Ultrasonic ablation of the prostate in the event of cancer would not only demonstrate a reduced recovery time, but would make it possible to avoid serious side effects or major complications such as incontinence or erectile dysfunction.
- Of 100 men followed after ultrasonic prostate removal, 73% did not experience treatment failure or cancer recurrence.
- Ultrasound ablation also improves quality of life, reducing the risk of decreased sexual function and urinary incontinence.
With 50,403 new cases in 2015 in metropolitan France and an estimated 8,207 deaths in 2017, prostate cancer is most common in men over 50.
If the therapeutic options reduced the mortality rate by 4% between 2005 and 2009, the latter remain heavy for the patients to this day. In addition to active surveillance of asymptomatic tumors and external radiotherapy, the main treatment today consists of total prostatectomy, that is to say the surgical removal of the prostate and surrounding tissues. A major operation, during which it is not uncommon for the nerves that control erection and the urinary sphincter to be affected. The result is urinary incontinence and erectile dysfunction in 95% of patients.
If over time, these troubles subside, at least partially, the recovery is often long and requires specific treatments.
It is for this reason that this new study, conducted by the University of Southern California and published in the Journal of Urology offers hope for patients affected by prostate cancer.
According to its authors, ablation of the prostate by high-intensity focused ultrasound (UFHI) would indeed be an effective alternative to surgery or radiation, with fewer side effects observed and a reduced recovery time.
Few treatment failures
To reach this conclusion, the researchers followed 100 men in the United States who underwent an UFHI procedure for prostate cancer between 2015 and 2019. The UFHI outpatient procedure involves focal removal of the prostate. It uses a focused ultrasound beam to raise the temperature inside the prostate to around 90 degrees Celsius to destroy targeted areas of prostate tissue. The procedure takes about two hours and patients are often sent home the same day.
During follow-up, 91% of patients who underwent HIFU ablation managed to avoid total prostate ablation and 73% did not experience treatment failure with cancer recurrence, appearance of metastases or the need for additional hormone therapy, chemotherapy, surgery, or radiation therapy.
A low risk of complications
Above all, radiation ablation helps preserve the quality of life of patients: in the men who participated in the study, no significant decrease in sexual function was observed. There were also no serious adverse events or major complications. Difficulty urinating and urinary tract infection occurred in a small proportion of patients and were treated without major intervention. Patients were generally able to return home the same day as the procedure and resumed their regular activities soon after.
“These positive data allow urologists to use focal HIFU ablation to effectively treat prostate cancer without the inherent side effects of radical therapies, explains Andre Abreu, physician, urological surgeon and first author of the study. We hope this study will encourage prostate cancer patients to talk to their doctor about all possible treatment options to ensure they receive a personalized care plan that meets their individual needs.”
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