New Radiotherapy Offers Prostate Cancer Treatment With Fewer Side Effects Than Surgery

A novel, non-invasive radiotherapy treatment for prostate cancer is as effective as surgery in controlling the disease but leads to fewer debilitating side effects, according to a recent study. The five-session stereotactic body radiation therapy (SBRT) has shown promising results, with 91% of men experiencing no signs of cancer recurrence after eight years, compared to 84% of those who underwent surgery.

Patients treated with SBRT also reported substantially less urinary incontinence and sexual dysfunction two years post-treatment. These benefits appear to be sustained long-term. After five years, only 8% of men treated with SBRT reported using urinary pads, a significant contrast to the 48% of men who had surgery. Patient-reported sexual function scores also declined in both groups over time, but remained significantly better for those receiving radiation. Erectile function scores five years after treatment were 19 for SBRT patients versus 5 for surgery patients, on a scale where higher scores indicate better function.

The findings come from the PACE-A trial, presented at the annual meeting of the American Society for Radiation Oncology (ASTRO). The study, which involved 123 men with low- or intermediate-risk prostate cancer treated between 2012 and 2022, randomly assigned participants to either radical prostatectomy or five SBRT sessions. SBRT utilizes advanced imaging to precisely target tumors while minimizing exposure to surrounding healthy tissue.

While the study was not designed to definitively declare radiotherapy superior in overall disease control, researchers noted a low number of treatment failures in both arms of the trial. "What we can say is that we saw very few cancer failures in either group, and that we have good data showing excellent cancer outcomes with five-treatment radiotherapy," stated Dr. Nicholas van As, a consultant clinical oncologist and lead author of the study.

This radiotherapy treatment was approved for routine use on the UK's National Health Service (NHS) in June. However, experts suggest that not all patients are adequately informed about their treatment options. "Patients should know that surgery is not their only curative treatment option and have the opportunity to discuss the benefits and side effects of both approaches," Dr. van As added. The study's authors believe these longer-term data provide patients with a more comprehensive understanding of what to expect from each treatment modality.

Prostate cancer is the most common cancer among men, with over 68,000 new diagnoses annually in the UK. Despite its prevalence, proposals for a national prostate cancer screening program were recently rejected by the UK National Screening Committee, citing concerns about potential over-diagnosis and over-treatment.