Sunday, 15 Dec 2019

Stronger radiotherapy could spare months of treatment for patients

Gruelling radiotherapy for prostate cancer could be cut from two months to just TWO WEEKS by giving patients higher doses, doctors say

  • Researchers gave five stronger blasts of radiation to patients over two weeks
  • Found it caused no more side effects than current eight-week standard therapy 
  • It could save patients months of gruelling treatments by condensing care

Prostate cancer sufferers could be spared months of gruelling radiotherapy if they were given a higher dose over a shorter period, a study suggests.

British researchers delivered five stronger blasts of radiation to patients over a one to two week period.

They found that the side effects were no worse three months later, compared to patients who had the standard therapy over two months.

But the scientists, from The Royal Marsden NHS Foundation Trust and The Institute of Cancer Research in London, are still awaiting data on long-term side effects.

The vast majority of men receive external beam radiotherapy, which bathes the entire pelvis in a low-powered radioactive beam. 

The external treatment is given over 37 days, requiring men to go to hospital every weekday for nearly two months.

A patient taking part in the trial is treated with radiotherapy using the CyberKnife machine 

Researchers delivered five stronger blasts of radiation to patients over a two- week period was just as safe as standard therapy over two months. Pictured: Lead author Dr Nick Van As 

But the research team used a technique known as ultra-hypofractionated stereotactic body radiotherapy, or SBRT.

SBRT uses image guidance to allow clinicans to target tumours with more precision.  

This reduces the chance of damaging surrounding healthy tissue with radio waves, researchers say.

When healthy cells are zapped by radio waves, it often leads to more frequent or urgent urination and diarrhoea. 

In Britain, prostate cancer treatments and diagnosis lag behind other diseases such as breast cancer.

Some 15,000 men with the disease receive radiotherapy every year – just a third of the 47,000 men diagnosed in Britain annually.

STEPHEN FRY BACKS £2M BOOST FOR PROSTATE CANCER

An extra £2 million of research funding was announced today by the charity Prostate Cancer Research Centre (PCRC).

Stephen Fry, who revealed last year he was suffering from the disease, welcomed the news.

The actor, 61, who had his prostate removed last year and is now cancer free, supported the charity last year through The Stephen and Martin Appeal, launched on BBC Radio 4.

Stephen Fry, 61, is now cancer-free 

Even though the number of men diagnosed with prostate cancer in the UK has shot up by 41 per cent since the early 1990s, money being spent on prostate cancer research is decreasing. 

Between 2016/17 and 2017/18 there was a 13.5 per cent decrease in the amount of money spent on prostate cancer research in the UK, according to figures from the National Cancer Research Institute (NCRI) 

Using the new funds, PCRC has awarded seven new grants, to researchers based in Oxford, Cambridge, London, Newcastle, Aberdeen, and Norwich

The money will go towards finding a cure or better treatments. 

The research team gave 432 patients the standard therapy of 39 doses over seven to eight weeks, or 20 doses over four weeks.

They then treated 415 with five higher doses of SBRT over one to two weeks. 

Patients on the normal dosage were assessed every other week. Those on the SBRT trial were tested after the final dose day, and on weeks two, four, eight and twelve after the end of treatment.

Researchers incorporated both assessments by clinicians and questionnaires completed by patients.

They found patients in both groups had similar levels of side effects over the three months after treatment. 

Lead author Dr Nicholas van As, consultant clinical oncologist at The Royal Marsden NHS Foundation Trust said: ‘It is reassuring to see from this trial that SBRT does not significantly impact patients’ quality of life in the short term, compared with the current standard of care.

‘Using SBRT to deliver this treatment would mean that patients could be spared numerous visits to hospital, allowing them to get back to their lives sooner. 

‘It is important to point out that we will not know for another few years about the long term side effects and outcomes of treatment, and that this treatment technique is still only available in a trial setting in the UK.’

Co-author Dr Douglas Brand, a researcher at the trust, said: ‘The new results from our clinical trial have shown that a much shorter course of higher-dose radiotherapy does not increase short term side effects compared with the current standard of care.

‘If the data on longer-term side effects and efficacy are also positive, we expect our trial could be practice-changing. 

‘This would enable us to deliver curative treatment over fewer days – meaning that men would get the same benefit from their radiotherapy while having to spend less time in hospital.’

Dr Brand presented the patient outcomes from the trial at today’s American Society for Radiation Oncology Annual Meeting. 

The findings were published in the journal The Lancet Oncology.

WHAT IS PROSTATE CANCER? 

Prostate cancer is the growth of tumours in the prostate gland.

Only men have a prostate, which is a walnut-sized gland between the rectum and the penis which creates a fluid to be mixed with sperm to create semen. 

How many people does it kill? 

More than 11,800 men a year – or one every 45 minutes – are now killed by prostate cancer in Britain, compared with about 11,400 women dying of breast cancer.

It means prostate cancer is behind only lung and bowel in terms of how many people it kills in Britain. In the US, the disease kills 26,000 each year. 

How quickly does it develop? 

Prostate cancer usually develops slowly, so there may be no signs someone has it for many years, according to the NHS. 

If the cancer is at an early stage and not causing symptoms, a policy of ‘watchful waiting’ or ‘active surveillance’ may be adopted. 

Some patients can be cured if the disease is treated in the early stages.

But if it diagnosed at a later stage, when it has spread, then it becomes terminal and treatment revolves around relieving symptoms.

Thousands of men are put off seeking a diagnosis because of the known side effects from treatment, including erectile dysfunction.

Tests and treatment 

There is no national prostate screening programme as for years the tests have been too inaccurate.

Doctors struggle to distinguish between aggressive and less serious tumours, making it hard to decide on treatment.

Men over 50 are eligible for a ‘PSA’ blood test which gives doctors a rough idea of whether a patient is at risk.

But it is unreliable. Patients who get a positive result are usually given a biopsy which is also not foolproof. 

Scientists are unsure as to what causes prostate cancer, but age, obesity and a lack of exercise are known risks. 

Anyone with any concerns can speak to Prostate Cancer UK’s specialist nurses on 0800 074 8383 or visit prostatecanceruk.org.

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