Less invasive treatments for prostate cancer, like cryotherapy and High-Intensity Focused Ultrasound (HIFU), are cost-effective and enhance patients’ quality of life. A recent study from Imperial College London, published in the Journal of Medical Economics, found that these focal therapies are more economical and offer better outcomes than traditional surgery or radiotherapy.
Cryotherapy and HIFU treatments target only the cancerous areas in the prostate, leaving normal tissue undisturbed. This reduces damage to surrounding nerves, blood vessels, and muscles, lowering the risk of side effects in urinary, sexual, and bowel functions. Focal therapy is a more precise approach compared to surgery or radiotherapy.
In the UK, only a small number of patients undergo focal therapy for prostate cancer. At the same time, many opt for complete surgical removal or radiation of the entire prostate gland. A recent study by Boston Scientific and Imperial College London researchers, including Imperial College Healthcare NHS Trust, analyzed data from over 1,300 patients treated at five hospitals from 2006 to 2018. The team created an economic model to compare the costs and outcomes of focal therapy against prostatectomy surgery or radiotherapy for up to 10 years post-treatment.
Researchers used information from prostate cancer patients, combined with existing literature and clinical input, to predict treatment pathways, costs, and outcomes. The study found that focal therapy involving cryotherapy, or HIFU, had lower overall costs and higher patient benefits than surgery or radiotherapy. This suggests that focal therapy is cost-effective for the NHS, with fewer sexual, urinary, and rectal side effects. It also resulted in more excellent quality-adjusted life year (QALY) gains at a lower cost than radical prostatectomy or external beam radiotherapy.
Professor Hashim Ahmed, Chair of Urology at Imperial College London and Consultant Urological Surgeon at Imperial College Healthcare NHS Trust, said: “Our study is the first to show that focal therapy, using either cryotherapy or high-intensity focused ultrasound (HIFU) to destroy prostate cancers, was associated with a lower overall cost and improved quality of life for patients compared to either surgery or radiotherapy.”
Focal therapy is beneficial because it precisely targets individual prostate cancers, causing less damage, enabling quicker recovery, and reducing side effects. Unlike the standard approaches of radical prostatectomy or radiotherapy, which treat the entire prostate, focal therapy is more effective in treating cancers. Xavier Bertrand from Boston Scientific stated that these findings favor patients and the healthcare system. Equal access to this minimally invasive treatment could address existing disparities in prostate cancer care in the UK.
The researchers acknowledge some limitations in their work, such as a restricted number of hospitals excluding potential treatment options. Data on later outcomes and quality-of-life were also limited, leading to literature-based estimates.
Despite these limitations, Professor Ahmed emphasizes that focal therapy provides good value for the NHS, offering lower side effects and improved quality of life compared to traditional treatments. The study, supported by the NIHR Imperial Biomedical Research Centre and funded by Boston Scientific Corporation, suggests potential benefits for approximately 10,000 UK patients diagnosed with prostate cancer annually.
Professor Ahmed, leading the study, emphasized the positive aspects of focal therapy, citing its cost-effectiveness, lower side effects, and improved quality of life for patients compared to conventional treatments.
The findings suggest that focal therapy could potentially benefit around 10,000 patients diagnosed with prostate cancer in the UK each year. Despite the study’s limitations, the results underscore the potential of focal therapy as a valuable alternative in prostate cancer treatment.
Journal reference:
- Deepika Reddy, Marieke van Son, et al., Focal therapy versus radical prostatectomy and external beam radiotherapy as primary treatment options for non-metastatic prostate cancer: results of a cost-effectiveness analysis. Journal of Medical Economics. DOI: 10.1080/13696998.2023.2251849.