UPDATE - Issue 31 - Autumn 2007
Research into third way
The choice for men who have prostate cancer that has not spread outside the gland is between active surveillance and treating the whole gland with surgery or radiotherapy.
Active surveillance involves monitoring the disease using blood tests and repeated biopsies every 2-3 years. Treatment is given only if the cancer shows signs of progressing.
Whole-gland treatment, on the other hand, reduces the risk of dying from the cancer, but carries the risk of incontinence, impotence and rectal problems.
The programme of research Prostate UK has been funding at University College Hospital, under Mr Hashim Ahmed is intended to find out if prostate cancer management can be developed in a similar way to how breast cancer treatment changed two decades ago. Today many women have lumpectomies rather than the whole breast removed. He asks 'for men with prostate cancer that is located to only one side, can we destroy only that side and achieve lower side-effects? At the same time, can we maintain good cancer control? We treated 15 men and so far all have had excellent return of erections (100%, although 3 have required viagra or viagra-like tablets) and no incontinence. These are very promising early results. We need to complete the follow-up of these men to at least one year after treatment and if this shows good results, we can run a larger multicentre trial looking at longer follow-up.'
Readers may find it of interest that Mr Ahmed's team have also set up a focal High Intensity Focused Ultrasound trial (not funded by the charity) evaluating the toxicity of treating just the areas of cancer in men who have bilateral disease.