Forum for Science, Industry and Business

Sponsored by:     3M 
Search our Site:

 

Focal therapy offers middle ground for some prostate cancer patients

06.03.2013
Men with low-risk prostate cancer who previously had to choose between aggressive treatment, with the potential for significant side effects, and active surveillance, with the risk of disease progression, may have a new option.

Focal laser ablation uses precisely targeted heat, delivered through a small insertion and guided into the prostate by magnetic resonance imaging, to burn away cancerous cells in the prostate.

A small, phase 1 trial, to published early online in the journal Radiology, found that this approach, designed to treat just the diseased portion of the prostate rather than removing or irradiating the entire gland, is safe and can be performed without the troubling complications associated with more aggressive therapies.

None of the nine men treated in the study had a significant side effect. Six months after therapy, seven of the nine patients (78%) no longer had evidence of cancerous tissue in biopsies of the treated area.

"Focal therapy is the male version of a lumpectomy for breast cancer," said study author Scott Eggener, MD, associate professor of surgery at the University of Chicago Medicine. "Rather than removing the entire organ, we are testing this less-invasive way of destroying just the cancer and leaving healthy tissue in place."

"This experimental approach appears to combine the most attractive element of treatment, eradication of the cancer, with the most appealing element of active surveillance, maintaining quality of life," said Aytekin Oto, MD, professor of radiology and chief of abdominal imaging at the University of Chicago Medicine. "These early safety results are promising, but we definitely need longer-term data."

More than 2 million American men have been diagnosed with prostate cancer. Due to prostate specific antigen testing (PSA), most of these cancers are detected early, long before they cause symptoms. Because this cancer occurs primarily in older men, treatment with radiation or surgery is not always necessary as these are man are much more likely to die from another cause than from prostate cancer.

But many healthy men who are relatively young, with a life expectancy greater than 10 years, are not comfortable deferring treatment of a potentially lethal disease. Surgery and radiation can often cure the cancer, but can cause side effects, such as incontinence, impotence and decreased bowel function.

This study enrolled nine men with biopsy-confirmed, low-risk prostate cancers (Gleason score 6 or 7, less than 12 mm of cancer) with an MRI of the prostate showing a small area of cancer. Patients were treated under conscious sedation while lying in an MRI scanner. After injecting a local anesthetic, the physicians inserted a small catheter across the perineum and used it to guide a tiny optical fiber, the laser and a cooling device into the prostate.

Under MRI guidance, the laser was positioned within the cancer and used to heat the area to a temperature that would kill cancer cells. The team checked the temperatures outside the treatment region every five seconds to protect healthy tissue, especially those near critical structures such as the urethra and rectal wall.

The entire procedure took less than four hours. That decreased to 2.5 hours as the team gained experience. The actual heat treatment averaged 4.3 minutes. All patients left the hospital the same day.

No patient had a major complication or a serious adverse effect. Average scores for urinary or sexual function were not significantly different one, three or six months after treatment. No patient had symptoms of rectal wall damage.

Biopsies of the treated areas six months after the procedure found no evidence of prostate cancer in seven of the nine patients (78%). The other two patients had small (2.5 mm and 1 mm) remaining cancers.

These are preliminary results, the authors caution, following a small number of patients for a short time. It will take much longer follow-up, the authors say, to fully evaluate this approach.

Focal laser ablation is the lastest in a series of efforts to target just the cancer cells and preserve normal areas of prostate. It appears to offer "measurable advantages over other ablative therapies for focal prostate treatment, namely that we can visualize our treatment as it is happening," according to the study authors.

Laser-induced heating can destroy cancer cells with little damage beyond the precisely targeted zone. The approach is well suited for prostate tissue and can be carefully watched in real-time with magnetic resonance imaging, which can also monitor the generation and consequences of the heat treatment.

A phase 2 trial of this procedure, sponsored by the National Institutes of Health, is now underway at the University of Chicago Medicine. The physicians hope to enroll 27 patients. Details are available at the NIH's ClinicalTrials.gov website, identifier: NCT01792024.

The paper, "MR Imaging-guided Focal Laser Ablation for Prostate Cancer: Phase I Trial," appears as an early release in Radiology [doi:10.1148/radiol.13121652]. The study was supported by a research grant from the Partnership for Cures Foundation and by Visualase, the manufacturer of the imaging software and laser ablation tools used in this study. Additional authors include Gregory Karczmar and Walter Stadler of the University of Chicago, and Ila Sethi, Roger McNichols, Karko Ivancevic and Sydeaka Watson of Visualase.

John Easton | EurekAlert!
Further information:
http://www.uchospitals.edu

More articles from Health and Medicine:

nachricht Routing gene therapy directly into the brain
07.12.2017 | Boston Children's Hospital

nachricht New Hope for Cancer Therapies: Targeted Monitoring may help Improve Tumor Treatment
01.12.2017 | Berliner Institut für Gesundheitsforschung / Berlin Institute of Health (BIH)

All articles from Health and Medicine >>>

The most recent press releases about innovation >>>

Die letzten 5 Focus-News des innovations-reports im Überblick:

Im Focus: Long-lived storage of a photonic qubit for worldwide teleportation

MPQ scientists achieve long storage times for photonic quantum bits which break the lower bound for direct teleportation in a global quantum network.

Concerning the development of quantum memories for the realization of global quantum networks, scientists of the Quantum Dynamics Division led by Professor...

Im Focus: Electromagnetic water cloak eliminates drag and wake

Detailed calculations show water cloaks are feasible with today's technology

Researchers have developed a water cloaking concept based on electromagnetic forces that could eliminate an object's wake, greatly reducing its drag while...

Im Focus: Scientists channel graphene to understand filtration and ion transport into cells

Tiny pores at a cell's entryway act as miniature bouncers, letting in some electrically charged atoms--ions--but blocking others. Operating as exquisitely sensitive filters, these "ion channels" play a critical role in biological functions such as muscle contraction and the firing of brain cells.

To rapidly transport the right ions through the cell membrane, the tiny channels rely on a complex interplay between the ions and surrounding molecules,...

Im Focus: Towards data storage at the single molecule level

The miniaturization of the current technology of storage media is hindered by fundamental limits of quantum mechanics. A new approach consists in using so-called spin-crossover molecules as the smallest possible storage unit. Similar to normal hard drives, these special molecules can save information via their magnetic state. A research team from Kiel University has now managed to successfully place a new class of spin-crossover molecules onto a surface and to improve the molecule’s storage capacity. The storage density of conventional hard drives could therefore theoretically be increased by more than one hundred fold. The study has been published in the scientific journal Nano Letters.

Over the past few years, the building blocks of storage media have gotten ever smaller. But further miniaturization of the current technology is hindered by...

Im Focus: Successful Mechanical Testing of Nanowires

With innovative experiments, researchers at the Helmholtz-Zentrums Geesthacht and the Technical University Hamburg unravel why tiny metallic structures are extremely strong

Light-weight and simultaneously strong – porous metallic nanomaterials promise interesting applications as, for instance, for future aeroplanes with enhanced...

All Focus news of the innovation-report >>>

Anzeige

Anzeige

Event News

See, understand and experience the work of the future

11.12.2017 | Event News

Innovative strategies to tackle parasitic worms

08.12.2017 | Event News

AKL’18: The opportunities and challenges of digitalization in the laser industry

07.12.2017 | Event News

 
Latest News

Long-lived storage of a photonic qubit for worldwide teleportation

12.12.2017 | Physics and Astronomy

Multi-year submarine-canyon study challenges textbook theories about turbidity currents

12.12.2017 | Earth Sciences

Electromagnetic water cloak eliminates drag and wake

12.12.2017 | Power and Electrical Engineering

VideoLinks
B2B-VideoLinks
More VideoLinks >>>