New procedure against prostate cancer in clinical use

German premiere: Prostate carcinoma was treated with laser fibers

German doctors first applied a new surgical method for prostate cancer outside of clinical trials. So far, there have only been three options for irradiation, removal or monitoring for those with low-risk prostate cancer. On May 3, 2018, a team of physicians carried out a minimally invasive treatment for the first time, which is known in professional circles as the "Tookad" procedure. Only the cancerous side of the prostate is treated.

Physicians led by Prof. Manfred Wirth of the Department of Urology at the University Hospital Carl Gustav Carus in Dresden successfully carried out the "Tookad procedure". This therapy uses the photosensitive agent Padeliporfin (Tookad). In minimally invasive surgery, laser fibers are inserted into the affected side of the prostate. With the laser, the Padeliporfin drug is stimulated. As a result, targeted vascular destruction occurs and the desired tissue dies. In the future, the patients of the University of Dresden this method of treatment with minor side effects is available, reports the hospital in a press release on the successful operation.

For patients with low-risk prostate cancer, a new minimally invasive treatment called the Tookad procedure is now available. (Image: estradaanton / fotolia.com)

Prostate cancer is common

In men, prostate cancer is the most common cancer and the second most common cause of cancer death. Every year around 57,000 men in Germany become ill with prostate cancer.

A milestone in urology

"The 'Tookad' procedure is a milestone in urology," reports Professor Wirth. For the first time, patients with low-risk prostate cancer in Germany could also be treated with low risk. Serious interventions such as tumor irradiation or radical prostatectomy, ie the removal of the prostate, are only to be recommended for prostate cancer with low risk only in exceptional cases, since they can cause considerable side effects such as incontinence or impotence.

Psychological burden of active surveillance

"The current standard procedure of actively monitoring the tumor through regular medical checks without therapeutic intervention is a constant psychological burden for many patients," explains the professor.

First clinic with regular care

In a multicenter study, the effectiveness of the "Tookad" procedure was confirmed. The process was developed by the renowned Israeli Weizmann Institute of Sciences. The Department of Urology of the Dresden University Hospital is the first clinic in Germany to use this procedure in the regular care.

How does the procedure work??

In the "Tookad procedure", doctors use the photo-sensitive drug Padeliporfin, which is contained in the "Tookad" drug. Light sources with a certain wavelength stimulate this drug. Laser fibers that are introduced minimally invasively into the prostate activate the drug. The 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 surgery. Nine to twelve months after the operation, a biopsy is used to determine the state of health of the remaining prostate tissue.

No incontinence and impotence

"Unlike patients who had to remove the entire prostate, no incontinence occurs in the 'Tookad' procedure," Wirth points out. Also restrictions on potency are very rare. So far, however, only a small proportion of all prostate cancer patients can benefit from the new therapy. Only for those with a low risk, the method can be used.

The process should be further developed

"Therefore, it is now in the context of further studies, if necessary, to expand the fields of application of the new surgical technique," said the tumor expert. This will allow the new method to be used in the future for patients suffering from prostate cancer at higher risk.

German Society of Urology agrees

"The procedure fills the gap between radical treatment and active observation," explains Professor Paolo Fornara, president of the German Society for Urology, to 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 successfully practiced in other disciplines such as dermatology and lung or bladder cancer. "We destroy the tumor instead of the whole organ," says Fornara.

So far, up to 15 percent of patients can benefit

"On average, ten to fifteen percent could benefit from Tookad's good prognosis," estimates Professor Fornara. For each patient, the optimal treatment option must be filtered out. For locally limited prostate cancer, the chance 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)