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Men with incurable prostate cancer could be thrown a lifeline by a new approach that ‘doubles up’ radiotherapy treatments.
During the procedure, tumour-blasting rays are fired at the prostate while injections of a radioactive substance target cancer cells that have spread to bones.
A study found it halved the speed at which the disease progressed, extending life by at least six months. Many patients survived far longer.
One patient in the trial, 68-year-old David Livingstone, was diagnosed in 2016 with prostate cancer that had spread to his spine. He was given six months to live – but the retired photographer from Richhill in County Armagh is still alive five years later. He said: ‘Since my diagnosis, I have seen my two daughters get married and I now have two wonderful grandchildren. Without this treatment I’d be long gone.’
Going strong: David Livingstone, 68, was given six months to live in 2016 after he was diagnosed with prostate cancer that had spread to his spine
Joe O’Sullivan, professor of radiation oncology at Queen’s University Belfast and lead investigator on the trial, said: ‘We found going early with these treatments all at once didn’t cause worse side effects and slowed the cancer’s progression.’
Prostate cancer is the most common cancer in the UK and will affect one in eight British men during their lifetime.
Almost 50,000 men are diagnosed every year – over the same period, 11,000 will die as a result of it.
Almost eight in ten men survive the disease, and many are cured by surgery and chemotherapy alone, but in a minority it can be lethal because of how quickly it spreads to other parts of the body.
Researchers have made huge steps in battling the disease with new drugs, but Prof O’Sullivan believes that radiotherapy, in which energy beams target cancer cells, remains the most effective tool for fighting it.
Patients normally undergo eight weeks of standard radiotherapy alongside hormone therapy – a medication that inhibits the body’s production of testosterone which can feed the growth of prostate cancer.
If this fails, patients could then be offered a variety of other more specialist treatments.
During the trial at Queen’s University, doctors investigated the benefits of immediately offering patients whose prostate cancer had spread to their bones two specialist forms of radiotherapy alongside hormone therapy. One, volumetric modulated arc therapy, specifically targets the prostate. The other, radium 223, is an intravenous drug containing a radioactive material absorbed by the bones, making it effective at tackling tumours that have spread there.
Prof O’Sullivan said: ‘This is the first time the effect of these two treatments together has been studied. But we believed, put together and used earlier on, they would have a strong impact.’
Prof Joe O’Sullivan believes that radiotherapy, in which energy beams target cancer cells, remains the most effective tool for fighting prostate cancer (file photo)
To conduct the trial, 30 patients aged between 40 and 80 who had failed to respond to chemotherapy received the combined radiotherapy and hormone therapy.
The study found that, on average, patients went 22 months before their cancer began to progress – more than doubling the average of ten months for advanced prostate cancer patients. Prof O’Sullivan says this translates to about six months longer survival time.
In 2016, Mr Livingstone was diagnosed with advanced prostate cancer after complaining of back pains. Scans and blood tests showed that it had spread to his spine. He said: ‘I’d always had a bad back so I wasn’t expecting it.’
He was referred to Prof O’Sullivan, and soon after finishing chemotherapy he was placed on the combined radiotherapy treatment.
He attended hospital every day for eight weeks for a ten-minute session of volumetric modulated arc therapy.
Every four weeks over six months, he also received an injection of radium 223.
Soon after, scans showed Mr Livingstone’s cancer was receding. He said: ‘The cancer in my spine had nearly gone while the cancer in my prostate was no longer growing.’
While he suffered bouts of nausea and fatigue, he said the side effects were never extreme.
Prof O’Sullivan said there was a strong argument to make the combination standard practice on the NHS.
‘While it’s by no means a cure, we are showing progress in extending the lives of patients,’ he added.
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