Less radical treatment options for prostate cancer are becoming increasingly important as younger men are being diagnosed with the disease. As reported in a new article in the journal Nature Clinical Practice Oncology , the increase in young patients is partly a result of better detection methods. The article, co-authored by LUA urologist Mark Emberton, notes that in many of these cases, the cancer is detected an early stage that affects a very small amount of tissue. Therefore, less radical treatment methods may be an option. These techniques may also be more likely to preserve sexual function and continence.
The traditional approach for treatment of prostate cancer was radical prostatectomy which is the surgical removal of the entire prostate gland. It was believed that most prostate cancers were present throughout the entire gland rather than within small isolated tumors. This, combined with the difficulty of precisely locating prostate cancer tumours, has meant that removal of the entire gland has been the standard for managing localised prostate cancer, despite the well known complications of impotence and incontinence.
Recent developments in imaging and ultrasound technology have allowed more comprehensive prostate biopsies which then allows more accurate mapping of the precise location of a tumour. Once the tumour has been located, focal therapy using high intensity focused ultrasound (HIFU) can be used to destroy the diseased tissue.
The article concludes that A significant proportion of men with organ confined,
low to moderate risk prostate cancer may be spared from disease progression and
have a high probability of preserving genitourinaryand bowel function with focal therapy.
This article was co-authored by LUA urologist Mark Emberton, who specialises in benign and malignant disease of the prostate. LUA performs HIFU for prostate cancer at the Princess Grace Hospital, London.