Targeted prostate cancer therapy matches surgery but with fewer side effects, 10-year NHS study finds

A less invasive therapy for prostate cancer is just as effective as surgery or radiotherapy but carries a lower risk of side effects, according to a major 10-year NHS study led by Imperial College London (https://www.bbc.com/news/articles/cwyq3lnndvxo). The treatment, known as focal therapy, uses high-intensity focused ultrasound or freezing (cryotherapy) to destroy cancerous tissue rather than removing or irradiating the whole prostate.

Researchers followed nearly 3,500 men who received focal therapy. Nearly all had intermediate- or high-risk prostate cancer, yet 10 years after treatment only two had died from the disease. The outcomes were as good as surgery or radiotherapy, with less than half the risk of side effects such as urine leakage or loss of sexual function, the study reported.

Joint senior author Prof Hashim Ahmed, a consultant urologist at Imperial College London and Imperial College Healthcare NHS Trust, said the findings demonstrated that "focal therapy delivers excellent long-term cancer control across a broad range of patients" and made "a compelling case for more centres to offer this treatment" (https://www.bbc.com/news/articles/cwyq3lnndvxo).

Despite the results, focal therapy is not routinely approved by the health regulator NICE, largely because long-term evidence had been limited; routine NHS access is currently restricted to 10 centres in England, a situation campaigners have condemned as a "postcode lottery." Prostate Cancer UK called on NICE to review the evidence, noting that serious side effects such as incontinence and sexual problems are a major reason the UK lacks a prostate cancer screening programme (https://www.bbc.com/news/articles/cwyq3lnndvxo). Last month the government committed up to £2.8m to expand focal therapy provision in England.

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