The findings of the latest study presented at the annual meeting of RSNA have shown that prostate cancer can be effectively treated by the new MRI-guided ultrasound therapy. This incision-free therapy can destroy cancerous cells causing minimal adverse effects and can also treat benign prostatic hyperplasia.
In males, prostate cancer is the second biggest reason for cancer-related deaths. This disease affects the small gland present (prostate) near the urethra. Treating prostate cancer is quite challenging, as radiation and surgery are not always helpful and can lead to bowel dysfunction, impotence, and incontinence.
Whereas, the other available treatment methods are a deficit of sophisticated temperature monitoring and imaging guidance. But in the past few years, MRI-guided transurethral ultrasound ablation (TULSA) has become apparent as a potential method to treat prostate cancer.
In MRI-guided transurethral ultrasound ablation, the diseased part of the prostate is exposed to particular doses of sound waves. On the contrary, protection from the exposure is provided to the healthy nerve tissue surrounding the gland.
In this treatment method, a rod-shaped device containing 10 ultrasound-generating elements, is introduced into the urethra. Sound waves generated by one or more of these elements can heat and damage the cancerous cells of the prostate gland.
A software algorithm automatically controls these elements and can also regulate the strength, direction, and shape of the ultrasound beam. MRI scanner is used for this procedure so that doctors can analyze the location and degree of heating and closely monitor the treatment process.
According to Steven S. Raman, study co-author, contrary to other available ultrasound systems, this new procedure requires minimal recovery time and allows real-time monitoring of the ultrasound ablation process. Moreover, it can also provide instant MRI feedback on thermal efficacy and dose.
In this study, the research team has described the results of the TULSA-PRO ablation clinical trial (TACT). The TULSA treatment was delivered (for about 51 minutes) to the entire prostate of 115 men, average 65 years old, having localized low or intermediate risk of prostate cancer.
In these individuals, a decrease in the prostate volume was observed 12 months after the treatment. On average, prostate volume was reduced from 39 cubic centimeters to 3.8 cubic centimeters.
In 80 percent of the individuals, there was the elimination of clinically significant cancer. While, on biopsy after one year, 65% of the study participants showed no indication of cancer.
Moreover, there was an absence of bowel complications and incontinence, lower levels of severe toxicity, and a 95% reduction in the blood PSA levels. Whereas, PSA (prostate-specific antigen) acts as a marker of prostate cancer.
This procedure is unique in two ways. Firstly, it can accurately control the area receiving treatment, protecting sexual function and continence. Secondly, it can be used for treating both localize and diffused prostate cancer and benign diseases such as benign prostate hyperplasia.
TULSA also permits further treatment if required. If the procedure fails, it can be repeated and invasive treatment options such as radiation therapy and surgery can still be performed. Moreover, after one year of treatment, TULSA also helps in the accurate detection of residual cancer, ruling out the chances of disease recurrence.