) and the HIFU procedure totaled 1,000 pounds, he
said. That compares with about 4,500 pounds to remove the
prostate, he said. Fewer side effects would also cost the health
system less, Ahmed said.

The technology may also be applied to other cell-based
cancers such as breast, thyroid, pancreas and liver, Ahmed said.

To contact the reporter on this story:
Allison Connolly in Frankfurt at
aconnolly4@bloomberg.net

To contact the editor responsible for this story:
Phil Serafino at
pserafino@bloomberg.net

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About the Author:

Paul Khunkhun, serving Southern California since 1998. Paul is the owner of MDIS. He is a Board Certified Ultrasound Sonographer with RDCS and RVT credentialing. He is also pending ICAEL accreditation.

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