Unique Treatment Offers Significant Advance In The Management Of Prostate Cancer
Treatment Options Although prostate cancer is often curable, no man wants to face the loss of healthy bladder, bowel, and erectile function — all possible side effects of traditional treatments, such as radiation therapy and surgery.
Luckily, though, there has been a significant advance in the treatment of the disease for men with localized prostate cancer. A new procedure combines the sophistication of real-time, magnetic resonance (MR) imaging with the precision and accuracy of thermal ultrasound ablation. The treatment holds promise for fewer side effects and a shorter recovery time than traditional treatments.
In this unique procedure, patients are placed in an MRI scanner and surgeons, who are guided by magnetic resonance imaging, use a device to deliver thermal ultrasound energy, which destroys cancer cells in the prostate gland, but does not harm healthy tissue outside the prostate. The MRI system is able to monitor the temperature of the heating pattern in real time during the treatment to ensure millimeter accuracy.
“The exciting thing is that the technology is safe and that it seems to be doing what it’s supposed to do — killing the cancer — with minimal side effects.”
Unlike surgery, a major intervention even if performed with robotic assistance, this procedure takes only about one hour of treatment time and can be carried out as same-day surgery, says Dr. Michael Bronskill, a Co-founder of the Technology and Scientist Emeritus at the Sunnybrook Research Institute. This precise treatment is “much less invasive for the patient, very accurate, and preliminary studies suggest it achieves a significant reduction in undesirable side effects,” he adds.
First phase of clinical trial wrapping up
In April, 2013, this unique procedure was first performed at London Health Sciences Center (LHSC) as part of the TULSA (Transurethral Ultrasound Ablation) clinical trial approved by Health Canada to evaluate the safety and feasibility of the ablation device to destroy prostate tissue. The results of the first phase of the study, which treated 30 patients with localized prostate cancer in three different centres (London, Michigan, and Germany), are still being analyzed.
Although there are still a lot of unknowns, “the exciting thing is that the technology is safe and that it seems to be doing what it’s supposed to do — killing the cancer — with minimal side effects,” says Dr. Joseph Chin, Chief, Surgical Oncology, LHSC, and principal investigator of the study. The second phase of the trial, will focus on the effectiveness of the actual treatment, says Chin. If proven effective at destroying cancer, the treatment’s main advantage is that it could minimize side effects like urine leakage or erectile dysfunction, says Chin. On the down side, Chin notes that treatment could only be carried out in health centres with MRI units.
An example of success
One of Chin’s patients, Brian Danter, a youth pastor and musician from Windsor, was the second patient to be treated in the study. Everything has gone so well that, “I feel like I’m 18 years old again,” says the 63-year-old, who had lived with prostate cancer for about five years and was potentially facing surgery if his PSA (Prostate-Specific Antigen) levels had risen much higher. Danter’s biggest concern about surgery was erectile dysfunction. “Psychologically, that has an effect on you.”
Instead, Danter was given the chance to participate in the treatment. “I can’t say it enough,” he says. “I feel extremely fortunate that I had this treatment. I recovered very, very quickly.” Although he was told that it would likely take six months for his sexual activities to get back to normal, they actually returned within two months. In addition, Danter’s PSA levels have dropped dramatically.
“Living life is important to me,” says the father of seven and soon-to-be grandfather.