Britain has launched a transformative trial for a prostate cancer treatment that has fewer side effects and which could work as well as if not better than traditional surgery, say experts.
Backed by the government-funded National Institute for Health and Care Research (NIHR), the trial will examine whether Aquablation – a therapy using robotics, AI and real-time imaging – is as effective or even surpasses traditional radical prostatectomy, reports The Independent.
Radical prostatectomy involves removing the entire prostate gland, and is recommended and works well for men whose cancer has not spread outside the prostate gland or has spread to the area just outside the gland.
But the surgey carries a risk of serious side effects, like infection, erectile dysfunction and urinary problems, and researchers hope Aquablation will minimise these issues.
The therapy is currently used in some centres to treat benign prostatic hyperplasia (BPH).
Aquablation involves a robotic-assisted, high-pressure waterjet. Surgeons can also map the entire prostate in real time with ultrasound.
Using the technique, medics find cancerous tissue to remove while avoiding surrounding nerves and muscles associated with erectile function and the bladder.
The Royal Marsden NHS Foundation Trust in London is the first hospital in Europe to recruit a patient to the trial, which is being run in seven countries.
Overall, 280 patients will be recruited globally, all with early-stage, localised prostate cancer who have already decided to have surgery.
Philip Charlesworth, consultant urological surgeon at the Royal Marsden, said: “For men with prostate cancer confined to the prostate, curative options are excellent, however, we are becoming increasingly focused on the side-effects of the treatment and how we can embrace new technology to maintain a man’s quality-of-life after surgery.
“This trial is measuring Aquablation therapy, with a robotic approach to surgically remove the cancer, and to preserve a man’s ability to remain continent and maintain sexual activity.
“The potential is very exciting, and could, depending on the results, add an alternative surgical treatment option for patients with localised prostate cancer.
“The ultimate aim, and my passion, is to improve prostate cancer treatments so that they cause less harm and are less invasive.”
Other potential treatments for localised prostate cancer include active surveillance or monitoring of the cancer and radiation.
The new trial is sponsored by US company Procept BioRobotics.
More than 25 centres globally are recruiting patients for the trial.
The trial comes after Health Secretary Wes Streeting said recently he was “surprised” by the decision from scientific advisers to limit prostate cancer screening.
In a draft recommendation, the UK National Screening Committee (UKNSC) had said prostate cancer screening should not be made routinely available for the vast majority of men in the UK.
It said it would not recommend population screening using the prostate-specific antigen (PSA) test because it “is likely to cause more harm than good”.
Experts are expecting data within two years from a large trial launched by Prostate Cancer UK into whether combining PSA with other tests, such as rapid MRI scans, could lead to a recommendation for population-wide screening.
For now, the committee will put forward only a recommendation to screen men with BRCA1 and BRCA2 genetic mutations – which puts them at far higher risk of prostate cancer – every two years, between the ages of 45 and 61.
Many experts argue that the PSA test is not very reliable because men with a high PSA level may not have cancer, and some men with cancer have a normal PSA result.
A positive test result may lead to unnecessary treatment for slow-growing or harmless tumours, leaving men at risk of side effects such as incontinence and erectile dysfunction.
But others argue that current evidence supports wider testing.
See more from MedicalBrief archives:
PARP inhibitors under-used for prostate cancer – Utah study
Genetics put African men most at risk of prostate cancer
Prostate cancer ‘over-diagnosed’ across Europe – global experts
Routine prostate cancer testing not recommended – international panel