MedicalResearch.com Interview with:
Prof. Hashim Ahmed
Professor and Chair of Urology
Imperial College London
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: Men with localised clinically significant prostate cancer currently undergo radical (whole gland) surgery or radiotherapy. These treatments are effective but can cause urine leakage in 5-30% and erectile dysfunction in 30-60%. Radiotherapy can cause rectal problems in 5%.
So, although there is benefit in treating the cancer in these men, the side effects significantly affect the quality of life.
MedicalResearch.com: What should readers take away from your report?
Response: Focal therapy using high intensity focused ultrasound or HIFU can be safely and effectively used to treat men who would otherwise need to have surgery or radiotherapy. It is used to treat areas of cancer alone rather than the whole prostate so collateral tissue damage is limited.
At 5 years average follow up it is as effective as traditional whole gland therapies.
The side effects are much lower. Urine leakage occured in only 2% whilst erectile dysfunction occurred in 15% of men. Rectal problems were rare.
MedicalResearch.com: What recommendations do you have for future research as a result of this work?
Response: Long term data is needed but one could reasonably argue that this data is convincing enough to ensure that all eligible should be made aware of it as a potential option.
Randomised controlled trials comparing focal therapy to whole gland surgery or radiotherapy may also be needed but these trials are notoriously difficult to recruit to.
Disclosure: I have had research funds for trial as well as being a paid expert trainer for new users from Sonacare Inc manufacturers of the HIFU device
I also receive research and trial or procedure training funds from Sophiris Biocorp and BTG/Galil in focal theapy treatments.
Eur Urol. 2018 Jun 27. pii: S0302-2838(18)30431-7. doi: 10.1016/j.eururo.2018.06.006. [Epub ahead of print]
Guillaumier S1, Peters M2, Arya M3, Afzal N4, Charman S5, Dudderidge T6, Hosking-Jervis F7, Hindley RG8, Lewi H9, McCartan N1, Moore CM1, Nigam R10, Ogden C11, Persad R12, Shah K5, van der Meulen J13, Virdi J14, Winkler M15, Emberton M1, Ahmed HU16
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