There is new hope for some patients with prostate cancer, thanks to a joint study by the Institute of Cancer Research in London and the UK’s leading cancer hospital, the Royal Marsden. The study found that a treatment option called IMRT could cure thousands of men whose disease was before thought to be incurable.
For patients with prostate cancer, the following treatment options are usually advised (depending on how far the cancer has spread and how aggressive it is):
– Hormonal treatment
– A combination of the above treatments
When a patient’s cancer spreads too far (meaning it spreads to the lymph nodes near the pelvis) doctors typically advise against radiation therapy, since radiation in that area can cause damage to the bowel, which could then prove to be fatal. (Telegraph)
So What is IMRT?
IMRT stands for Intensity Modulated Radiation Therapy. It’s a highly targeted form of radiation therapy that the Royal Marsden’s study claims can successfully eliminate cancer without causing fatal damage to surrounding organs.
For the treatment, your doctor uses a computer to plan the exact dose of radiation that will be aimed at the cancer. The computer then uses information about the size, shape, and location of the tumor to determine how much radiation is needed to kill the cancer cells.
The treatment uses the high amounts of radiation that are necessary to completely kill prostate cancer cells while still protecting the healthy cells that surround them. (UCLA) So IMRT can potentially be a safe option for patients whose cancer has spread to the pelvis.
Some newer radiation machines also have imaging scanners built into them to allow the doctor to take pictures of the prostate and make minor adjustments in aiming just before giving the radiation. This is called “image guided radiation therapy” or IGRT. It can help deliver radiation even more precisely, which could result in fewer side effects from the radiation. (American Cancer Society)
If you are considering going through IMRT, be sure to ask your physician about whether or not these additional options can be available to you.
Potential Side Effects of IMRT
Short term side effects of radiation can include:
– Skin damage (like a severe sunburn)
– Temporary diarrhea
– Rectal pain
Some possible long-term side effects can include:
– Painful or frequent urination
– Loose bowels
These problems could develop six months or more after the treatment ends and may be permanent. (Genomic Health) Again, be sure to consult your physician about the likelihood of these side effects and if there are options to help prevent them.
About the Study:
In the study mentioned above by the Institute of Cancer Research in London and the Royal Marsden, 447 men were treated with IMRT and monitored for five years. When the trail began in 2000, many of the patients were considered incurable.
The object of the study was to look at the long term effects of IMRT treatment as well as whether or not it could be used to treat those patients who were considered incurable before.
Study leader David Dearnaley, a professor of uro-oncology at the ICR and consultant clinical oncologist at the Royal Marsden said, “Our trial was one of the first of this revolutionary radiotherapy technique, which was pioneered by colleagues here at the ICR and The Royal Marsden.”
71% of the patients were alive and completely cancer free at the end of the five years. Just between eight and 16% of the patients in the trial suffered from issues with their bladder or bowel.
Ultimately, the trial found that IMRT can in fact be safely given to cancer cells that have spread to the pelvis to help stop the disease from spreading further.
Dearnaley calls the technique a “game-changer” for men with prostate cancer and says, “The work done here has already been carried forward into later-stage phase II and phase III trials. I’m excited to see this treatment become available to every man with prostate cancer who could benefit from it.”
The changes in use of IMRT have caused a “complete revolution” in the way it is delivered, with doses now delivered in only two minutes.
Professor Paul Workman, chief executive of the ICR says, “Radiotherapy is often seen as perhaps old-fashioned and crude compared with other cancer treatments — but nothing could be further from the truth.” With new advances in IMRT and the findings from this study, radiotherapy is now considered a highly precise and sophisticated treatment.
“It’s great to see this long-term evidence of the degree to which precision radiotherapy has transformed outcomes for men with prostate cancer,” Workman says.
How Big of An Impact Does This Study Have?
Prostate cancer affects tens of thousands of men in the U.S. each year, and those rates are rising. In 2017 there were about 161,360 new cases of prostate cancer and about 26,730 deaths from the disease.
Most men diagnosed with prostate cancer don’t die from it. When the disease is caught early, treatment is often successful. More than 2.9 million men in the U.S. who have been diagnosed with prostate cancer at some point in their lives are still alive today.
Still, about 1 man in 7 will be diagnosed with prostate cancer in his lifetime. And often, the cancer is not caught early enough.
Prostate cancer is the third leading cause of cancer death in American men, behind lung cancer and colorectal cancer. The American Cancer Society estimates that 1 man in 39 will die of prostate cancer. (American Cancer Society)
Still, even with the new findings from this study it is important to consider your options and decide whether or not IMRT is the right treatment for you.
Dr. Matthew Hobbs, Deputy Director of Research at Prostate Cancer UK said that the findings were promising, but also called for larger randomized trials to confirm definitive answers about the benefits of IMRT and its suitability for different cases. (Telegraph)
IMRT still may not be for every patient, but this new study does provide hope for a number of men who were once considered incurable.