Prostate cancer treatment with potential for fewer side effects to be trialled in UK

A groundbreaking trial for a prostate cancer treatment has been launched in the UK, with the hope of reducing the side effects.

Backed by the government-funded National Institute for Health and Care Research (NIHR), the trial will examine whether Aquablation – a therapy using robotics, AI and real-time imaging – works as well or better than traditional surgery.

Currently, the entire prostate gland is removed in a bid to cure men of prostate cancer, in a procedure called radical prostatectomy.

It is only suitable for men whose cancer has not spread outside of the prostate gland or has spread to the area just outside the gland, and carries a risk of serious side effects, such as infection, erectile dysfunction and urinary problems.

With Aquablation, which is less invasive, experts hope to minimise these issues.

The new therapy, which involves a robotic-assisted, high-pressure water jet, allows surgeons to map the entire prostate in real time with ultrasound.

Using the technique, medics find cancerous tissue to remove while avoiding surrounding nerves and muscles associated with erectile function and the bladder.

Aquablation is currently used in some centres to treat benign prostatic hyperplasia (BPH).

An ‘incredibly exciting’ alternative surgical treatment

The new trial – which is sponsored by US company Procept BioRobotics – is being run in seven countries.

The four UK centres are the Royal Marsden, Guy’s and St Thomas’ NHS Foundation Trust, the Royal Free London NHS Foundation Trust and Norfolk and Norwich University Hospitals NHS Foundation Trust.

Overall, 280 patients will be recruited globally, all with early-stage, localised prostate cancer who have already decided to have surgery.

Philip Charlesworth, consultant urological surgeon at the Royal Marsden, said: “For men with prostate cancer confined to the prostate, curative options are excellent, however we are becoming increasingly focused on the side effects of the cancer treatment and how we can embrace new technology to maintain a man’s quality-of-life following their surgery.

“This trial is measuring Aquablation therapy, which uses a robotic approach to surgically remove the cancer, and to preserve a man’s ability to remain continent and maintain sexual activity.”

Calling the trial “an incredibly exciting prospect for the future of prostate cancer care”, he said positive results could lead to the addition of “an alternative surgical treatment option for patients with localised prostate cancer across the globe”.

Other potential treatments for localised prostate cancer include active surveillance or monitoring of the cancer and radiation.

Cases on the rise

Figures from Prostate Cancer UK suggest about one in eight men will have the cancer in their lifetime.

A total of 58,218 men were diagnosed with prostate cancer in England last year – an increase of almost 9% compared with 2023.

Last month, scientific advisers said prostate cancer screening should not be made routinely available for the vast majority of men in the UK, telling the government they would be “likely to cause more harm than good”.

For now, the committee will put forward only a recommendation to screen men with BRCA1 and BRCA2 genetic mutations – which puts them at far higher risk of prostate cancer – every two years, between the ages of 45 and 61.

Health Secretary Wes Streeting said he was “surprised” by the decision.

In recent months, there has been growing pressure for screening from high-profile public figures such as Olympian Sir Chris Hoy and former Sky News presenter Dermot Murnaghan. Both have been diagnosed with advanced prostate cancer.

Former prime minister Lord Cameron had also backed the campaign for screening after revealing he had been treated for prostate cancer.