Minimally invasive therapies for prostate cancer beneficial for patients

Minimally invasive therapies for prostate cancer which remove the cancer while leaving the rest of the prostate intact are beneficial for patients and cost effective.

These are the findings of a study from a team of partners in the UK including UCLH and the Netherlands, and published in the Journal of Medical Economics.

The study, led by Imperial College Healthcare NHS Trust, shows that when compared to surgery or radiotherapy, these minimally invasive treatments, known as focal therapies, are associated with improved quality of life and lower overall costs. The research indicates that focal therapy represents good value for money in the NHS.

UCLH co-authors on the paper were Dr Clement Orczyk, Prof Caroline Moore, Mr Manit Arya and Prof Mark Emberton.

Focal therapies can include cryotherapy, which freezes the areas of cancer in the prostate, or high intensity focused ultrasound (HIFU), which heats the areas of cancer. Both treatments target only the cancer cells. This means less damage to surrounding nerves, blood vessels, and muscles and a lower risk of urinary, sexual and bowel side-effects compared to surgery to remove the prostate or radiotherapy.

Currently, few patients in the UK receive focal therapy for prostate cancer. The treatments are available at 7 centres in the country, including at UCLH.

In the latest study researchers analysed data from over 1,300 patients treated at five hospitals between 2006–2018, including UCLH. The team developed an economic model to compare costs and outcomes following focal therapy, surgery or radiotherapy for up to 10 years after treatment.

Focal therapy was associated with better outcomes in a questionnaire measuring quality of life than radical prostatectomy or external beam radiotherapy (EBRT).

The study is the first to show that minimally invasive therapies are linked with a lower overall cost and improved quality of life for patients compared to either surgery or radiotherapy.

This is thanks to the fact that these therapies target individual cancers in the prostate leading to less tissue damage, faster recovery and fewer side effects – whilst being effective at treating cancers.

The researchers highlight some limitations with the work, explaining the limited number of hospitals mean that other potential treatment options were excluded, and that limited data were available on later outcomes, and none on quality of life data, so literature-based estimates were used.

The work was also supported by the NIHR UCLH Biomedical Research Centre.

Image: Prof Caroline Moore (credit: Adam Scott / UCLH) and Prof Mark Emberton