Soundwave treatment ‘safer’ for prostate cancer

Feb 2022

Blasting prostate tumours with high-energy soundwaves may be safer than surgery or radiotherapy, a major new study shows.

Researchers found that blasting prostate tumours with high-energy soundwaves was just as good at destroying cancer but with far fewer side-effects than current mainstream treatments.

Yet many men, certainly those in the UK, who are eligible for the safer therapy are not told about it by their cancer teams, the researchers warned. Only a few NHS centres, plus some private hospitals, routinely offer focal high-intensity focused ultrasound, or HIFU – which uses powerful beams of sound energy to attack tumours – even though it has been around for over a decade. 

The US Food and Drug Administration has approved HIFU use in prostate cancer treatment, but trials are still ongoing in the US to establish precisely how effective it is. 

During the treatment, doctors give the patient a general anaesthetic and then insert a probe into the rectum. It has a tiny camera on the end to allow them to take precise aim at the tumour, significantly reducing the risk of damage to healthy surrounding tissue seen with both surgery and radiotherapy. 

At the press of a button, the tip of the probe fires an ultrasound beam on to the tumour site on the prostate. The beam generates temperatures of up to 80 Celsius on the surface of the prostate, enough to destroy cancerous cells in the area. Patients may need a second round of treatment before they are declared clear of cancer. 

A team of surgeons at Imperial College London set out to compare HIFU results with surgery to remove the prostate entirely and radiotherapy to the whole prostate. While both are effective cancer treatments, they can also damage surrounding nerves and muscles, as well as the bladder and rectum. 

Up to 30 per cent of men having surgery or radiotherapy end up with long-term urinary or faecal incontinence.  And up to 60 per cent develop erectile dysfunction. 

Researchers analysed outcomes in 1,379 men, with an average age of 66, who were treated with HIFU at 13 hospitals across the UK over the last 15 years. 

None of the men had cancer which had spread beyond the prostate. 

The results, published in the journal European Urology, found that seven years after their ultrasound treatment, all the men were still alive, although some (about five per cent) had needed further follow-up treatment, such as surgery or radiotherapy. 

This ‘failure’ rate, they found, was about the same as in men given surgery or radiotherapy as their first-line treatment. In other words, HIFU is just as effective for many men with prostate cancer, but also much safer. 

Professor Hashim Ahmed, a urologist from the Department of Surgery and Cancer at Imperial who led the study, said:

‘Side effects of surgery or radiotherapy to the whole prostate can leave many patients leaking urine every day, or with erectile dysfunction. And radiotherapy can cause rectal problems. We know that after focal HIFU men recover quickly and have fewer side effects. We can be confident that HIFU is an effective cancer treatment for prostate cancer that should be offered routinely on the NHS.’ 

Dr Deepika Reddy, a fellow researcher, likens the procedure to a lumpectomy in breast cancer – where surgeons only remove or target the tumour site itself, along with a very tiny amount of surrounding tissue where cancerous cells might be lingering. He adds:

‘We treat the one or two cancer areas, rather than the whole prostate. And men only need one or two HIFU sessions to destroy the tumour.’ 

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