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Medicine Technology

Low-Risk Ultrasound Procedure Destroys 80 Percent of Prostate Cancers In One-Year Study (slashgear.com) 78

Posted by BeauHD from the extremely-promising dept.
An anonymous reader quotes a report from SlashGear: A new treatment shows promise for revolutionizing prostate cancer treatment, offering a minimally-invasive and relatively low-risk alternative to traditional surgeries and radiotherapies. Called TULSA, this method uses sound waves to eliminate the diseased tissue in the prostate, leaving the rest of the healthy tissues behind. According to the researchers, patients treated with this method experience "minimal side effects." The transurethral ultrasound ablation (TULSA) method uses an MRI to guide the procedure, which involves inserting a rod through the urethra into the prostate, where it uses heat via sound waves to destroy the cancerous tissues. Unlike the surgery typically used to treat this condition, TULSA is minimally invasive and can be performed as an outpatient procedure.

Using guided and controlled sound waves, doctors are able to preserve the nerves near the prostate while eliminating the diseased tissues using a total of 10 elements located on the insertable rod. A software algorithm is part of the system -- it controls the strength, direction, and shape of the ultrasound beam, though doctors watch carefully using the MRI in real-time. A new study involving 115 men found that the average treatment time for this procedure is a bit less than an hour. The researchers found that 80-percent of patients experienced elimination of "clinically significant" cancer and that 72 of the men had no signs of cancer after the first year. As well, incontinence was a very rare side effect of the procedure, which also had low instances of impotence.
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Low-Risk Ultrasound Procedure Destroys 80 Percent of Prostate Cancers In One-Year Study More

Low-Risk Ultrasound Procedure Destroys 80 Percent of Prostate Cancers In One-Year Study

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  • Minimally invasive? (Score:2, Funny)

    by Anonymous Coward

    "which involves inserting a rod through the urethra into the prostate"

    Tangentially, to quote the late great Jackie Martling: "I'll take a pinky on my birthday but that's about it"

    • Re: (Score:1)

      by Anonymous Coward

      compared to surgical resection a rod up the schmeckel aint all that bad.

    • Maybe not a wholly accurate description. On the positive side, it is very refreshing to see the word "destroys" used correctly in a non-clickbaity way in a headline. As opposed to "Athlete destroys world record" or "AOC destroys senator in debate"

  • That must be one hell of a hummer!

  • Cheaper alternative... (Score:5, Funny)

    by SuperKendall ( 25149 ) on Wednesday December 11, 2019 @11:51PM (#59511170)

    Just get an an Echo Dot, insert in trousers, and say "Alexa, play Metallica for an hour".

    Since heat seems to play a role as well, may as well stuff a few activated hand warmers down there with it.

  • MRI real time? That sounds unlikely. It takes ten minutes of being motionless the scan a joint.

  • Just reading the description makes me wince. They literally shove a speaker up your dick and turn it on full blast with the explicit goal of burning your insides. Is this safe, doctor? This entire thing has me screaming "meatloaf".. because I will do anything for love, but I wont do that.

    • Re:They burn the cancer with sound? (Score:5, Insightful)

      by dgatwood ( 11270 ) on Thursday December 12, 2019 @01:01AM (#59511310) Homepage Journal

      The alternatives, of course, are:

      • removal of the entire gland, which has the disadvantage of shortening your urethra (which can be painful), along with a decent risk of impotence and incontinence,
      • inserting a radioactive pellet, which tends to turn the entire prostate to jelly so it can't be removed surgically if they didn't get it all, or
      • using beam radiation, which has all the disadvantages of pellet treatment coupled with the risk of burning holes in your colon that require colostomy.

      If this approach avoids the problem of making subsequent surgery infeasible, it's a huge win. Heck, the fact that this might actually be repeatable, unlike radiation, would make it a huge win by itself. Of course, using targeted delivery of metal in the bloodstream, letting it accumulate in the tumor, and then burning out the tumor cells electromagnetically would be even better, assuming it works for that type of cancer, and using the immune system to attack it would be better still, but this approach still sounds like it is probably a significant improvement over what's out there.

      • Re: (Score:3)

        by bobby ( 109046 )

        Much more recent and very low collateral damage therapies include proton beam and CyberKnife (super focused x-ray).

      • I don't get those people who bitch about procedures they would brush off as easy if the were done on their foot or nose, if it somehow involves their penis or anus or something else down there.

        It's like a meme they repeat because they believe that somehow makes them look like a "real man" (a true Scotsman too ;).

        • It's like a meme they repeat because they believe that somehow makes them look like a "real man" (a true Scotsman too ;).

          Living in Scotland by choice for over 35 years, and remaining a true Irishman, the amount of stupid girning I get from non-Scots when I'm togged up in a kilt ("dress"-kilt, or "drinking"-kilt, whatever) about how it's cold, and do I wear it "traditionally" ... is tedious.

          Yes, you don't wear anything under your kilt apart from a smile. No, it's not cold, even if the snow is whipping aroun

      • One more major advantage of this new procedure is that it doesn't physically the prostatic capsule. It's not uncommon for treatments that involve cutting the prostate open to result in metastasis.

      • using beam radiation, which has all the disadvantages of pellet treatment coupled with the risk of burning holes in your colon that require colostomy.

        My father was treated with beam radiation, and I think you're exaggerating the risks, at least for the more advanced methods where multiple treatments are made along different axes so the maximum cumulative dose is only delivered to the specific part of the prostate that's being targeted.

        The "tends to turn the entire prostate to jelly so it can't be removed su

        • Re: (Score:2)

          by dgatwood ( 11270 )

          My father was treated with beam radiation, and I think you're exaggerating the risks ...

          So was my grandfather, and no, I'm not. Fistulas and bowel damage are a rare, but serious side effect. To be fair, though, this was back in... probably the late 1980s or early 1990s, so it is probably much less likely these days.

          Although I wonder how often discovering "they didn't get it all" happens outside the context of it metastasizing, in which case it's game over.

          No idea.

          • My father was treated with beam radiation, and I think you're exaggerating the risks ...

            So was my grandfather, and no, I'm not. Fistulas and bowel damage are a rare, but serious side effect. To be fair, though, this was back in... probably the late 1980s or early 1990s, so it is probably much less likely these days.

            My father was treated in 2011 with no side effects to speak of, this mentions a set of increasingly sophisticated treatments [webmd.com]. Medical imaging for better targeting has also gotten a lot better

      • [both methods of radiation therapy tend] to turn the entire prostate to jelly so it can't be removed surgically if they didn't get it all

        I previously mentioned I hadn't come across this; now doing more research I found this [sperlingpr...center.com] on a page extolling the virtues of multiparametric MRI:

        EARLY DETECTION OF RECURRENCE AND SALVAGE THERAPY

        Unlike prostatectomy, which removes the prostate from the body, both radiation and focal therapy treat the gland while it is still in place. If there is localized recurrence after tr

    • Re:They burn the cancer with sound? (Score:5, Informative)

      by bobby ( 109046 ) on Thursday December 12, 2019 @03:18AM (#59511534)

      The transducer is maybe the size of a grain of rice. The "rod" is a very thin stiff wire. All of it is way smaller than a Foley catheter.

      A good friend of mine made the prototypes and some early production.. They were doing this more than 10 years ago. Shame it takes so long to get to mass public.

      The ultrasonic energy heats the prostate to maybe 107-110 F. Turns out tumors don't like heat. But neither do many organs including brain, so overall heating isn't a good therapy. Tumor destruction by heat works better on some tumors more than others.

      In Canada they've approved external ultrasonic heating of tumors, where they use many transducers, sometimes arrays, to focus the energy on a tumor. It's had some success.

      Also called "HIFU" https://www.icr.ac.uk/news-features/latest-features/hifu-using-ultrasound-to-heat-and-destroy-tumours [icr.ac.uk]

      • Comment removed based on user account deletion

        • Re: (Score:2)

          by bobby ( 109046 )

          I wonder if there's been a study between those that habitually soak in hot springs (or baths) or use saunas relative to the average cancer rates and the type of them.

          Yes, great point, I was wondering that too, especially for tumors that are near the skin. But hot tubs should max at 104F, which isn't quite enough to kill tumors, but maybe some tumors are more susceptible to mild heat?

          I've always considered people's natural desires for food, hot, cold, etc. Some urea comes out through skin pores, so I've wondered if saunas, hot tubs, etc., are a way to get rid of poisons, and maybe the person has weak kidneys, or there are heavy metals in the water or food, or something

      • The ultrasonic energy heats the prostate to maybe 107-110 F.

        Prostate Sous Vide.

  • Because I was under the impression most prostate cancers don't require treatment and are largely asymptomatic. I mean I've heard doctors have a joke about how you figure out if a guy has prostate cancer which pretty much goes like this, "How do you figure out the probability a guy has prostate cancer. Step one: ask him his age in years. Step two: yeah that's pretty much the probability he has prostate cancer."

    • Re: Wait, do you even need to treat most of them? (Score:4, Informative)

      by Way Smarter Than You ( 6157664 ) on Thursday December 12, 2019 @01:08AM (#59511320)
      Actually the idea is that if you're old enough they figure you -might- die of something else first. Not that the prostate cancer won't kill you.

      • Re: (Score:2)

        by dgatwood ( 11270 )

        The other problem with that approach is that there are a couple of different kinds of prostate cancer. Most of the time, it is very slow-growing, but every now and then you run into an aggressive form that metastasizes, at which point you're pretty much screwed.

    • I think they find lots of slow growing prostate cancer in people of 80+ years, which makes no sense to be treated. But if they find it in 60 years old people they have to do something. Also as already mentioned there are fast-growing forms.

    • Step one: ask him his age in years. Step two: yeah that's pretty much the probability he has prostate cancer."

      That is about right. I was told that most men over 50 have it, they just don't know it. It acts slowly though and most guys die of something else first. So it is worth the treatment if you are otherwise in good health.

  • I unfortunately know about this subject... (Score:5, Informative)

    by Anonymous Coward on Thursday December 12, 2019 @01:10AM (#59511334)
    After 10 years of lurking on Slashdot, this article finally got me to make an account and comment on the article. I was diagnosed with prostate cancer approximately 1 year ago and I had to educate myself on the subject. Prostate cancer is the 2nd most prevalent cancer for men. 1 in 9 will be diagnosed and 80% of men have prostate cancer cells in their prostate by age 80. The cancer is very much driven by testosterone (in fact, one treatment is to give men drugs to get rid of their testosterone and halt the cancer), so I think it is one of these evolution holdovers where the male gets an advantage early with high testosterone but gets nailed late in life. Fun fact: African American men have a higher incident of prostate cancer because they, as a group, have a higher average testosterone level. Prostate cancer is, right now, about at the same level that breast cancer was about 20 years ago. They have learned a great deal about it and new procedures are coming along that will "spot" treat it. Unfortunately, the main treatment options right now are radiation and surgery to remove the prostate gland. For older patients, the radiation treatment is preferred. For younger patients, the surgery option is preferred. I was presented with both and didn't like them, so I looked for other options. What I found was that many new treatments are being explored and tested. The two most promising ones (in my opinion) are the HIFU (High Intensity Focused Ultrasound) and Cryotherapy (freezing of tissue with a probe using liquid nitrogen). HIFU is best for tumors on the posterior side (back) side of the prostate, is very spot specific and is done with a probe inserted into the rectum. It is currently being tested in the UK and the US. Cryotherapy is best for tumors on the front side of the prostate and is normally done over 1/2 of the prostate gland due to the large treatment zone done by the cyro probe. The TULSA method listed in the article is just a variation of the HIFU procedure and allows the ultrasound method to be done both in the front and back of the prostate gland. At the current time, only surgery and radiation is being covered by insurance. If you want either the HIFU procedure or cyrotherapy for initial treatment, you will need to pay for it yourself. They are not cheap. The reason for this is that long term survival statistics for the procedures done for initial treatment are not settled yet. After looking at options, I got the HIFU procedure and got treated last summer. I can most highly recommend it (if you can afford it) and I am currently waiting to get a 6 month checkup and hopefully with be cancer free at the end of it. For those of you interested in the HIFU procedure and are on the West Coast, go to the UCLA Urology Department and see Dr. Leonard Marks. Here is a link to the department: https://www.uclahealth.org/uro... [uclahealth.org] and here is a link to Dr Marks presentation on HIFU: https://www.youtube.com/watch?... [youtube.com] . Dr. Marks is a bit dry but I can most highly recommend him.

    • Thank you for the useful information.

    • If anything ever needed to be modded up, it's this post.

    • Re: (Score:2)

      by dwywit ( 1109409 )

      Good luck to you.

      I'm 58, and one of my annual blood tests is for PSA (Prostate Specific Antigen). It's not the gold standard of markers, but mine is so low, my GP said I'd have to live to to 120 to develop prostate cancer. Doesn't mean I won't have other, more accurate tests, but it's reassuring.

      I gave up smoking at 50, so that danger recedes, but I've got the usual white male issues of weight, blood pressure and cholesterol. Most of the weight came after I gave up smoking, it's *really* hard to shift, desp

      • Good luck to the GP poster. Regarding weight, I'm not sure what you have tried or not but I wanted to share something I've been doing the last few months with great success so far. I had been overweight for years. I'd recommend reading "The Obesity Code" by Dr. Jason Fung. I've started intermittent fasting 3 months ago and am down 28 lbs. It is surprisingly easy to do after the first few days. I've also started going to the gym more often, but nothing crazy.

    • Re: (Score:1)

      by swelby ( 215750 )

      Thank you for sharing this. Can I ask - How much were your out of pocket costs?

      • Re: (Score:1)

        by Anonymous Coward

        Thank you for sharing this. Can I ask - How much were your out of pocket costs?

        Hello There. Original Poster here. UCLA charges $25K for the HIFU procedure as do third party medical groups. The reason they do this is because right now HIFU is in the medical "no man's land" of medical procedures. It is looked at as a valid and superior treatment procedure for specific tumors (one keeps both urinary function and erections) but their is not enough scientific studies on long term survival rates for insurance will cover it. But it's an incredibly quick and easy procedure done in 1/2 a day.

    • Here is a link to the department: https://www.uclahealth.org/uro... [uclahealth.org] and here is a link to Dr Marks presentation on HIFU: https://www.youtube.com/watch?... [youtube.com] . Dr. Marks is a bit dry but I can most highly recommend him.

      Wow, it's been a while since I've seen those animations.

      I actually worked on this while it was undergoing its clinical trials for FDA approval. At the time, most patients were routed through hospital sites outside the U.S. (at significantly lesser expense, despite the travel).

      It has been used to treat kidney cancer laparoscopically, and there was some heavy R&D that went into pancreatic applications as well, though I think that it stalled out eventually.

    • I'm glad you caught it early and got satisfying treatment.

      I also researched prostate cancer a bunch after I noticed some weird symptoms with my urinary tract. It turned out not to be cancer or BPH (a benign enlargement of the prostate), but I read up a bunch on the disease and the remedies.

      For all the people with prostates out there, here's a few quick things to know:

      1. Prostate cancer has the highest five, ten and fifteen year survival rates of any cancer that I saw stats for. Somewhere in excess of 95% s

      • Re: (Score:1)

        by dccase ( 56453 )

        Another reason not to panic: By the time you have symptoms it has probably already spread and you won't have to have any of these icky procedures.

        I am among the lucky 1% that won't make it to 5 years. Younger guys that get it often end up with a more aggressive strain.

        The only real lesson is to live a good life. Enjoy every sandwich.

        • Oof. I'm really sorry to hear that. I've got no platitudes or misplaced optimism to offer you, I just hope you enjoyed a lot of sandwiches and have time to enjoy a few more.

        • Re: (Score:2)

          by kackle ( 910159 )
          I offer my deepest condolences and the best of luck going forward. Did you have any prostate infections or similar issues way before the diagnosis? I wonder about "triggers".

          • Re: (Score:1)

            by dccase ( 56453 )

            Not really. I had felt a little run down for a while. Thought that came from turning 50.
            Then I started pissing blood.

            That was over 2 years ago now. Since then I have felt quite good most of the time, got back into shape between treatments, and had lots of fun because nothing else matters.
            I'm down to clinical trials now, but there are more left to try.

            I didn't expect to make it through this year. I don't expect to make it through next year. One of these years I won't be wrong.

            • Re: (Score:2)

              by kackle ( 910159 )

              One of these years I won't be wrong.

              True for us all. I have my virtual fingers crossed for you.

    • Fun fact: African American men have a higher incident of prostate cancer because they, as a group, have a higher average testosterone level.

      Sad(?) fact: Oriental men have a lower incidence because they have lower levels of testosterone. Might explain their ladyboy tendency and their not seeming to be bothered by western men getting off with their best girls; I'm being serious.

  • They just shove their light saber up their ass. Problem solved. That's how Yoda lived 900+ years.
  • Tulsa... the Paris of Oklahoma

  • Why not convert it back? Aka actually *curing* it.

    Why must it always involve cutting things out, or otherwise destroying them?
    That is not a cure. It is better than nothing. And better than those even more bullshit "cures" where they make you an addict of their expensive pills for the rest of your life, to merely hide the symptoms.
    But it is still horribly medeival and not a cure.

    Maybe in 200 years, when we have left the dark ages.

    • Um, maybe because cancer (by definition) is the destruction of normal organs & cells? The doctor is stopping the destruction by removing the cancer.

      Getting rid of the cancer is indeed a cure. You don't die of cancer when you remove the cancer. I'd call that a cure.

      If you want to "convert it back", best bet currently is to clone a new organ. Even then, that's "swap out a defective part", not "converting".

      Next time you see a car crash, go ask the mechanic to "convert it back" when repairing the airbags a

    • Cancer cells are so deranged there's no realistic way to convert them back to normal cells. So removing or killing them are the only methods. Although prostate cancer can be an exception, if its sufficiently in an old man it can just be ignored, he'll likely die of something else before that cancer gets him.

      For cancer there's no "bullshit 'cures' where they make you an addict of their expensive pills for the rest of your life", chemotherapy is brutal because cancer cells are too much like normal cells, a

  • does not sound minimally invasive to me .. I guess it beats a knife though.

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