A novel prostate cancer treatment, focal therapy, is demonstrating comparable effectiveness to traditional methods like surgery and radiotherapy but with a substantially reduced risk of side effects, according to a new study. This advanced therapy targets cancerous tumors with high precision, minimizing damage to surrounding healthy prostate tissue and nerves crucial for urinary and sexual function.
Former Prime Minister David Cameron and television personality Jeremy Clarkson are among the public figures who have undergone focal therapy. While the treatment shows significant promise, its availability on the UK's National Health Service (NHS) remains limited. Access is currently restricted to a few specialist centers, primarily located in London and the southeast of England. Men outside these areas, without private health insurance, face costs of approximately £15,000 per treatment round or must opt for treatments with a higher likelihood of side effects.
Prostate Cancer UK is advocating for the National Institute for Health and Care Excellence (NICE) to review the latest findings and approve focal therapy for widespread NHS adoption, aiming to eliminate this "postcode lottery."
The study, conducted by Imperial College London, analyzed data from 3,477 men treated with focal therapy, utilizing either high-intensity focused ultrasound (HIFU) or cryotherapy. Over a ten-year period, the study found that only 0.13% of participants died from prostate cancer, and 3.3% experienced metastasis, indicating that focal therapy's cancer control rates are comparable to surgery or radiotherapy.
Crucially, the research identified a five-fold reduction in the risk of side effects such as incontinence, erectile dysfunction, and rectal issues among men receiving focal therapy compared to those undergoing traditional radiotherapy or surgery. Lord Cameron commented on his personal experience, stating that he benefited from a more advanced focal therapy that reduced the risk of life-changing side effects and expressed hope that new evidence will expedite wider access for other men.
Prostate cancer is the most prevalent cancer among men, with over 60,000 diagnoses annually in the UK. For localized prostate cancers, surgery or radiotherapy are common treatments, but they can lead to persistent side effects. These potential harms have been a factor in the UK National Screening Committee's recent recommendation against universal prostate cancer screening for all men. Researchers estimate that focal therapy could be suitable for about half to two-thirds of men with localized prostate cancer, equating to approximately 15,000 men per year, yet only around 1,000 currently receive it.
Amy Rylance, director of health services, equity and improvement at Prostate Cancer UK, highlighted the significance of the study in potentially alleviating devastating side effects and noted that reducing these harms could make a national screening program more feasible. Professor Hashim Ahmed, chair of urology at Imperial College Healthcare NHS Trust, expressed satisfaction with the data, confirming that focal therapies are as effective in controlling cancer as whole-gland treatments while offering a fraction of the side effects.