'Male Lumpectomy' Works for Prostate Cancer
New Freezing Technique Controls Cancer, Few Side Effects, in Early Study
March 17, 2004 -- Early evidence shows that a new procedure for prostate cancer, dubbed the "male lumpectomy," may be highly effective, less invasive, and result in fewer side effects than what is typically seen with current treatments.
Technically, the procedure is known as focal cryosurgery, and it's exactly that -- a focused freezing of only the portion of the prostate that's affected with cancer and some surrounding tissue. This spares the rest of the prostate gland, unlike current treatments in which the entire prostate is surgically removed, or treated with radiation or cryosurgery to kill cancer cells.
What we're seeing is no postoperative complications and low rates of impotence, says Gary Onik, MD, who pioneered the procedure and recently presented its first evidence before two medical associations." And cancer control that, frankly, is hard to believe," he adds.
After performing the outpatient procedure on 20 men aged 58 to 70 with prostate cancer, he reports that 19 had no evidence of cancer in follow-up exams between two and eight years later. "This is certainly competitive to radiation or surgery, and maybe slightly better," he tells WebMD.
What's more, 80% of the men getting focal treatment eluded impotence and none became incontinent -- two common side effects of traditional treatments.
"This is really remarkable when you consider that in focal cryosurgery, only one of two nerves that control erections is spared -- the other is destroyed along with cancerous tissue," says Onik, director of surgical imaging at Florida Hospital near Orlando, Fla. Conversely, Onik says only about 30% of men remain potent after getting a similarly "nerve-saving" radical prostectomy -- the surgical removal of the prostate and surrounding tissue -- and most are incontinent for up to a one year.
Onik, an interventional radiologist who also runs a private practice in the Disney-built town of Celebration, Fla., presented findings at the annual meeting of the Society for Uroradiology on those first 20 men who got the procedure. He is currently recruiting more prostate cancer patients to better evaluate the technique in a larger, multisite study.
"Be it cryosurgery, high-intensive focused ultrasound or another technology, there is no doubt in my mind that treatment that allows you to focally treat the prostate is going to be the next major advance in prostate cancer," Onik tells WebMD.
Another expert agrees there is great potential for the localized treatment, which like breast lumpectomy, provides a less invasive but still viable treatment for some patients.
"This answers a fundamental problem in the treatment of prostate cancer," says
David Bostwick, MD, a nationally known prostate cancer pathologist. "What does one do with a patient who presumably has a small prostate cancer that many be amenable to partial treatment of the prostate? Now we have something for patients that is in between 'watchful waiting' and radical prostectomy and defensive radiation therapy."