Physicians at the Society of Interventional Radiology’s 35th Annual Scientific Meeting in Tampa, FL announced that they have treated men using magnetic resonance-guided heat (laser interstitial thermal therapy) or cold (cryoablation) to treat prostate cancer recurrence after surgical removal of the prostate gland. Many of these men have already failed salvage radiation treatment.

It is hoped that MR-guided focal therapy can offer a new treatment choice for men because of the improved detection of early prostate cancer recurrences that might be able to be seen with MR imaging. (my note- most early recurrences can not be detected by MRIs.)

“Magnetic resonance-guided ablation may prove to be a promising new treatment for prostate cancer recurrences; it tailors treatment modality (imaging) and duration to lesion size and location and provides a less invasive and minimally traumatic alternative for men,” said David A. Woodrum, M.D., Ph.D., an interventional radiologist at the Mayo Clinic in Rochester, Minn. “The safe completion of four clinical cases using MR-guided ablation therapy to treat prostate cancer in patients who had failed surgery demonstrates this technology’s potential,” he said. However, he did say that the application for using ablation therapy in treating prostate cancer is relatively new.

This study of four patients with recurrent prostate cancer who had previously been treated with a failed radical prostatectomy, of was a collaboration of physicians from Mayo Clinic radiology and urology departments.

The men in the study were given salvage therapy treated with either MR-guided laser interstitial thermal therapy, which uses high temperatures generated by laser energy, or cryoablation, that uses freezing from extremely cold gases. By using MR imaging with temperature mapping and/or ice ball growth monitoring, clinicians tailored treatments to lesion size and location. “Immediately after treatment, we found no definite residual tumor. The treatment preserved the patients’ baseline sexual and urinary function and had no major complications,” added Woodrum.

Points to ponder

1- All of the men had prior surgery, so, it is unclear what organ was actually treated.
2- We also do not know what was the actual erectile ability or urinary functioning of any of the men going into the therapy and
coming out.
3- A sample of four is not useful for making any decisions about treatment.
4- Knowing that there was no change in baseline sexual and urinary functioning at the time of treatment ignores any impact on the
more important longer term.

Joel T Nowak, MA, MSW