| TARGETED
CRYOABLATION OF THE PROSTATE (TCAP): PROPOSED TRIAL INVESTIGATING
THE QUALITY OF LIFE, MORBIDITY AND EFFICACY.
David Haines The Norfolk & Norwich Hospital |
 |
Long Term outcome in Patients having undergone TCAP as Primary Treatment or as Salvage Treatment post Radiotherapy
Cryoablation “freezes” the prostate by placing liquid nitrogen probes directly into the gland through what was initially an open incision. Nowadays the probes are inserted directly into the prostate, through the perineum, (the area behind the scrotum); their placement there being guided by ultrasound probes positioned in the rectum.
As a relatively new treatment, cryoablation is still “investigative” in the UK. This research simply aims to add to our knowledge by looking at its use in three groups of patients.
- Patients who’ve failed radiotherapy and who have proven local recurrences but no metastatic disease.
- Patients who would be offered radical surgery were cryoablation not available.
- Patients with advance local disease but no involved lymph nodes who would otherwise be offered radiotherapy.
The funding provided by this grant helps fund a “stepper”; an expensive piece of equipment designed to hold the freezing probes in place at the perineum.
Second quarterly update on the progress to date with the trial (October 2006):
1. Mr Edwin Ho, Consultant Urology Surgeon has attended a course of training in Europe in the technique, and our second surgeon, Mr Robert Mills, is due to complete his familiarisation next week. This will give us the optimum requirement of two experienced consultant surgeons available to conduct the trial.
2. The first candidate patient in Norfolk has been identified, assessed, and is now awaiting treatment as soon as training, preparations and equipment deliveries are complete. It is hoped that this will be possible by the end of this month. Other patients are being identified prior to assessment.
3. We have experienced some delays in equipment procurement and delivery, due to circumstances beyond our control, but remain optimistic that the first patients will shortly be able to demonstrate the benefits offered by this promising treatment, and firm results will progressively become available during the current financial year ending April 2007.
Third quarterly update on the progress to date with the trial (January 2007):
The trial is now under way, and the first two patients were treated on 11th December. Mr Edwin Ho, the surgeon conducting the trial, has reported that all went well, with the patients being discharged after overnight observation, and to date no problems have come to light, although they will be monitored for some time to come.
Mr Ho has also told us that the next two patients will be treated on 18th January, and others are being assessed for suitability.
The financial problems at both the NNUH and the newly formed Norfolk PCT have not been resolved; the NPCT has an inherited debt of £50m, (the reduction of which under Government pressure seems to be the first priority). This has consequent impacts on funding pioneering work of this type, and we may well have to review the extent of our own financial support to the trial, should a cash flow problem arise.
Thank you once more for your interest and support to this vital work.
Research interim report dated 06 January 2007
Project 2005/03