Newer treatments for early prostate cancer

If you think that one of the treatments may be suitable for you it’s best to discuss this with your cancer specialist. They can advise whether the treatment could be helpful in your particular situation.

Cryotherapy Back to top

Cryotherapy is available as a treatment for early prostate cancer in some hospitals in the UK.

The National Institute for Health and Clinical Excellence| (NICE), reviews all the evidence about new treatments and makes recommendations on whether they are effective and should be available on the NHS. NICE guidance is that current evidence appears adequate to support cryotherapy as a treatment for early prostate cancer.

However, NICE also says that there isn’t enough evidence about quality of life and long-term survival after cryotherapy treatment. So it’s still not known whether cryotherapy is as effective as radical prostatectomy or radiation therapy. As a result, NICE recommends that cryotherapy is only used to treat prostate cancer as part of a clinical trial.

Cryotherapy is carried out under general or spinal anaesthetic. A number of metal probes are put through the skin and into the affected area of the prostate gland. The probes contain liquid nitrogen, which freezes and destroys the cancer cells. Local anaesthetic is used to numb the treatment area, but the treatment can still cause pain. Painkillers may be necessary for a few days afterwards. Men who’ve had this treatment can have radiotherapy or surgery if their cancer comes back.

After the cryotherapy procedure, a tube (catheter) is inserted into the bladder through the skin of the abdomen to drain urine. The catheter is left in place for 1–2 weeks.

The possible side effects include erection problems in approximately 8 out of 10 men (80%), and urine leakage (incontinence) in less than 1 in 10 men (10%). However, the long-term side effects are not yet known. It’s only suitable for very small prostate cancers and can’t be used for cancers near the outer edge of the prostate.

High intensity focused ultrasound (HIFU) treatment Back to top

High intensity focused ultrasound (HIFU) is sometimes used as a treatment for early prostate cancer.

Like cryotherapy, the use of HIFU has been assessed by NICE. Its guidance is that current evidence appears adequate to support HIFU as a treatment for early prostate cancer. However, NICE also says that there isn’t enough evidence about quality of life and long-term survival following HIFU treatment, so it’s still not known whether it is as effective as radical prostatectomy or radiation therapy. As a result, NICE  recommends that HIFU is used to treat prostate cancer as part of a clinical trial|.

HIFU treatment is given under a general or spinal anaesthetic. A probe is inserted into the back passage (rectum). The probe produces a high-energy beam of ultrasound. This heats the affected area of the prostate gland, destroying the cancer.

The probe is surrounded by a cooling balloon to protect the normal prostate tissue from damage. The side effects can include urine infections, leakage of urine, erection difficulties and, rarely, damage to the bowel wall. This may need to be repaired by surgery. The long-term side effects of HIFU treatment are not yet known.

After HIFU treatment you’ll have regular PSA blood tests|. If your PSA remains slightly elevated you’ll be offered a different type of treatment, such as radiotherapy or surgery.