Game Changing Treatments for Prostate Cancer

Prostate cancer is the most common cancer in men in the UK — one in eight will be diagnosed with it at some point in their lifetime. The positive news is that for most men, early diagnosis and treatment mean there is good reason to look forward to a positive outcome, with nearly 85 per cent of men surviving their cancer for at least ten years — often more.

GenesisCare runs specialist cancer care centres throughout the UK that focus on the latest, evidence-based treatments from around the world. These innovations for prostate cancer include super-targeted radiotherapy that can be completed in five treatments, an ingenious spacer that shields the rectum from radiation and a ground-breaking combination therapy that can seek out and destroy prostate cancer cells that are not yet visible on a normal scan.

Six out of ten prostate cancers are diagnosed at an early stage. Because the cancer has not yet spread, there are a number of treatment options, including surgery, to remove the prostate or radiotherapy.

While there are different ways of delivering the radiotherapy, it is often preferred over surgery as a less invasive option.

Both surgery and radiotherapy carry risks of damage to the surrounding organs, including incontinence, impotence and diarrhoea.

MRIdian Radiotherapy - Sees As It Treats

The MRIdian combines high-definition magnetic resonance imaging (MRI) with a linear accelerator (the technology that delivers radiation therapy) — it is called an MR linac. In recent years, the MR linac has caused immense interest in the world of oncology and is heralded as the new frontier for radiotherapy. One such new machine, the MRIdian by ViewRay, can see exactly where the tumour is at the same time as treating it and, more importantly, can track the tumour movement, ensuring incredibly accurate treatment while avoiding the healthy tissue and organs surrounding it. To date, more than 5,000 patients have benefited from treatment on this revolutionary machine worldwide.

Conventional radiotherapy uses CT scans (3D X-rays) to visualise tumours before starting radiation therapy, but CT imaging cannot be done at the same time as treatment.

As a result, doctors cannot be completely certain the radiation is hitting only the tumour during treatment, due to the natural movements of your body and the organs inside it, such as when you’re breathing.

With MRIdian, live MR imaging during treatment means it can detect even the slightest movement and automatically switches off the radiation beam every time the target site moves out of alignment. This means the doctor can be completely confident of hitting the target and avoiding the surrounding healthy organs. It may also make it possible to give a higher dose of radiation per treatment with a much lower risk of damaging healthy tissue.

A study of 101 patients with localised prostate cancer (cancer that had not spread to other parts of the body) showed very few early side effects in the organs surrounding the prostate as reported by doctors and the patients themselves.

Dr Philip Camilleri, a consultant clinical oncologist specialising in prostate cancer, says: “It’s possible to safely give radiotherapy to the prostate over five days using the MRIdian, instead of the usual 20 to 37 days. It gives me peace of mind on two counts: one, that I am hitting the target every time, and two, that I am avoiding damage to surrounding tissues — with fewer side effects than conventional radiotherapy.”

The MRIdian will also enhance the treatment of oligometastatic disease, where the cancer has spread but only to a small number of areas. Cancer specialists have shown that treating these areas with highly accurate radiotherapy, called stereotactic ablative radiotherapy, can prolong life and reduce the need for more toxic therapy like chemotherapy, as well as occasionally curing the disease completely.

Spacing Gels

The second exciting advance is much simpler but described by many doctors as a game-changer in reducing radiotherapy side effects. Spacing gels are placed between the prostate and rectum to provide a protective shield for the rectum against the radiotherapy beam. Patients who have spacing gels report fewer long-term side effects to their bowel, as well as minor improvements to urinary and sexual functions and an overall improvement in quality of life. Clinicians at GenesisCare are so convinced of the benefits that spacing gels are offered at no extra cost, as standard pre-radiotherapy treatment for men with prostate cancer.

¹⁷⁷Lutetium PSMA

Four in ten prostate cancers are diagnosed at a late stage, when cancer cells have spread to other areas of the body (metastatic prostate cancer), such as the lymph nodes, bones or other organs. These cancers are unable to be completely eradicated and eventually become more difficult to locate and treat effectively, as the cancers become more resistant to therapy.

A new personalised treatment is ¹⁷⁷Lutetium PSMA — a fresh option for hard-to-treat metastatic prostate cancers. It sends a radioactive substance called ¹⁷⁷Lutetium directly to a cancer cell where it can destroy it without damaging healthy tissue. The ¹⁷⁷Lutetium can hunt down and bind to prostate cancer cells because it is attached to a carrier molecule which is attracted to PSMA, a substance found in high concentrations on prostate cancer cells. Injected into the bloodstream, the carrier molecule locks on to PSMA, delivering the ¹⁷⁷Lutetium to its target. Typically, the treatment is given every six to eight weeks over four sessions and aims to reduce the size and progress of the cancer and ease symptoms.

GenesisCare has invested in all of these new treatments, together with advanced prostate cancer diagnostics, and provides them alongside novel therapies such as exercise medicine — a tailored therapeutic approach which helps patients to improve their treatment tolerance and reduce cancer-related fatigue. For men diagnosed with prostate cancer today, life outcomes continue to improve, thanks to new technologies such as these.