The ERECT trial, investigating methods to preserve erectile function in men undergoing treatment, treated them using MRI-guided radiotherapy.
This method targets the prostate while avoiding the nerves and blood vessels needed for erections.
Erectile dysfunction is one of the most common side-effects of prostate cancer treatment, especially following radiotherapy or surgery.
Treatments can affect the nerves and blood vessels involved in achieving and maintaining an erection, leading to varying degrees of sexual dysfunction in many patients.
The study, by University Medical Centre Utrecht, found the targeted method had less than half the risk of erectile dysfunction compared with standard techniques.
In the UK, prostate cancer is the most common cancer in men. Each year, approximately 55,000 men are diagnosed with it and, despite advances in detection and treatment, around 12,000 die from the disease annually with around 10,000 deaths a year in England.
The incidence of prostate cancer has been rising, partly because of increased awareness and PSA testing.
However, survival rates have also improved significantly. Nearly 80 per cent of men diagnosed with prostate cancer today are expected to survive for at least 10 years.
The Telegraph is campaigning for the introduction of targeted screening for prostate cancer.
Health advisers are currently considering the evidence for rolling out screening that could target tests to those at increased risk of the disease, such as black men or those with a family history of the disease.
However, getting the focus right is crucial. Too many false positives can lead to over treatment of slow-growing disease, which can mean needless potentially distressing side-effects.
Dr Jochem van der Voort van Zyp, the lead investigator, said: “With MRI guidance, we limit radiation to erectile tissues but still treat the prostate effectively. With the enhanced precision of MRI guidance, we gain the confidence to limit the dose these erectile tissues receive.
“The prostate gets the therapeutic dose while the erectile tissues receive a much lower dose, thus preserving their function.”
The trial of 70 men found that, at six months, six per cent had erectile dysfunction, compared to 21 per cent with conventional treatment. After 18 months, 16 per cent experienced dysfunction compared to 36 per cent in the control group.
Experts said the new technique could offer men a better chance of maintaining sexual function following prostate cancer treatment without compromising cancer control. It is estimated that more than 16,000 men a year – those with low to intermediate risk disease – who receive radiotherapy could potentially benefit from such advances.
So far, the technology is being used at the The Royal Marsden NHS Foundation Trust and The Christie NHS Foundation Trust in Manchester, with plans for rollout to two more sites.
So far, the technology is being used at the The Royal Marsden NHS Foundation Trust and The Christie NHS Foundation Trust in Manchester, with plans for rollout to two more sites.
If, for example, if the prostate shifts because of motion of the bowels or bladder filling, the radiation treatment can be discontinued to avoid unnecessary radiation to surrounding normal tissues.
The preliminary results were presented by clinicians from University Medical Centre Utrecht at the European Society for Radiotherapy and Oncology annual congress earlier this year.
– The Telegraph
