Targeted radiotherapy treatment could provide cure for men with advanced prostate cancer

Posted: 28/09/2017

A pioneering study has led to a breakthrough in the method of treating patients with “incurable” prostate cancer.

Prostate cancer is one of the most common forms of cancer in men, with 47,000 diagnoses per year. If caught early, men are often given the option of surgery to remove the tumour, radiotherapy or hormonal treatment. The available treatment options become fewer and more difficult when the cancer becomes more advanced and spreads to other areas surrounding the prostate. Some patients are advised that the tumour is so advanced that the risk of damage to other organs is too high and that their cancer is incurable.

The new study has been carried out at the Royal Marsden Hospital which found that intensity modulated radiotherapy (IMRT) could be used in patients with advanced disease and provide a cure. This is because the radiotherapy beam during IMRT can be targeted at and destroy only the affected cancerous cells while protecting the surrounding healthy tissue cells.

One of the most difficult outcomes faced by patients who are treated with radiotherapy for prostate cancer is the side effects. Radiotherapy is applied at such an intensity that it kills all of the tissue with which it comes into contact. If healthy tissue cells are damaged during the traditional radiotherapy technique, the patient may suffer side effects such as incontinence and erectile dysfunction. The IMRT technique, however, should lead to fewer patients suffering side effects after treatment because it only targets cancer cells.

Over the last few years, IMRT has become the standard treatment in NHS trusts for early stage prostate cancer. However, patients with advanced cancer were not offered IMRT because of concern over the dangers of applying high intensity radiotherapy to large areas of the pelvis. This study, in which nine out of ten men given the treatment were still alive eight years after treatment, seems to have allayed those fears. David Dearnaley, professor of uro-oncology at the Institute of Cancer Research and leader of the study, said that the technique was a “game changer” and a “giant leap forward”.

The next step now is for larger randomised trials in order to produce definitive answers about the benefit of the treatment and its suitability for more advanced cases of prostate cancer. 

Arran Macleod, a solicitor in the clinical negligence team at Penningtons Manches, said: “We act for many patients with prostate cancer, some of whom have been told that they are no longer suitable for treatment because their cancer is too advanced. This is a very positive step for patients such as these and, although it seems further research is required to understand the true efficacy of the treatment, we will continue to follow this story with interest.

“We are also often approached by patients who have experienced a delay in diagnosis of their cancer, either because their GP failed to act on a rising prostate specific antigen (PSA), or their treating doctor failed to accurately interpret or act on abnormal MRI or prostate biopsy investigations. Some of these patients do go on to have treatment, but suffer life-changing side effects such as incontinence and erectile dysfunction. The side effects are more likely to occur when the cancer is larger than it would have been with earlier diagnosis, and are often avoidable. If you, a family member or a friend have any concerns about a diagnosis of prostate cancer or a delay in diagnosis, we would be happy to speak with you.”

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