Prostate cancer ultrasound treatment as effective as surgery or radiotherapy

Using high energy ultrasound beams to destroy prostate cancer tumours may be as effective as surgery or radiotherapy, but with fewer side effects | European Urology | via ScienceDaily

A new study, carried out at six hospitals across the UK, tracked 625 men with prostate cancer who received a type of treatment called high-intensity focused ultrasound (HIFU).

The research, published in the journal European Urology, is the largest ever study of HIFU treatment used to target prostate tumours. The treatment is similar to a ‘lumpectomy’ for other cancers — where doctors remove only tumour cells, leaving as much healthy tissue as possible.

The findings, from a number of institutions including Imperial College London and University College London, found that after five years the cancer survival rate from HIFU was 100 per cent. Approximately, 1 in 10 men needed further treatment. The cancer survival rate from surgery and radiotherapy is also 100 per cent at five years.

The research also showed the risk of side effects of HIFU, such as urinary incontinence and erectile dysfunction, were lower than other treatment options, at 2 per cent and 15 per cent respectively.

Full story at ScienceDaily

Journal reference: Guillaumier, S. et al. | A Multicentre Study of 5-year Outcomes Following Focal Therapy in Treating Clinically Significant Nonmetastatic Prostate Cancer |European Urology, 2018

Trial of prostate cancer saliva test

A new test which uses saliva to identify men with a high risk of developing prostate cancer has been devised by international researchers led by scientists at the Institute of Cancer Research, London.  The DNA test which identifies the 1 per cent who are at highest risk of prostate cancer, and are also six times more likely to develop the disease than the general population. The scientists will now trial the test in 300 patients across three GP practices in London (via The Institute of Cancer Research).

This study has recently been published in Nature Genetics 
Related:

NHS England Time to talk about the prostate cancer risk in black men and what we can do about it

In the media:

The Independent Prostate cancer saliva test could identify men more likely to contract killer disease

BBC News Prostate cancer spit test is trialled
Mirror Simple £10 saliva test to identify the men with 50% chance of developing prostate cancer

Guardian Trials begin of a saliva test for prostate cancer

Rapid cancer diagnostic and assessment pathways

NHS England has published three rapid cancer diagnostic and assessment pathways.  These documents set out how diagnosis within 14 days and diagnosis within 28 days can be achieved for the colorectal, lung, and prostate cancer pathways:

Implementing a timed colorectal cancer diagnostic pathway:

This handbook sets out how the 28 day standard can be achieved in colorectal cancer patients, in preparation for full monitoring against the standard from April 2020.

Implementing a timed lung cancer diagnostic pathway:

This handbook sets out how the 28 day standard can be achieved for lung cancer patients, in preparation for full monitoring against the standard from April 2020.

Implementing a timed prostate cancer diagnostic pathway:

This handbook sets out how the 28 day standard can be achieved for prostate cancer patients, in preparation for full monitoring against the standard from April 2020.

 

PM announces funding for research into prostate cancer

NIHR | April 2018 | Prime minister announces £75 million to support new prostate cancer research

Prostate cancer is the most common cancer in men. It has recently overtaken breast cancer as the third most common cause of cancer deaths in the UK. Now, £75 million funding has been announced by the Prime Minister to support new research into early diagnosis and treatment of prostate cancer.  This will be used to complement and extend research undertaken over the past 15 years by the NIHR, Cancer Research UK, Prostate Cancer UK and the Medical Research Council.

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New studies will  test treatments such as more precise radiotherapy, high-intensity focused ultrasound, and cryotherapy, alongside supportive  interventions including exercise and dietary advice.

They will also particularly target groups at higher risk of prostate cancer, such as black men – one in four of whom will develop the disease – men aged 50 or over, and men with a family history of prostate cancer.

Dr Jonathan Sheffield, Chief Executive at the NIHR Clinical Research Network, said:

“Clinical research brings us closer to the development of new treatments for prostate cancer patients.

“The NIHR will work closely with the NHS, life sciences industry, charities and research funders to support the recruitment of 40,000 men into research studies over the next five years. This will provide more opportunities for earlier access to new drugs and therapies, which will ultimately lead to improved diagnoses and care in the future.”

Full story at NIHR 

In the media:

ITV News PM announces £75m for prostate cancer research

The Guardian Theresa May launches £75m drive against prostate cancer

 

PSA Screening for Prostate Cancer

This article by Scott Gavura discusses the findings of a recent study which concluded that PSA screening for prostate cancer offers no survival benefits | via Science based Medicine

In this article, the author discusses the controversy surrounding PSA testing, and the findings of a new study, “Effect of a Low-Intensity PSA-Based Screening Intervention on Prostate Cancer Mortality”

The study included over 400,000 British men aged 50-69. Men were randomized into an RN appointment, where they were offered information on a PSA test, and if they chose, the test. The other group didn’t invite men for testing. After a 10 year period, the study found that there were more prostate cancers detected from this one-time testing. However, this group was no less likely to die from prostate cancer.

Given there was no difference in mortality between the two groups Gavura asks the question as to whether to PSA screen or not?

PSA
Image source: Cancer Research UK

Full article: Gavura, S | PSA Screening for Prostate Cancer | Science based Medicine

Link to the research: Martin, R. et al .| Effect of a Low-Intensity PSA-Based Screening Intervention on Prostate Cancer MortalityThe CAP Randomized Clinical Trial  | JAMA | 2018 Vol 319(9) p883–895

 

Related: Why a one-off PSA test for prostate cancer is doing men more harm than good | Cancer Research UK

Faster and more accurate diagnosis for prostate cancer

NHS ‘one stop shop’ for prostate cancer means faster and more accurate diagnosis | NHS England

The NHS is using cutting edge technology to help slash diagnosis times for prostate cancer from six weeks to one day in a world-leading new approach that virtually eliminates the risk of deadly sepsis.

The new scanning and diagnosis method means a ‘one-stop-shop’ for suspected prostate cancer, the most common cancer in men in the UK, with over 40,000 new cases diagnosed every year.

The NHS is determined to cut the mortality rate for prostate cancer in the same way that has seen breast cancer rates decline by 10%.

The usual process is an MRI scan followed by a biopsy where around a dozen samples may have to be taken with a needle through the rectum, in order to locate suspect growths on the prostate.

Under the new ‘rapid pathway’ approach, which is being developed in three hospitals across West London, men have a scan, get their results and can have any necessary biopsy, using new FUSION technology, in one day, rather than multiple outpatient visits over four to six weeks.

Full story at NHS England

Improving the Diagnosis of Prostate Cancer

Improving the Diagnosis of Prostate Cancer | The University of York Centre for Health Economics

In diagnosing prostate cancer, the objective is to find the men with clinically significant prostate cancer, who are at high risk of metastases and who benefit the most from immediate treatment.

This economic evaluation examines a model which simulates the long-term costs and health consequences of immediate diagnosis and treatment compared with monitoring. By linking the diagnosis outcomes with the long-term costs and consequences, the model evaluates the costs and health consequences of the different diagnosis strategies over the patients’ expected lifetime.

Full document: Improving the diagnosis of prostate cancer