Newer treatments, such as HIFU and cryosurgery may occasionally be used to treat some men with T3 prostate cancer. It is recommended by NICE that because of a lack of evidence about their benefits for locally advanced prostate cancer these treatments should only be given within the context of a clinical trial. (21)
HIFU (high intensity focused ultrasound)
HIFU is a method of focusing ultrasound waves on a particular area to create heat in the tissues. This heat can result in tissue death due to coagulative necrosis.
Cryosurgery
Cryosurgery, or cryoablation, uses liquid nitrogen to produce temperatures of -50°C or lower in the tumour tissue. The liquid nitrogen is circulated through an instrument called a cryoprobe which can be placed in or up against the cancer.
Stampede trial
Stampede is a multi-centre international randomised trial. Its main aim is to assess the effectiveness and safety of new approaches as a first-line treatment given earlier in the course of the disease in combination with hormone therapy. At this point patients would be fitter and better able to tolerate treatment than when the cancer has become hormone refractory. The new treatments are:
- Zoledronic acid. A bisphosphonate drug which is used when prostate cancer has spread to the bones
- Docetaxel (Taxotere). A chemotherapy drug which has already been shown to have a role in palliation and survival benefit in advanced prostate cancer.
- Celecoxib (non steroidal anti inflammatory drug used to treat arthritis) a COX-2 inhibitor. Celecoxib has already been used in clinical trials in men with prostate cancer.