HIFU - Ultrasound als operatietechniek net zo effectief dan standaard chirurgie maar met 72% minder bijwerkingen, zoals incontinentie, bij 240 prostaatkankerpatiënten, aldus vijfjaars studie.

d.d. 22 februari 2004: Bron: Nature en Wallstreet Journal.

Opereren met ultrasound - geluidsgolven - net zo effectief maar met 72% minder bijwerkingen, zoals incontinentie, dan na standaard chirurgie bij oudere prostaatkankerpatiënten.

Franse onderzoekers hebben de afgelopen vijf jaren een studie gedaan bij 240 oudere prostaatkankerpatiënten met opereren met HIFU = geluidsgolven - ultrasound. Na vijf jaar bleek 65% van de geopereerde patiënten geen recidief te hebben gekregen, een resultaat dat gelijk staat aan effect na standaard operatie. Maar de bijwerkingen zoals incontinentie (en impotentie) was vermindert van 80% naar 8 %, dus 72% van de patiënten had geen last van chronische incontinentie. Dus zeer hoog significant. De onderzoekers stellen dat deze vorm van opereren wellicht voor vele andere vormen van kanker kan worden ingezet.

Ultra sound is een vorm die voornamelijk tot nu toe werd gebruikt bij het maken van echo's bij zwangere vrouwen. In 2000 schijnt een Duitse studie bewezen te hebben dat deze manier van opereren verre te prefereren is bij lever- en niertumoren. Volgens onderstaand artikel wordt in China al jaren met deze techniek gewerkt bij levertumoren en niertumoren. Wij vragen ons af of deze studie niet gewoon een nieuw bewijs is van een succesvolle RFA-behandeling, omdat ook bij RFA wordt gewerkt met radiogolven. De behandeling duurt afhankelijk van plaats en grootte tumoren 1 tot 3 uur. En zoals bij RFA met gesloten huid en holle naald onder echobegeleiding. Dus ook de ingreep op zichzelf is al veel en veel minder belastend..

Hieronder twee artikelen over deze nieuwe studie, 1 uit Nature en 1 uit de Wallstreet Journal.

American Association for the Advancement of Science,
Seattle, February, 2004

Silent sound zaps cancer
Ultrasound cuts side effects when used to remove tumours.
16 February 2004
JIM GILES

Replacing a surgeon's scalpel with a beam of high-energy sound could reduce the side effects that hamper some cancer treatments, says the team behind a new clinical trial.

The study of prostate cancer patients, announced on 14 February, adds to the growing hope that high-frequency sounds beyond the range of human hearing will one day transform the removal of tumours. "It will eventually revolutionize treatment for some cancers," predicts Gail ter Haar of the Royal Marsden Hospital in Sutton, near London.

The French study used a high-energy version of the ultrasound waves that are used to image unborn babies. The waves normally travel harmlessly through the body, but when focused on one spot, they boost tissue temperature to above 60 °C and kill cells. By moving the focus of the waves, doctors can remove whole tumours without a single incision.

Jean-Yves Chapelon and his colleagues at the French National Institute for Health and Medical Research in Paris used ultrasound to treat around 240 elderly prostate cancer patients for whom surgical removal of the prostate - a common strategy for combating the cancer - was considered too risky. They then tracked the patients' progress for five years.

Around 65% of the patients remained free of cancer during this time, a similar success rate to surgery. But rates of incontinence, the major side effect of surgery, were cut from 80% to 8%. Unlike other therapies, the treatment can be safely repeated if the cancer reappears. "This is now ready to challenge other therapies," says Chapelon.

The result backs up a similar study of German patients, published in 2000, and adds to mounting evidence of the benefits of ultrasound. The therapy is already widely used in China to attack cancers of the liver and kidney, says ter Haar, and Chinese doctors say the treatment has fewer side effects than alternatives such as radiotherapy. She is now running a clinical trial designed to assess these claims.

Ultrasound can tackle cancer anywhere in the body, as long as tumours are not obstructed by bone or pockets of gas such as air in the lungs. The treatment lasts one to three hours.

© Nature News Service / Macmillan Magazines Ltd 2004

-- =WSJ.COM/The Daily Scan: Using Ultrasounds To Fight Cancer --

By Mark Ingebretsen
Of THE WALL STREET JOURNAL ONLINE

NEW YORK (Dow Jones)--Researchers are working on a gentler alternative to
prostate-cancer surgery by harnessing greatly energized versions of the same
sound waves used to image babies in the womb.
The New Scientist reports: "Focused pulses of ultrasound can eradicate
prostate cancer as effectively as cutting the tumor out with surgery, but with
far fewer side effects."
In fact, patients may not even be sedated when they undergo the precise
surgical technique, the Guardian said. "In the same way as a magnifying glass
can be used in bright sunlight to set fire to dry tinder, sound energy can be
focused and used to raise temperatures to the point at which the cells will
die," one researcher explained in the Guardian.
Nature described how sound "waves normally travel harmlessly through the body,
but when focused on one spot, they boost tissue temperature to above 60 degrees
Celsius (140 degrees Fahrenheit) and kill cells. By moving the focus of the
waves, doctors can remove whole tumors without a single incision," the article
said.
Unlike other methods used to treat cancer such as "radiotherapy and drugs, the
(ultrasound) technique also leaves healthy tissue next to a tumor undamaged,"
the British Broadcasting Corp. said.
To treat a prostate-cancer patient, "Physicians use a probe inserted through
the rectum to image and send the ultrasound waves into the prostate," the
Seattle Times said.
Besides treating prostate cancer, ultrasound might one day be used to zap
other cancerous tumors, and researchers also envision the technique could be
enlisted to halt bleeding in trauma patients, the Seattle Times said.

Rise of the Patient Medical Consultant

In addition to getting a doctor's second opinion, patients now have another
way to learn more about their conditions and treatment options. The Los Angeles
Times reported that more patients are enlisting "independent research firms...to
review the treatment recommendations of their doctors on medical issues ranging
from the mundane to the potentially life-threatening." And they're also using
"programs or firms that help them find the best surgeons, hospitals or clinical
research trials."
Like consultants hired to advise companies, the medical research firms may
provide customized reports detailing their findings. Fees typically start at
$200 a report. Some doctors refer their patients to the firms, the article said.
The L.A. Times story notes that the vast quantity of health information
available on the Internet actually has increased the use of such services. Enter
a common medical condition into a search engine, and you'll likely receive
thousands of entries. Moreover, there currently is no single source aimed at
consumers that unites vital medical information such as "comparing drug
effectiveness, treatment options and quality of medical care" relating to the
specific condition a patient is suffering from, the article said.

Satellites Guide the Blind

The same satellite-based global positioning system, or GPS, that guides ships,
aircraft and hikers is now being used to help the blind, Wired reports. A system
called VoiceNote GPS uses a keyboard for input plus a synthesized voice to
inform users what street they're walking on and when they arrive at a desired
destination. Costing $2,000 per machine, VoiceNote GPS "combines computer
technology, including digital voicing, with the GPS device, which allows a
person to pinpoint his or her location. The device, in essence, makes an audio
map," Wired explained, allowing users to be automatically guided as they retrace
a route.

Dust to Dust

All your life you've recycled, voted consistently for candidates who support
the environment and only used organic chemicals on your lawn. As a final act of
earth friendliness, there is one more thing you might consider. Out of "Concerns
about the environmental impact of embalming fluids or cremation," a Swedish
company is offering nonpolluting freeze-dried burials, according to the BBC. The
company's "method involves freeze-drying the corpse in liquid nitrogen. Sound
vibrations then shatter the brittle remains into a powder that can be 'returned
to the ecological cycle,' " the article said.