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'Game changing' surgery could cure prostate cancer

Author
Daily Telegraph UK,
Publish Date
Mon, 3 Jan 2022, 3:34PM
Photo / Getty Images
Photo / Getty Images

'Game changing' surgery could cure prostate cancer

Author
Daily Telegraph UK,
Publish Date
Mon, 3 Jan 2022, 3:34PM

Prostate cancer could be cured with a "game changing" one-hour operation that uses electric currents to destroy the most difficult to reach tumours. 

The pioneering treatment has been used to treat the disease for the first time on the NHS, with surgeons saying the breakthrough could offer hope to thousands of men. 

One in six men will be diagnosed with prostate cancer during their lifetime, with more than 50,000 cases detected each year. 

Treatments offered normally involve surgery to remove the prostate, or radiotherapy, both of which can cause distressing side-effects such as problems with urination, incontinence and loss of sexual function. 

Surgeons said the new therapy, called NanoKnife, which has been used to treat prostate cancer patients at University College London Hospital (UCLH), was "amazingly simple and quick". 

Charities said up to 20,000 men a year diagnosed with localised disease could be helped by more targeted treatments and called for more research so the use of such methods can be expanded. 

It comes as Britain faces record backlogs of patients needing treatment. Diagnoses of prostate cancer fell by almost one quarter during the pandemic, with research suggesting there were about 15,000 "missing" cases yet to be found, and there are widespread delays to starting treatment. 

Experts said the new treatment was far less invasive, meaning it could be carried out more quickly and with fewer distressing side effects. 

The technique – called irreversible electroporation - administers quick electrical pulses into the tumour, cutting open the membrane of the cancer cells without the need for any kind of cut or incision. It means treatment can be targeted with ultra-precision, posing fewer risks to surrounding organs. 

It can also be used on tumours that were previously difficult to treat. 

Surgeons at UCLH have now carried out the first six operations for prostate cancer on the NHS. 

Professor Mark Emberton, a UCLH consultant urologist, said: "This offers us a new class of therapy, it's a completely new way of destroying cells. The beauty of it is that it's such a simple technique to train surgeons in - that makes it a game changer." 

Emberton, one of the country's leading prostate surgeons, said this gave it the potential to become a standard treatment. 

Targeted treatments, known as "focal" therapies, which also include the freezing technique cryotherapy and focused ultrasound, are currently only available in major specialist centres. 

"At the moment you can only get focal therapies in a few centres in the south of England - which is terrible," Emberton said. 

"Around a third of men with prostate cancer could benefit from some type of focal therapy but only a tiny fraction of them even get a discussion about it." 

Emberton said he hoped to see a rapid uptake of the therapy at hospitals across the country, as part of efforts to tackle a huge cancer backlog. 

"It's an amazing treatment – so quick. And it means we can reach tumours that are beyond where the knife can reach." 

Because the treatment can be done as a day case, and in less than an hour, surgeons can carry out at least twice as many procedures in the time it would normally take to do one traditional operation, and without a hospital stay. 

"At times like this, when the NHS is under great pressure, day surgery avoids the need for overnight stays in hospital and means that we can use our operating theatres more efficiently," he said. 

Alistair Grey, the consultant urologist who led the first operations, said: "What is very exciting about this treatment is its precision in targeting and attacking the cancerous cells, without damaging healthy tissue and maintaining the prostate's important functions." 

NanoKnife, as the technology is trademarked by its manufacturer Angio-Dynamics, works by administering quick electrical pulses, using electrodes, around the tumour to kill the cancerous cells. 

Natalia Norori, knowledge manager at Prostate Cancer UK, said: "Early studies suggest that treatments like NanoKnife could effectively treat prostate cancer while also reducing side-effects for men." 

This technology is one of many types of focal therapy on the horizon, which are designed to target the tumour more precisely and limit damage to the rest of the prostate. This could make a big difference to the quality of life of men diagnosed with localised prostate cancer, and it now needs to be tested in much larger trials to see whether it is as effective as traditional treatments." 

Surgeons said the effectiveness appeared similar to other targeted treatments, while side-effects compared favourably. 

Around one quarter of other minimally invasive techniques such as cryotherapy (freezing) and high-intensity focused ultrasound (Hifu) typically require re-treatment at five years. 

So far, three-year data shows that NanoKnife only has a 10 per cent rate of re-treatment. It comes as the NHS faces record backlogs for treatment. 

Analysis by Macmillan Cancer Support shows diagnoses of prostate cancer fell by 22 per cent between March 2020 and August of this year, resulting in 14,473 "missing" cases, and widespread delays starting treatment. 

- by Laura Donnellyy, Daily Telegraph UK

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