Men with low-risk, slow-growing prostate cancer are often advised to skip surgery or radiation in favour of “watchful waiting.” But there could soon be another option: an ultrasound technique that’s being pioneered by Canadians.
It’s called transurethral magnetic resonance. Unlike traditional prostate surgery, the prostate is not removed or cut. Instead, a high-powered ultrasound is inserted into the prostate, where it burns off cancerous cells.
Brian Danter, 62, recently underwent the experimental procedure. He says his doctor recommended watchful waiting or “active surveillance” because his prostate cancer was considered low-risk.
But he found the approach stressful. It required ongoing blood tests and biopsies to ensure his tumour wasn’t growing and he always worried that his cancer might suddenly grow.
“I would more or less get anxious a night or two before my test,” he recalls.
So five years ago, Danter agreed to be part of a trial studying a new approach at London Health Sciences Centre in southwestern Ontario.
The Centre’s Dr. Joseph Chin used an MRI to measure Danter’s prostate. His team then inserted a probe into the prostate to deliver ultrasound beams to heat and kill the cancerous tissue, a technique called ultrasound ablation.
"With this procedure, you are basically treating it from within," Dr. Chin explains. “It heats and causes temperature changes in the prostate.”
Danter was patient No. 2 in a pilot study, approved by Health Canada, to determine the safety and feasibility of the approach.
“Both patients have done well, and there have been few complications,” Dr. Chin reports.
Now, both patients are being monitored to evaluate the longer term effects of the treatment.
Dr. Laurence Klotz, chief of urology at Toronto’s Sunnybrook Health Sciences Centre, has also tested the method in prostates that were surgically removed.
He says ablation could offer an alternative to traditional surgery or radiation treatments, both of which can lead to debilitating side effects, such as incontinence and impotence.
“I think because the quality-of-life benefits are so substantial, for patients whose prostate cancer looks like it is fairly slow growing and not that aggressive, I think it is very appealing to try this treatment and see if it works,” Klotz says.
For now, it’s unclear whether the treatment works in the long term.
“It is probably going to take another five years or so before we can turn around and say, ‘Okay, this really deserves to replace existing therapy,’” Klotz says.
Doctors will know in a year if Danter’s cancer has been eradicated.
But Danter says he's more than happy to have traded the uncertainty of simply monitoring his prostate cancer with a treatment that has a chance of eliminating it.
With a report from CTV’s medical specialist Avis Favaro and producer Elizabeth St. Philip