- Researchers have unveiled a new technique using ultrasound to treat prostate cancer.
- The procedure known as TULSA doesn’t involve surgery and has minimal side effects.
- The technique is already available for clinical use in Europe and has received initial permission from U.S. regulators to test the device.
A new procedure using ultrasound techniques may soon be available to treat prostate cancer without the complications of surgery.
The new outpatient procedure has shown promise and carries minimal side effects — all without making a single incision.
It could also help treat benign prostatic hyperplasia (enlargement of the prostate).
“There are two very unique things about this system,” Dr. Steven S. Raman, a professor of radiology and urology as well as director of prostate MR imaging and interventions and prostate MR research at the University of California at Los Angeles, said in a statement.
“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.”
Researchers presented their work this week at a meeting of the Radiological Society of North America.
The research hasn’t been published yet in a peer-reviewed journal.
The method is known as MRI-guided transurethral ultrasound ablation (TULSA).
It involves inserting a device into the urethra. Once it’s in place, it uses sound waves that target, heat, and destroy problematic prostate tissue.
The process takes place in an MRI scanner and is controlled automatically by a software algorithm that can make adjustments during the procedure.
Doctors are on hand to assess and monitor the treatment, which lasts an average of 51 minutes.
“Unlike with other ultrasound systems on the market, you can monitor the ultrasound ablation process in real time and get immediate MRI feedback of the thermal dose and efficacy,” Raman said. “It’s an outpatient procedure with minimal recovery time.”
In a trial with 115 men with a median age of 65, researchers say they saw promising results.
After a year of treatment, prostate volume was reduced from 39 cubic centimeters to less than 4 centimeters. On top of that, 80 percent of study participants saw their clinically significant cancer eliminated while 65 percent had no evidence whatsoever of cancer.
“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 Raman.
An added bonus of TULSA is that, as a minimally invasive procedure, it can be repeated if the first treatment isn’t effective.
It’s also compatible with traditional, more aggressive forms of treatment such as surgery and radiation therapy.
Dr. Louis Potters, deputy physician-in-chief and chairman of radiation oncology at the Northwell Health Cancer Institute in Lake Success, New York, told Healthline that the research demonstrates the efficacy of treating prostate cancer with ultrasound.
“Using focused ultrasound to treat prostate cancer has been in the works for years, and the use of high intensity frequency ultrasound (HIFU) has shown some preliminary promise,” he explained.
“The ability to preserve the prostate and ‘plumbing,’ as it were, avoids issues like incontinency and potency that is generally associated with surgery,” he added. “The TULSA study that is being presented is important as it outlines the feasibility for utilizing ultrasound for treating the prostate. Until now, it was thought that entire prostate ultrasound treatment would be associated with universal impotence and urinary bother.”
Follow-up studies are planned to further demonstrate the efficacy of TULSA.
The treatment is already approved for clinical use in Europe. It could eventually get approval in the United States as well.
Researchers have received 510(k) clearance from the U.S. Food and Drug Administration — essentially permission to demonstrate that their device can be safely and effectively used in clinical practice.
Potters cautioned that more research is necessary, but he expressed optimism for the future of TULSA.
“This preliminary study begins to make a science out of ultrasound delivery to avoid toxicity and potentially show favorable cancer control,” he said. “Additional work is needed to validate these results and to assess longer term tumor control. But with careful study, it may be that ultrasound becomes an option for men to avoid radical surgery for prostate cancer.”
The research is seen as crucial since prostate cancer is the second most common cancer in men in the United States.
More than 170,000 new cases are expected to be diagnosed this year with more than 31,000 men dying from the disease.