New Laser Treatment For Prostate Cancer

Prostate Cancer Laser Treatment: What You Need To Know

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When a space-age cure for cancer thats truly transformative and a huge leap forward hits the headlines, its going to catch peoples eyes.

And that was the case for one study published yesterday in the journal Lancet Oncology that received widespread media attention. The results came from a clinical trial testing an experimental laser treatment on men with prostate cancer. And the findings were positive: the therapy is safe to use in these patients.

Thats good news.

But what do the results really mean for men with prostate cancer? We spoke to an expert on prostate cancer, Professor Malcolm Mason, to find out.

The great thing is that this study showed the treatment is safe to give to patients, he says.

So this is a good study that we can now expand on with further research. But for new treatments, the most important thing is to show that they can save lives. This trial didnt show that.

Heres what it did show.

Benefits And Limitations Of Laser Treatment

Lasers have some benefits and drawbacks compared with standard surgical tools. Each persons case is different, so its important to discuss the pros and cons of laser therapy with your doctor to decide if it might be right for you.

Lasers have some advantages and disadvantages compared with standard surgical tools.

Transurethral Resection Of The Prostate

This operation is more often used to treat men with non-cancerous enlargement of the prostate called benign prostatic hyperplasia . But it is also sometimes used in men with advanced prostate cancer to help relieve symptoms, such as trouble urinating.

During this operation, the surgeon removes the inner part of the prostate gland that surrounds the urethra . The skin is not cut with this surgery. An instrument called a resectoscope is passed through the tip of the penis into the urethra to the level of the prostate. Once it is in place, either electricity is passed through a wire to heat it or a laser is used to cut or vaporize the tissue. Spinal anesthesia or general anesthesia is used.

The operation usually takes about an hour. After surgery, a catheter is inserted through the penis and into the bladder. It remains in place for about a day to help urine drain while the prostate heals. You can usually leave the hospital after 1 to 2 days and return to normal activities in 1 to 2 weeks.

You will probably have some blood in your urine after surgery.

Other possible side effects from TURP include infection and any risks that come with the type of anesthesia used.

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The Grade Group And Psa Level Are Used To Stage Prostate Cancer

The stage of the cancer is based on the results of the staging and diagnostic tests, including the prostate-specific antigen test and the Grade Group. The tissue samples removed during the biopsy are used to find out the Gleason score. The Gleason score ranges from 2 to 10 and describes how different the cancer cells look from normal cells under a microscope and how likely it is that the tumor will spread. The lower the number, the more cancer cells look like normal cells and are likely to grow and spread slowly.

The Grade Group depends on the Gleason score. See the General Information section for more information about the Gleason score.

• Grade Group 1 is a Gleason score of 6 or less.
• Grade Group 2 or 3 is a Gleason score of 7.
• Grade Group 4 is a Gleason score 8.
• Grade Group 5 is a Gleason score of 9 or 10.

The PSA test measures the level of PSA in the blood. PSA is a substance made by the prostate that may be found in an increased amount in the blood of men who have prostate cancer.

How Lasers Are Used To Treat Cancer

The word LASER stands for Light Amplification by Stimulated Emission of Radiation.

Laser light is different from regular light. The light from the sun or from a light bulb has many different wavelengths and spreads out in all directions. Laser light, on the other hand, has a single, high energy wavelength and can be focused in a very narrow beam. This makes it both powerful and precise.

Lasers can be used instead of blades for very careful surgical work, such as repairing a damaged retina in the eye or cutting body tissue. They can also be used to heat and destroy small areas , or to activate light-sensitive drugs.

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How Greenlight Laser Prostatectomy Works

GreenLight laser prostatectomy is a procedure in which the excess prostate tissue is removed to relieve constriction of the urethra, allowing easy passage of urine.

During the procedure, which is also known as photoselective vaporization of the prostate , the patient is sedated. The physician passes a cystoscope, a thin tube with a very small camera, into the urethra, the vessel that carries urine from the bladder through the penis and out of the body. A small fiber that transmits laser energy is then passed through the cystoscope.

The laser is used to vaporize excess prostate tissue that is limiting the flow of urine. Most patients can expect very rapid relief of their BPH symptoms, often within 24 hours of GreenLight Laser prostatectomy.

For most men, GreenLight laser prostatectomy is an outpatient procedure, allowing them to return home the same day.

Laser Treatment However Preserves Erectile And Urinary Functions

Date:

University of Texas Medical Branch at Galveston

Summary:

Researchers have shown that selectively destroying cancerous prostate tissue is as effective as complete prostate removal or radiation therapy while preserving more sexual and urinary function than the other treatments.

Researchers from The University of Texas Medical Branch at Galveston, led by prostate cancer treatment pioneer Dr. Eric Walser, have shown that selectively destroying cancerous prostate tissue is as effective as complete prostate removal or radiation therapy while preserving more sexual and urinary function than the other treatments. This study is currently available in Journal of Vascular and Interventional Radiology.

Prostate cancer the second most common form of cancer in men. In fact, 1 in 9 men will be diagnosed during his lifetime. The American Cancer Society estimates 174,650 new cases and 31,620 deaths from prostate cancer in 2019.

With current screening techniques, prostate cancers are now often detected early enough so that with treatment, they stay within the prostate gland and don’t spread or cause harm to the patient. However, aggressive treatments such as removing the prostate or radiation therapy can result in difficulty with urinary and sexual functions.

In 120 men with low- to intermediate-risk prostate cancer treated with FLA, 17 percent needed additional cancer treatment after one year with no noticeable change in quality of life or urinary function.

Story Source:

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Positive Aspects Of Laser Treatment

• Lasers are more precise and exact than blades . For instance, the tissue near a laser cut is not affected since there is little contact with skin or other tissue.
• The heat produced by lasers helps clean the edges of the body tissue that its cutting, reducing the risk of infection.
• Since laser heat seals blood vessels, there is less bleeding, swelling, pain, or scarring.
• Operating time may be shorter.
• Laser surgery may mean less cutting and damage to healthy tissues . For example, with fiber optics, laser light can be directed to parts of the body through very small cuts without having to make a large incision.
• More procedures may be done in outpatient settings.
• Healing time is often shorter.

Limitations Of Laser Treatment

• Not many doctors and nurses are trained to use lasers.
• Laser equipment costs a lot of money and is bulky compared with the usual surgical tools used. But advances in technology are slowly helping reduce their cost and size.
• Strict safety precautions must be followed in the operating room when lasers are used. For example, the entire surgical team and the patient must wear eye protection.
• The effects of some laser treatments may not last long, so they might need to be repeated. And sometimes the laser cannot remove all of the tumor in one treatment, so treatments may need to be repeated.

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After Prostate Cancer Has Been Diagnosed Tests Are Done To Find Out If Cancer Cells Have Spread Within The Prostate Or To Other Parts Of The Body

The process used to find out if cancer has spread within theprostate or to other parts of the body is called staging. The information gathered from the staging process determines the stage of the disease. It is important to know the stage in order to plan treatment. The results of the tests used to diagnoseprostate cancer are often also used to stage the disease. In prostate cancer, staging tests may not be done unless the patient has symptoms or signs that the cancer has spread, such as bone pain, a high PSA level, or a high Gleason score.

The following tests and procedures also may be used in the staging process:

Laser Photodynamic Therapy ‘transforms’ Prostate Cancer Treatment

20 Dec 2016

Combination of near-infrared light and aquatic photosensitizer clears early-stage disease in half of men treated in major European trial.

A large clinical trial across 47 European hospitals has shown laser photodynamic therapy to be an effective treatment for early-stage prostate cancer, with no side effects.

Surgeons have just on more than 400 men in the journal Lancet Oncology. They found that, of the 206 patients to receive PDT, 101 had a negative biopsy result when tested two years after the treatment, while in 58 the disease had progressed.

At the same time, of the 207 men in the active surveillance group who did not receive PDT only 28 showed a negative biopsy at the two-year follow-up, while 120 tested positive for disease progression.

Destructive interactionSpeaking to the BBCs Today radio program the papers lead author Mark Pemberton, a professor at University College London, said: Interaction between the laser and photosensitizer destroys the cancer cells, and also importantly the blood vessels that supply the tumor.

Pemberton also highlighted how those treated with PDT were much less likely to require radical treatment after the two-year follow-up, and said that the lack of side effects was a key finding.

Weizmann licensed the drug to Steba via the Yeda Research and Development Company, the institutes technology transfer wing. Steba now manufactures a soluble version of Tookad.

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Prostate Cancer Laser Treatment ‘truly Transformative’

Health and science reporter, BBC News website

Surgeons have described a new treatment for early stage prostate cancer as “truly transformative”.

The approach, tested across Europe, uses lasers and a drug made from deep sea bacteria to eliminate tumours, but without causing severe side effects.

Trials on 413 men – published in The Lancet Oncology – showed nearly half of them had no remaining trace of cancer.

Lifelong impotence and incontinence are often the price of treating prostate cancer with surgery or radiotherapy.

Up to nine-in-10 patients develop erectile problems and up to a fifth struggle to control their bladders.

That is why many men with an early stage tumour choose to “wait and see” and have treatment only when it starts growing aggressively.

“This changes everything,” said Prof Mark Emberton, who tested the technique at University College London.

The Nyulmc/sperling Prostate Cancer Center

Between April 2013 and April 2014, 21 men underwent focal laser ablation as part of a collaboration between the NYULMC Smilow Comprehensive Prostate Cancer Center and the Sperling Prostate Cancer Center. All candidates for this collaborative focal laser ablation of the prostate study signed informed consent to participate in a longitudinal outcomes study.

The selection criteria for focal laser ablation included a 10-year life expectancy, between one to two focal abnormalities on mpMRI consistent with prostate cancer, no Gleason pattern 4 disease on random TRUS-guided biopsies of the normal appearing prostate on mpMRI, focal abnormality on MRI < 15 mm, and no Gleason score over 7. In most cases, preservation of potency was a very high priority. Candidates are extensively counseled regarding the very limited short-term and lack of long-term oncologic outcomes data with focal prostate cancer laser ablation.

Fiber placement T2-weighted axial sequence.

Temperature-sensitive fast spoiled gradient-recalled echo images.

Postablation gadolinium-enhanced T1-weighted axial sequence.

To date, there has been no significant change in the mean AUASS, IPSS, or SHIM between 3 to 6 months and baseline . Incontinence has not been reported by any patient in the perioperative or postoperative setting. The mean preoperative PSA value was 5.40 . Among the 12 patients in whom the 6-month PSA was available, the mean PSA value decreased from 5.10 at baseline to 3.69 at 6-month follow-up .

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Risks Of Prostate Surgery

The risks with any type of radical prostatectomy are much like those of any major surgery. Problems during or shortly after the operation can include:

• Reactions to anesthesia
• Blood clots in the legs or lungs
• Damage to nearby organs
• Infections at the surgery site.

Rarely, part of the intestine might be injured during surgery, which could lead to infections in the abdomen and might require more surgery to fix. Injuries to the intestines are more common with laparoscopic and robotic surgeries than with the open approach.

If lymph nodes are removed, a collection of lymph fluid can form and may need to be drained.

In extremely rare cases, a man can die because of complications of this operation. Your risk depends, in part, on your overall health, your age, and the skill of your surgical team.

Survival Rates By Stage

According to the National Cancer Institute, below are the survival rates based on the stages of cancer. Please note that the rates below are just estimates.

• Local stage: During this stage, there are no signs that cancer has spread outside the prostate gland. It is estimated that 4 out of 5 prostate cancers are found in this early stage. The relative 5-year survival rate for local stage prostate cancer is nearly 100%. 5-year survival rates are based on men diagnosed and first treated more than five years ago.
• Regional stage: During this stage, cancer has spread from the prostate to nearby areas. The relative 5-year survival rate for regional stage prostate cancer is nearly 100%.
• Distant stage: During this stage, cancer has spread to distant lymph nodes, bones, or other organs. The relative 5-year survival rate for distant-stage prostate cancer is about 29%.

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Newer Treatments For Early

Researchers are looking at newer forms of treatment for early-stage prostate cancer. These new treatments could be used either as the first type of treatment or after unsuccessful radiation therapy.

One treatment, known as high-intensity focused ultrasound , destroys cancer cells by heating them with highly focused ultrasonic beams. This treatment has been used in some countries for a while, and is now available in the United States. Its safety and effectiveness are now being studied, although most doctors in the US dont consider it to be a proven first-line treatment for prostate cancer at this time.

What Treatments Are Used In Focal Therapy For Localized Prostate Cancer

Focal therapy uses ablation, which is the use of extreme temperatures to destroy tissue. In focal ablation, the area of the prostate that contains the index lesion is targeted, rather than treating the entire prostate gland. Focal ablation techniques include:

• Cryotherapy: The use of very cold gases passed through needles to freeze and destroy cancer tissue.
• HIFU : The use of high-frequency sound waves directed at the tumor through an ultrasound probe inserted into the rectum. The high intensity waves cause the diseased tissue to heat up and die.
• : A drug called a photosensitizer is injected into the bloodstream. This drug then absorbs light rays directed at the tumor, and produces an active form of oxygen that destroys cancer cells.
• Laser ablation: The use of laser radiation energy pinpointed to a very small area to burn away cancerous tissue. Some laser ablation has the advantage of being able to be performed at the same time as magnetic resonance imaging , allowing very specific targeting and also real-time views of results.

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Fusion Guided Focal Laser Ablation Of Prostate Cancer

The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. Read our disclaimer for details.

Recruitment Status : Enrolling by invitationFirst Posted : May 3, 2016Last Update Posted : July 14, 2021

• Study Details

Background:

Prostate cancer is the most common non-skin cancer in U.S. men. Treatments for early or less aggressive disease are limited. Researchers want to test a device that destroys cancerous tissue with laser energy. They want to see if using it with ultrasound is more comfortable than using it with magnetic resonance imaging .

Objectives:

To test a cooled laser applicator system to treat prostate cancer lesions. To see if ultrasound imaging is a practical and feasible treatment with laser ablation for focal prostate cancer treatment.

Eligibility:

Men at least 18 years old with prostate cancer seen on MRI that has not spread in the body.

Design:

Participants will be screened with standard cancer care tests. These can include physical exam, lab tests, and MRI. For the MRI, they lie in a machine that takes pictures. Participants will have a prostate biopsy. Needle samples will be taken from 12 places in the prostate. This will be guided by MRI and ultrasound, which is obtained through a coil in the rectum.

The cooling catheter will be removed. A different catheter will be put in the urethra to keep the bladder emptied.

Background: