German premiere: prostate cancer was treated with laser fibers
German doctors used a new surgical method for prostate cancer outside of clinical trials for the first time. So far, those with low-risk prostate cancer have had only three options: radiation, removal, or surveillance. On May 3, 2018, a team of doctors performed minimally invasive treatment for the first time, which experts call the "Tookad" procedure. Only the side of the prostate affected by cancer is treated.
Physicians led by Prof. Manfred Wirth of the Clinic for Urology at the Carl Gustav Carus University Hospital in Dresden successfully carried out the "Tookad procedure". This form of therapy uses the photosensitive active ingredient Padeliporfin (Tookad). In the minimally invasive operation, laser fibers are inserted into the affected side of the prostate. The Padeliporfin drug is stimulated with the laser. As a result, targeted vascular destruction occurs and the desired tissue dies. In the future, this treatment method with few side effects will be available to the patients of the Dresden University Hospital, the clinic reports in a press release on the successful operation.
Prostate cancer is common
In men, prostate cancer is the most common cancer and the second leading cause of cancer death. Every year, around 57,000 men in Germany develop new prostate cancer.
A milestone in urology
"The 'Tookad' procedure is a milestone in urology," reports Professor Wirth. For the first time, patients in Germany with low-risk prostate cancer could also be treated with low risk. Serious interventions such as radiation to the tumor or a radical prostatectomy, i.e. the removal of the prostate, are only recommended in exceptional cases for low-risk prostate cancer because they can cause considerable side effects such as incontinence or impotence.
Mental stress through active surveillance
"The previous standard method of actively monitoring the tumor through regular medical checks without therapeutic intervention is an ongoing psychological burden for many patients," explains the professor.
First clinic with regular care
The effectiveness of the "Tookad procedure" was confirmed in a multicenter study. The process was developed by the renowned Israeli Weizmann Institute for Science. The Urology Clinic of the Dresden University Hospital is the first clinic in Germany to use this procedure in regular care from now on.
How exactly does the process work?
In the "Tookad procedure", the doctors use the photosensitive active ingredient padeliporfin, which is contained in the "Tookad" drug. Light sources with a specific wavelength stimulate this active ingredient. Laser fibers that are inserted into the prostate in a minimally invasive manner activate the medication. Activation leads to the destruction of vessels and the death of the tumor tissue. The procedure is so gentle that the patient can leave the hospital on the third day after the operation. The health status of the remaining prostate tissue is determined in a biopsy nine to twelve months after the operation.
No incontinence and impotence
"Unlike patients whose entire prostate had to be removed, no incontinence occurs with the 'Tookad' procedure," emphasizes Wirth. Potency restrictions are also very rare. So far, however, only a small proportion of all prostate cancer patients could benefit from the new therapy. The method can only be used for those with a low risk.
The process is to be developed further
"Therefore, it is now necessary in the context of further studies to expand the fields of application of the new surgical technique if necessary," said the tumor expert. As a result, the new method should also be used in the future for patients who are at risk of prostate cancer.
German Society for Urology agrees
"The procedure fills the gap between radical treatment and active observation," Professor Paolo Fornara, President of the German Society for Urology, told the news agency "dpa". The previous methods are a choice between black or white. Fornara reports that the targeted destruction of tumor cells is already being successfully practiced in other areas such as dermatology and lung or bladder cancer. "We are destroying the tumor instead of the entire organ," says Fornara.
So far, up to 15 percent of patients can benefit
"On average, ten to 15 percent could benefit from Tookad with a good forecast," estimates Professor Fornara. The optimal treatment option must be filtered out for each patient. With locally limited prostate cancer, the chances of recovery would be 90 percent. "And we now have the luxury of being able to choose between four individual options," sums up Fornara. (vb)