New hope in revolutionary prostate cancer treatment

Prostate cancer treatment is set to be ‘revolutionised’ for many Australian patients as a result of a new precision therapy that minimises devastating surgery or radiation therapy side effects.

Surgeon Jeremy Grummet is leading a clinical trial for a new type of prostate cancer treatment which will be a breakthrough for men with the disease. Picture: NCA NewsWire/David Crosling

Prostate cancer treatment is set to be “revolutionised” for as many as one in five patients in Australia as a result of a new precision therapy that minimises the devastating side effects that many men suffer after surgery or radiation therapy.

About 100 men have so far been treated in a clinical trial with the new method, known as focal brachytherapy, which is suitable for prostate cancers classified as low to medium-risk.

Brachytherapy has been used to treat prostate cancer for many years and involves the insertion of small radioactive seeds into the prostate, which deliver radiation over a period of time. Focal brachytherapy uses the same technique, however, offers greater precision as the radioactive source into the tumour itself rather than the whole prostate, preserving the rest of the prostate gland.

“The whole premise is you’re only killing the cancer, and you’re leaving the rest of the prostate alone, which in turn, means very few side effects,” says urological surgeon Jeremy Grummet, who is leading the LIBERATE clinical trial together with radiation oncologist Andrew See. “It is going to revolutionise the patient experience of getting treated with prostate cancer.”

Focal therapy has been made possible because of advances in diagnostics and imaging that allow doctors to pinpoint the ­location of the tumour. There are also clinical trials under way of different types of focal therapies that freeze or electrocute ­tumours or use high-intensity ­ultrasound to destroy cancerous tissue.

Currently, men who are diagnosed with prostate cancer who require treatment often have surgery that involves removing the entire prostate. Alternatively, they may have radiation therapy that also targets the entire prostate. Men are often left with ­urinary incontinence and sexual dysfunction following treatment. The harms associated with prostate cancer treatment have heavily influenced testing policies, with many doctors believing the harms of PSA screening may outweigh the benefits.

National screening policy is under review and Professor Grummet said new treatments such as focal brachytherapy stood to have a significant impact on the debate.

“Because the risk of side effects in focal therapy is so low, it bolsters the argument in favour of PSA screening,” he said.

Melbourne patient Andrew Mackinnon underwent focal brachytherapy two years ago and ­experienced no side effects after treatment. He has remained cancer-free.

“Life has just gone on normally for me,” he said.

Mr Mackinnon got married for the first time last year at 70, and said he was incredibly grateful to have retained full sexual function.

“Certainly if I’d had the prostate out I wouldn’t have had that function,” he said. “It is important for relationships, feeling that you’re a complete male.”

Professor Grummet likened the likely introduction of focal therapies to the shift that took place when some breast cancers began to be treated by lumpectomy rather than radical mastectomy.

“The preliminary data that we’ve published is super encouraging,” he said.

“If the evidence continues to build the way it’s been building, then I wouldn’t be surprised if focal therapy becomes a standard option for very selected patient with intermediate grade disease.”

The LIBERATE clinical trial is running out of Icon Cancer centres in Victoria and the ­Epworth Hospital in Melbourne.