New hope fighting prostate cancer

Image: NIH Image Gallery

A new clinical trial is underway, which could change the way we treat certain types of cancer. The PRISM study, or less catchy the Prostate Radiotherapy Integrated with Simultaneous MRI study 1, is putting into practice a highly accurate treatment machine which can adjust its target in real time. This novel and innovate approach means potentially shorter treatment times, with greater success rates and fewer side effects.

This year saw the number of deaths from prostate cancer (11,819)  surpass those who died from breast cancer (11,442) 2, whilst this is not some sort of morbid high stakes competition, these numbers reflect the sincerity of the situation and call for equal dedication in awareness, identification and treatment of the disease.

Approximately 47 000 men are diagnosed with prostate cancer in the UK each year, these diagnoses are usually in those over 90 years of age and when the cancer has developed to what is known as late stage 2. These factors can make certain treatment types, such as surgery unfeasible, leaving limited treatment options. Fortunately, one of these options is Radiotherapy, the unsung hero of the frontline triad of cancer therapies, the other two being Surgery and Chemotherapy.

Despite the prevalence of prostate cancer within our population (UK is currently ranked 17th in Europe2) 75% of those who are diagnosed are treated with such success that they survive ten years or longer. Such a high success rate in the long term survival outcome, means that a lot of focus should be placed, not only on the success of the treatment, but also on the long term side effects an individual should expect to endure as a result of that treatment.

One of the main treatment approaches for prostate cancer is Radiotherapy. In this approach, highly accurate beams of radiation are directed towards the tumour and a small surrounding area to give the best chance of destroying the tumour cells whilst minimising damage to healthy tissue.

These beams of radiation however, do not distinguish between the tissues they hit. Therefore it is down to the skill of the staff member who plans the treatment, to ensure the healthy tissue within the treatment field is minimalised.

Radiotherapy treatment plans, currently work with millimeter accuracy, they are the result of several patient appointments, and many hours in treatment planning and before the first dose of radiation is delivered a practice run will occur to ensure they are aiming at the correct area. The current treatment approach using Radiotherapy is obviously effective, however it can be better.

The most common approach to planning a Radiotherapy prostate treatment is predominantly dependent on what is known as a planning CT scan. In this scan the patient will undergo a CT scan of the prostate region, this allows the planning staff to identify the location, size and shape of the prostate, from this scan the treatment plan will be created. A Radiotherapy prostate treatment can currently take 6 weeks of daily (Mon to Fri) treatments, all of which use the planning CT scan of the prostate as a reference point.