Prostate Cancer Is Treated Successfully With a New Treatment Option

(CTN News) – MRI and transurethral ultrasound are effective treatments for prostate cancer, according to new research to be presented at Salt Lake City’s Society of Interventional Radiology Annual Scientific Meeting.

Radiation or surgery, which are traditional treatment options, come with a risk of side effects, such as urinary incontinence and erectile dysfunction, which cause significant morbidity and adverse lifestyle consequences. Some patients now have a durable alternative for whole-gland treatment with MRI-guided transurethral ultrasound ablation (TULSA) that is not limited to surgery or radiation in the future.

Steven S. Raman, M.D., FASR, FSIR, professor of radiology, urology, and surgery at UCLA, said TULSA’s success represents a revolution in whole-gland prostate cancer treatment.

A study conducted by TULSA has the potential to change the standard of care for thousands of men with prostate cancer, which effects one in eight men in their lifetimes. We need to do more research, but if validated, TULSA could change the standard of care for many men.

A catheter-like device is inserted through the urethra into the prostate during the TULSA procedure. Following MRI, 10 therapeutic ultrasound elements are precisely positioned inside the prostate using MRI guidance.

As the device rotates around the entire prostate gland, MR thermometry monitors the tissue temperature as it is heated to more than 55 degrees inside the prostate without heating the sensitive nerves surrounding it. A two-to-three-hour procedure can be performed under general or spinal anesthesia as an outpatient or as an inpatient.

Image-guided therapy, says Dr. Raman, maximizes the ability to kill cancer cells while minimizing collateral damage to the prostate, enabling us to achieve the ultimate trifecta in prostate cancer treatment: complete local cancer control, potency and continence in the urine. Patients hate these complications of prostate cancer therapies because they are caused by a lack of precision in treatment monitoring.”

Prostate-specific antigen levels (PSA), which are markers for cancer, were reduced among participants in the prospective observational study.

At one year after TULSA, 76% of patients had undetectable cancer on follow-up biopsy, and the median prostate volume had decreased by 92%, and PSA had decreased from 6.3 ng/ml to 0.63 ng/ml.

Compared to alternative surgical, radiation, and thermal therapies (US-guided HIFU or cryotherapy), TULSA had a very favorable side-effect profile, with patients retaining continence and erectile function after five years.

115 men from 13 sites in five countries participated in the study. The remaining or newly formed tumors led to the need for follow-up conventional treatment with surgery or radiation in 25 men who were treated.

In the process, researchers discovered that calcifications between the urethra and the target PCa were early predictors of TULSA failure, which led to improved detection and management of prostate swelling, targeting, and misalignment during the procedure, reducing these preventable errors.

According to Dr. Raman, the study confirms that interventional radiologists are well suited to detect and manage prostate cancer as they are with lung, kidney and liver cancers.

Image-guided procedures and ablation experience make IRs an important component of prostate cancer treatment, according to him.

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