At the University Medical Center (UMC) Utrecht, 180 prostate cancer patients taking part in scientific research have been given a new type of treatment. The patients were given high-dose radiotherapy that can be very accurately targeted. The very latest in imaging technology allows the radiation to be applied to just the tumor.
When using the new treatment, doctors can radiate the tumor site inside the prostate and not the whole organ. The high dose of radiation ensures that the cancer cells in the prostate are completely destroyed. The healthy prostate tissue surrounding the tumor remains unaffected. This lowers the risk of the tumor returning. Moreover, the risk of complications occurring, such as damage to the bladder or intestines, which are considerable where prostate surgery is concerned, is lower. The new treatment is in line with modern trends in health care that look for ways of removing malignant tumors without doing too much damage to the body. This is sometimes referred to as surgery without an incision.
The treatment is being done as part of the FLAME trial. Up to now, 180 patients have participated in the FLAME trial which will eventually include 600 patients. The research, which was set up by UMC Utrecht, is also being conducted in hospitals in Leuven (Belgium), Nijmegen and Amsterdam.
Radiotherapist Professor Marco van Vulpen of UMC Utrecht is leading the trial. “From the preliminary results, this new treatment seems to be just as safe as the standard treatment approach. There do not seem to be any more complications than otherwise. Of course, we hope that the new treatment will ultimately be better for patients. We expect that prostate tumors will not return due to the higher and more accurately targeted dose of radiation. But we will only be able to determine this after the research is completed.”
Accurate positioning
This new treatment can now be given because of the latest developments in imaging technology. Technological advancements have now met the following preconditions: accurately determining the position of the prostate gland or organ itself, and being able to detect tumor tissue inside the prostate. The latest MRI scans provide images of both the prostate tumor and the entire organ. In addition, it is important to accurately locate the position of the prostate itself; this is because the organ (the size of a small mandarin) can move some centimeters back and forth. To help this process of locating the organ, doctors deposit small pieces of gold into the prostate. This enables the movements of the prostate to be followed with precision so that radiation can be given with extreme accuracy.
The FLAME trial falls under the Center for Image-guided Oncological Interventions (CBOI) at UMC Utrecht. One of the aims of the trial is to find new ways of using image-guided methods (surgery without incisions) to treat tumors as effectively as possible.
Prostate cancer is the most commonly occurring type of cancer in men. In the Netherlands there are approximately 35,800 (or 4.5 per 1,000 men) with prostate cancer. Of these, about half are older than 75. The prostate is a gland that is wrapped around the urethra and makes special fluid which is added to the sperm. Another function of the prostate is to prevent sperm from flowing into the bladder. The size of the prostate increases with age. An enlarged prostate results in urinary problems.