30 Mar 2011
S'pore doctors pioneer method that eliminates need for surgery, radiation
DOCTORS in Singapore have come up with a new treatment for prostate cancer that does not involve surgery or radiation therapy.
Instead, it uses ultrasonic waves which converge on the tumour without affecting the surrounding tissue.
This eliminates the side effects of current treatments, such as incontinence and impotence.
The first treatment of its kind in the world, it has been developed by Singapore General Hospital (SGH) and the National Cancer Centre.
Prostate cancer is the third most common cancer affecting men in Singapore.
About 2,500 cases are diagnosed each year. Seven patients in Singapore have been treated since last August in the project's first clinical trial. They reported no side effects apart from temporary discomfort while urinating.
The treatment lasts three hours and the patients were back to their normal lives within two days.
The second clinical trial started here last month and will involve 40 patients with early stage prostate cancer to be selected over the next two years.
The treatment works by using the ultrasonic waves to heat the tumour to between 65 deg C and 85 deg C, effectively killing it.
It is not useful for people with large or multiple tumours.
This is because it targets only the tumours, not the surrounding cells. But if a large area or many areas are targeted, there would still be side effects such as incontinence and impotence.
Professor Christopher Cheng, who heads the SGH urology department as well as the project, said: "You might as well do radiation therapy or surgery then."
People with metallic heart valves or pacemakers, or who are claustrophobic, are also excluded from treatment, since it takes place within a magnetic resonance imaging chamber that affects these devices.
Prof Cheng said people who cannot undergo anaesthesia may be excluded as well, since the treatment requires patients to be mostly still.
He said: "The machine will correct for minor movements, but because the waves need to hit a specified point in the body, the patient cannot move around too much during the three hours."
This process, called magnetic resonance guided focused ultrasound, may have other uses, for example to treat brain and breast cancer and to shrink uterine fibroids, a common non-fatal tumour found in women.
If the ongoing clinical trial produces good results, the procedure may be available in hospitals within three years. If not, a Phase 3 trial may be required which would take many more years.
The project has cost $1.5 million to date. Treatment during the clinical trial will be free, but patients will have to pay routine costs for the mandatory follow-up examinations.
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Dept of Urology
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