If you have prostate cancer, your current options for therapy include sitting back and waiting to see if the cancer grows (active surveillance), total removal of the prostate gland, or radiation therapy of the entire prostate gland. The second and third options often results in life-altering side effects such as erectile dysfunction (in up to 50% of patients) or urinary incontinence (in up to 25% of cases).[sup]1[/sup]
A clinic trial being conducted locally by Desert Medical Imaging (DMI) offers a middle ground option through Focal Laser Ablation Therapy which aims to treat only the areas of cancer. It preserves tissue in order to reduce the side effects associated with whole-gland therapy. DMI is the first place in the world to offer this therapy in an outpatient setting.
DMI is over half way through this Phase I study which is approved by an Investigational Review Board. “The first such procedure was done here at DMI in June 2010,” states Dr. John F. Feller, DMI’S Medical Director. “Since then, we have treated 10 patients with none experiencing erectile dysfunction or urinary incontinence. These results are very promising.”
New MRI guided technology for identifying prostate cancer that has emerged in the last 5 years, led to the development of Focal Laser Ablation Therapy for prostate cancer. Feller adds, “We are hopeful that in the next 5 years, focal laser therapy may become more readily available for qualifying patients.”
Those participating in the clinical trial are carefully selected based on specific criteria. Feller indicates that “patients who have biopsy-proven prostate cancer that includes a Gleason Score of 6 or 7 may qualify to participate in the study.”
The entire outpatient procedure takes 2-3 hours. The laser probe is placed trans-rectally into the prostate gland. Using MRI real time temperature imaging, specially-trained physicians are able to target and destroy the prostate cancer by laser without having to remove or radiate the whole gland.
According to the professional medical website, MedScape.com, focal therapy has gained considerable interest worldwide over the last 5 years as a treatment paradigm that could offer the middle ground between surveillance and radical therapies.[sup]1[/sup]
A related study of 4 patients by Mayo Clinic clinicians showed the same promising results. “MRI-guided ablation may prove to be a promising new treatment for prostate cancer recurrences. It tailors treatment modality and duration to lesion size and location and provides a less invasive and minimally traumatic alternative for men,” said lead investigator David Woodrum, MD, PhD, an interventional radiologist at Mayo.[sup]2[/sup]
The remaining question is whether the treatment will reduce mortality rates. Currently, the only data that shows improved patient survival is on radical prostatectomy for treatment of prostate cancer. These studies show that 10 years out, survival rate is improved compared to active surveillance or ‘watchful waiting.’
“Because this technology is new, there is currently no data to show that focal therapy for prostate cancer improves the rate of survival. We do know that the side effects are significantly reduced, but until we can follow our patients for 10 years or more, we will not know whether survival is improved.”
Feller states that it takes 10 years for these studies because prostate cancer is much more slow growing than other cancers. 80% of men who are over 80 years old have prostate cancer, and 1 in 6 men will develop prostate cancer during his lifetime, but only 1 in 35 will die from it. So it is important to distinguish which cancers are non-aggressive, and which are aggressive, prior to any treatment.
Throughout this clinical trial, Feller and DMI Radiologist Dr. Stuart T. May are working closely with the staff of the manufacturer of the laser ablation equipment.
“Our professional team has 40 combined years of experience working with prostate cancer patients. When new technology delivers such promising results, the future starts looking a whole lot brighter.” Dr. Feller concludes, “We are privileged to be conducting this premier study and impressed with the results to date.”
Desert Medical Imaging has four locations throughout the Coachella Valley. For more information call 760-694-9559.
References: (1) www.medscape.com: Is Focal Therapy the Future for Prostate Cancer? Ahmed and Emberton. Future Oncology.2010;6(2):261-8; (2) www.renalandurologynews.com Focal Ablation May Treat PCa Relapses. Schieszer May 21, 2010.