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A new way of using sound waves to treat prostate cancer is effective and produces minimal side effects, researchers say.
Guided by MRI, a new ultrasound procedure led to no evidence of cancer after a one-year follow-up in 65% of men in a clinical trial, according to a presentation made this week at the annual meeting of the Radiological Society of North America (RSNA). Cancer nearly or completely disappeared in 80% of the 115 men who received the procedure, the researchers said.
The treatment is called transurethral ultrasound ablation (TULSA), and it takes 51 minutes to perform on average.
"We saw very good results in the patients, with a dramatic reduction of over 90 percent in prostate volume and low rates of impotence with almost no incontinence," said study co-author Steven S. Raman, M.D., professor of radiology and urology, and director of Prostate MR Imaging and Interventions and Prostate MR Imaging Research at the University of California at Los Angeles.
"There are two very unique things about this system," Dr. Raman said. "First, you can control with much more finesse where you're going to treat, preserving continence and sexual function. Second, you can do this for both diffuse and localized prostate cancer and benign diseases, including benign hyperplasia."
Prostate cancer is the most commonly diagnosed cancer in men, according to the CDC, accounting for 101.4 cases out of 100,000 men on average in the year 2016, the latest year provided by the agency for such statistics. It is also the third-deadliest cancer in men, behind lung cancer and colorectal cancer, according to MedicineNet author Pamela I. Ellsworth, MD.
What Is Prostate Cancer?
The prostate is a walnut-shaped gland that is a part of the male reproductive system that wraps around the male urethra at its exit from the bladder, Dr. Ellsworth said. It is partly responsible for producing the liquid portion of semen, and is thus essential to reproduction.
Prostate cancer arises from glandular tissue, Dr. Ellsworth said, adding that this disease commonly affects men over age 50, with risk increasing with age.
According to Dr. Ellsworth, problems with the prostate may start with a variety of symptoms including:
- decreased force of urine stream;
- difficulty starting (hesitancy);
- the need to strain to urinate;
- stopping/starting of the urine stream (intermittency);
- frequent urination;
- pain or burning during urination;
- erectile dysfunction;
- painful ejaculation;
- blood in urine or semen and/or deep back, hip, pelvic or abdominal pain.
Researchers have not been able to identify the exact cause of this cancer. But they have identified factors that increase a man's risk, Dr. Ellsworth said. These include genetic susceptibility, which may be inherited or develop after birth, as well as age, family history, nationality, obesity, and eating a diet that is high in fat and low in fruits and vegetables.
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There are many treatments available for prostate cancer, Dr. Ellsworth said, each with its own strengths and weaknesses. These include:
- Active surveillance
- Surgery (radical prostatectomy: open, laparoscopic, robotic, perineal)
- Radiation therapy (external beam therapy and brachytherapy)
- Focal therapy, including cryotherapy
- Hormonal therapy
- Immunotherapy/vaccine and other targeted therapies
- Bone-directed therapy (bisphosphonates and denosumab)
- Radiopharmaceuticals (radioactive substances used as drugs)
- Research techniques including high-intensity focused ultrasound (HIFU) and others