To print: Select File and then Print from your browser's menu --------------------------------------------------------------------------------------- Title: Image-Guided Focal Therapy of Prostate Cancer: Presented at CURy URL: http://www.pslgroup.com/dg/21C352.htm Doctor's Guide February 3, 2008
By Chris Berrie BARCELONA, SPAIN -- February 3, 2008 -- Image-guided targeted ablation therapy represents a new concept in the treatment of patients with small-volume, low-risk prostate cancer, and should be more effective than watchful waiting while showing fewer side effects than aggressive conventional therapies, according to an early stage study presented here at the World Congress on Controversies in Urology (CURy). John Trachtenberg, MD, Professor and Fleck Tanenbaum Chair of Prostatic Disease, Department of Surgery, Division of Urology, University of Toronto, Toronto, Canada, said, "We need to find a way to treat this low-risk, low-volume prostate cancer that will have the best balance of cancer control and maintenance of quality of life." In an oral session on February 2, Dr. Trachtenberg presented the results of research on behalf of the Prostate Focal Therapy Development Team. This initial primary therapy trial enrolled eight patients who would have been candidates for active surveillance: biopsy-proven, solitary focus, low-risk prostate cancer, with Gleason score of 6 or less, one or two positive cores in a single sector, stage T1c disease, and PSA <10 ng/mL. Following multiparametric magnetic resonance imaging (MRI) to locate the tumour, a standard brachytherapy set-up was used with a transrectal ultrasound probe. This enabled targeted insertion of the treatment probes for the photothermic therapy using an Indigo Optima laser. Temperature probes positioned at the expected ablation boundary ensured complete treatment of the target volume, and contrast-enhanced ultrasound allowed real-time monitoring. This 20-to-30 minute treatment sees the target tissue heated to 55 °C, with final treatment effects measured by tissue devascularisation after 1 week with gadolinium-enhanced MRI and a 6-month biopsy. Patients were treated as outpatients and had no perioperative complications; there have also been no postoperative complications after 1 to 18 months of follow-up. Patients maintained normal potency and continence, and were discharged without a catheter. After discharge, they had no urinary, rectal, or erectile complications. All eight of these target lesions were seen to have been destroyed on MRI, which for the mean pretreatment tumour volume of 0.35 mL, showed the mean volume of devascularised tissue on follow-up MRI as 2.4 mL. In a follow-up biopsy, one patient showed a Gleason 7 tumour in the contralateral prostate, for which he had an uncomplicated lap radical prostatectomy. This interstitial laser thermal therapy is thus technically feasible and easy to perform in an outpatient setting, while avoiding potential morbidities of whole-gland therapies, such as radical surgery or radiotherapy, and allowing patients with low-volume disease to have their cancer removed. However, as prostate cancer is multifocal, Dr. Trachtenberg noted that this treatment will only be effective if it is applied in conjunction with a strategy of active surveillance coupled with a holistic approach to cancer prevention and repeat treatment when necessary. [Presentation title: Image-Guided Focal Therapy of Prostate Cancer. Abstract 12] --------------------------------------------------------------------------------------------- Copyright © 1999 P\S\L Consulting Group Inc. All rights reserved. Republication or redistribution of P\S\L content is expressly prohibited without the prior written consent of P\S\L. P\S\L shall not be liable for any errors, omissions or delays in this content or any other content on its sites, newsletters or other publications, nor for any decisions or actions taken in reliance on such content. --------------------------------------------------------------------------------------------- This news story was printed from *Doctor's Guide to the Internet* located at http://www.docguide.com --------------------------------------------------------------------------------------- Return to News Story Page This site is maintained by webmaster@pslgroup.com Please contact us with any comments, problems or bugs. All contents Copyright (c) 1998 P\S\L Consulting Group Inc. All rights reserved.