Thousands of men with prostate cancer are set to benefit from a pioneering surgical technique that slashes the risk of one of the most common and feared complications.
The news comes after a major study published today in the Lancet, found that the technique slashed rates of erectile dysfunction for patients in half.
The technique has already been rolled out at five NHS hospitals but surgeons now say that it should be made available for more men with a diagnosis.
Unlike older methods the procedure—NueroSAFE—better preserves the nerves responsible for erections that run through the outer layers of the prostate.
Experts say that the groundbreaking op is the first of its kind in being able fully remove prostate cancers and reduce complications.
Professor Greg Shaw, the trial lead from University College London, said: ‘This trial shows men do not have to face the life changing loss of erectile function.
‘[The technique] should now be used more widely across the NHS, so as many patients as possible can benefit.’
The trial assessed 344 men over five UK hospitals. Twelve months after surgery, 39 per cent of men who had NeuroSAFE had no or mild erectile dysfunction.
Twelve months after surgery, 39 per cent of men who had NeuroSAFE had no or mild erectile dysfunction. In those men who had standard surgery this was 23 per cent
In those men who had standard surgery this was 23 per cent. NeuroSAFE also spared more men from urinary incontinence, another common complication.
The pioneering difference between NueroSAFE and standard robotic surgery is that doctors are able to analyse each layer of the prostate gland during the procedure so they can leave any tissue that is not cancerous and keep the nerves intact.
One of the patients that was part of the trial, Courtney Ming, said: ‘Without this surgery I wouldn’t be living the same quality of life as I am now, and my sex life would have been gone.’
The 62 year-old from London was diagnosed with ‘no symptoms, no pain, no waking up during the night, nothing,’ he said.
The father of two only got tested because his colleagues at work kept pressuring him to.
‘For me the priority was survival, so I did not think twice about having the surgery but I knew that there could be side effects. I feel incredibly fortunate to be alive and be able to still be able to enjoy life,’ said Courtney.
Prostate cancer is the most common form of the disease in men, with 52,000 new diagnoses every year.
It occurs in the prostate gland, the walnut-sized organ which sits below the bladder and produces semen. The disease kills around 12,000 every year.
Around 8,000 have their prostate removed every year in the UK as a result of cancer, in a procedure known as a radical prostatectomy.
During radical prostatectomy the surgeon’s goal is to remove the outer layers of the prostate, without impacting the delicate nerves responsible for erections and urine control.
The problem is that MRI scans can not accurately determine where the boundaries of the cancer is, so Professor Shaw says they ‘often have to urge on the side of caution’ and often remove unnecessary nerves causing the common side effects.
NueroSAFE fixes that problem. Using the technique, the surgeon extracts the prostate gland while preserving the maximum amount of nerve tissue around it as possible.
Layers of the prostate are then flash frozen and samples of it are examined by a pathologist while the operation is still underway and the patient is under general anaestheic.
If cancer is found at the edges of the prostate, around where key nerves are situated, the surgeon can then remove additional tissue, sacrificing the nerves but achieving a complete removal of the tumour.
If no cancer is found, the operation is complete and the nerves are left intact and allowing the patient to maintain sexual function.
Experts say that advancements like this will help calls to introduce a new national screening programme for prostate cancer.
‘The balance is tipping to move towards a national screening and procedures like this that bring down the risk of harm after diagnosis are part of that,’ says Professor Shaw.
‘As if I was screened I would want to know that there are effective treatments that can help me keep my day to day life and this is doing that.’
