NEW HOPE OF BETTER LIFESTYLE OUTCOMES FOR PROSTATE CANCER PATIENTS

‘The best news in 20 years for men with prostate cancer”

A new study has given real hope of better lifestyle outcomes for men suffering with prostate cancer following treatment.   

Doctors at Imperial College Hospital in London, led by Professor Hashim Ahmed and Mr Matt Winkler, have compared new less invasive treatments known as focal therapies against ‘traditional’ radical treatments, such as surgery and radiotherapy.

The results, published in a peer-reviewed journal, show that cancer control is the same as radical surgery at 5 to 8 years after treatment but lifestyle outcomes are better.  

Read the full white paper / study here

Focal therapy targets just the areas of cancer inside the prostate rather than removing or irradiating the entire prostate. This is carried out by focusing ultrasound beams to heat and ablate just the cancerous cells and has been likened to a ‘male lumpectomy’.

In some cases cryotherapy is used instead to freeze and destroy the cancer. These targeted treatment options cause less damage to surrounding tissue so the risk of urine leak and sexual function problems are much lower. There is also dramatically reduced hospital stays and recovery times. 

Even better are the same authors’ findings that in the current Covid-19 pandemic, focal therapy treatment needs far less interaction within the hospital setting and proved safer in cases treated during the first UK wave and lockdown.  All treatment is provided within one self-contained area meaning minimal involvement with the rest of the hospital, and being a day stay procedure men can usually go home to recover in the safety of their own homes.   

Focal treatments have actually been in use for several years in a few hospitals in both NHS and private settings, but until this new report was released very little long-term data had been available.  Therefore, until now many clinicians favoured the radical approach believing that recurrence of the disease was less likely, but this study clearly shows that longer term outcomes up to 8 years after treatment are no worse than a similar group of men who had radical surgery, called a prostatectomy. 

Men in the study were treated with high intensity ultrasound (HIFU) which focuses ultrasound waves to a fine point and heats targeted tissue to at least 65 degrees centigrade with millimetre precision.  Some men underwent cryotherapy which similarly only targets the tumour itself using minute balls of ice at minus 40 degrees centigrade or lower. The choice of HIFU or cryotherapy is dictated by the location of the tumour and the size of the prostate itself. 

The well-known actor, Peter Duncan, famed for his daredevil role in Blue Peter and a former UK Chief Scout is a strong advocate for focal therapy. Peter underwent HIFU in 2019 under Professor Ahmed for a prostate cancer diagnosis and is delighted with the outcome.  “I was symptom free but after a poor PSA test and MRI scan detected cancer in my prostate I was originally offered a radical prostatectomy. I rejected this and chose HIFU as a less invasive option. I truly feel as though the cancer never happened now” he said “and I have had only minor after-effects” 

The publication today of this major study by Imperial College London clearly shows that men with cancer that has not spread to other areas, most of whom had medium and high risk cancer, can clearly benefit from less invasive treatment options as much as they would do with whole prostate radical options.  This gives new hope of faster treatment and a better lifestyle outcome for up to 12,000 men every year in the UK with an early diagnosis, and as many as 10,000 more as a salvage treatment for men whose cancer has returned after radiotherapy, all without detriment to long term effectiveness.  

Senior author and prostate cancer surgeon Mr Matt Winkler of Imperial College Healthcare NHS Trust said, “So far, evidence to support widespread use of focal therapy was rather limited. However, having diligently collecting data over the last 10years, we can now for the first time provide comparative evidence of equivalent cancer control rates for 5 to 8 years. While our method does not provide the highest level of evidence, a randomised controlled trial, it is as good as it gets at this point in time.”

Mr Winkler added, “As a prostate cancer surgeon I know far too well the devastating impact of erectile dysfunction or urine incontinence on the lives of many men after prostate cancer surgery. 

We are proud to provide colleagues and affected men with information that may make it easier to avoid radical prostate removal or radiotherapy.”

Professor Ahmed, one of the UK’s most authoritative prostate cancer experts, said “We know that about 1 in 3 patients who have radical surgery for prostate cancer regret their decision afterwards. Often this is due to not being fully informed of options that carry fewer side-effects.” 

“Our study has shown that focal therapy carries up to 10-fold reductions in urine leak and sexual problems. Importantly, for the first time we have shown that it has similar cancer control to radical prostatectomy, at 5-8 years after treatment.”   He added “Whilst focal therapy is not suitable for all patients, there are thousands every year who are suitable and they should be fully informed about it.” 

This study may provide highly welcome news for men with prostate cancer, but the challenge now is to get the equipment to provide focal therapy out into the NHS to provide access for every man who chooses this option.  A charity set up specifically to provide this, Prost8 UK, is launching a campaign this month to raise the funds to deploy 6 new focal therapy suites into hospitals across the UK over the next 18 months at a cost of around £500,000 each, which is much lower than the millions that are required for surgical and radiotherapy equipment. Details can be found on the charity’s website at prost8.org.uk. 

At a time when many men are struggling to be seen in the NHS for even an initial consultation for prostate cancer, let alone be treated, this initiative will bring respite and hope to both the creaking health system and the patients themselves. The charity states that this campaign will bring about the single biggest change in treating men with prostate cancer in more than 20 years.  

Founder of the charity, Paul Sayer, from Southend on Sea has himself undergone focal therapy for his prostate cancer in 2018 at the age of 62 and is now cancer free.  Paul says ‘I was just so lucky to find out about HIFU as my local hospital was just offering me surgery or radiotherapy. I researched my options and found professor Ahmed at Imperial College and I truly owe my lifestyle to him and his team. 

I am all but unchanged from my pre-cancer self.  As a result, I am now driven to make sure as many men as possible know about focal therapy and, more importantly, can access it when needed”. 

In fact, Peter Duncan, who is an ambassador for the charity, has recently produced and appeared in a pantomime film and some of the profits are going to support Prost8.  He added “I continue to do everything I ever did before as well as being plant based andstaying fit. It’s hard to believe that 1000’s of men are unnecessarily undergoing radical treatments leaving them with long-term life-changing after-effects when this incredible alternative exists”. 

 “I am fully supporting the Prost8 charity initiative and am working with them to make sure this happens!”.