Pioneering Oxford surgery technique could improve treatment for prostate cancer

Technology developed in Oxford to make tumour cells fluorescent could improve surgery outcomes for men with prostate cancer. From this Autumn, the method will be offered to patients as part of a trial at the Churchill Hospital run jointly by Oxford University and Oxford University Hospitals Trust and supported by Cancer Research UK.

Fluorescent compounds show up diseased cells during keyhole operations, allowing surgeons to be more precise when removing the prostate and tissue around it. Freddie Hamdy, the Nuffield Professor of Surgery and Cancer Research UK Oxford Centre Member, said this meant doctors could avoid taking away too much tissue, or too little.

He said: “The keyhole surgery programme is doing very well, but when we look inside we cannot always see the cancer. We see the prostate and most of the structure but the cancer is not often visible to the naked eye. If we take too much then it can have an adverse impact on continence and sexual function. If we do not take enough we leave cancer cells behind. So we need to create a new eye for the surgeons.”

The new technique combines the fluorescent compound with new camera technology developed by Boris Vojnovic, of the university’s Department of Oncology. The compound illuminates cancer cells, so the surgeon can use the camera to see exactly what needs to be removed.

Prof Hamdy added: “This means when we do the surgical procedure we can take exactly the right amount of tissue and try and guarantee a good outcome.”

Each year about about 40,000 men in the UK are diagnosed with a prostate tumour, the most common cancer in men. Treating prostate cancer in its early stages can be beneficial in some cases, but the side effects of the various treatments are also potentially serious. Prof Hamdy said: “You could over-treat someone even though he may have gone through life without seeing any of the effects.”

A major trial, called ProtecT (Prostate testing for cancer and Treatment) and funded by the National Institute for Health Research, has been completed to try and help reduce over-treatment. It has been running in nine centres of the UK since 1999, with Oxford University acting as a sponsor, and has involved more than 80,000 men – making it the largest study of its kind. The study is due to report back in the coming months. A separate trial, PART (Partial prostate Ablation versus Radical prosTatectomy), is also looking at focal therapy. Because treatments for prostate cancer can have a range of side effects, scientists also want to develop new methods that reduce the burden on patients but still control the cancer. PART is comparing the effects of removing the whole prostate with those of partial destruction using high-intensity focused ultrasound.

This article originally appeared in the Oxford Mail, and can be viewed online here