Men with prostate cancer face tough choices: when, or even if, to treat their cancer; what procedure to use; and how to balance their chosen treatment with their quality of life. Now, a new multicenter clinical trial seeks to offer men another option - one that physicians hope will treat prostate cancers with fewer side effects.
As part of that trial, City of Hope has become the first center in the nation to perform a new procedure using a focused beam of ultrasound energy to "ablate" the prostate cancer. Traditional treatment approaches, such as surgery and radiation, are potentially very effective in treating prostate cancer - but some men are left facing incontinence or impotence. (Men with very slow-growing cancers may choose a "watch and wait" approach, monitoring the cancer and determining appropriate interventions if they become necessary.)
In this ultrasound ablation technique, the ultrasound is guided by MRI technology, allowing the ultrasound to be delivered very precisely to the site of the cancer. The imaging provides real-time thermal feedback, which helps physicians determine at the time of the procedure if enough ultrasound was delivered to the targeted area.
"The potential is that if we could provide a focal therapy that has a much lower risk profile compared to standard therapies, this may potentially be an option for men who choose not to 'watch and wait,'" said Jeffrey Wong, M.D., chair of Radiation Oncology at City of Hope and a primary investigator on the trial. "At this time, the treatment is under trial and still being evaluated."
The technology is approved by the Food and Drug Administration to treat painful bone metastases, and has been used in other countries to treat prostate cancer.
Jaime Negrette, who lives in Long Beach, was diagnosed with prostate cancer by a PSA test and sought out an alternative treatment to surgery or radiation. He was treated in mid-November. About six months after treatment, Negrette will know more definitively if the treatment was a success - but so far, he's had no side effects and is doing well.
"I've had friends who have been treated for prostate cancer," he said. "Some men have issues that last long after their prostate was removed, so I was very happy to have another choice."
The trial include men with low-risk prostate cancer, with no more than two areas in the prostate gland involved with cancer. The muticenter feasibility trial is ongoing.
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