London – Prostate cancer victims could be spared the cruel side-effect of impotency thanks to a pioneering surgical technique.
Men with aggressive forms of the disease usually have the gland removed – but the operation can damage nerves that are vital to sexual function.
The new technique, which limits this damage, has been developed by British scientists who hope it will be available within five years. They say the results of a three-year trial involving 400 patients have been very promising.
Some patients, especially younger men, turn down surgery because of the potential side-effects and then go on to develop incurable cancer.
Greg Shaw, who is leading the trial at University College London, said: "Almost all men who have had prostate surgery suffer nerve damage. This damages their sex life and means they are not able to have full erections. This new technique should allow men who have surgery to remove their prostate to remain sexually active."
While the patient is under anaesthetic on the operating table, the removed prostate is analysed under a microscope by a pathologist. If no cancer is detected in the area adjoining the nerves, the ‘all clear’ is given and the operation finishes.
If cancer is found, the surgeon removes the nerves to ensure that all cancerous cells are removed. In contrast, under existing procedures, doctors have no way of knowing for certain whether nerve cells have cancer and are more likely to remove them to be on the safe side.
Shaw said: "The tendency is to not spare the nerves if there is thought to be a risk of leaving cancer behind. We know that nerve-sparing works. The more nerve tissue is left behind, the greater a man’s chances of being potent after surgery.
"If we can’t leave the nerves at all, they’re extremely unlikely to be potent, even with Viagra."
Shaw launched the trial after seeing two young men end up with untreatable cancer after deciding against surgery.
The consultant urological surgeon said: "They chose not to have surgery because they were so scared of the side-effects. But the cancer spread, meaning it was no longer curable. They are going to die of that cancer."
The procedure is being offered in London, Bristol, Sheffield and Glasgow. The trial will test if it is clinically effective and suitable for the NHS. It is the first time the technique has been tried anywhere in the world.
Dr David Montgomery, who is director of research at Prostate Cancer UK, said: "For too many men with potentially curable prostate cancer, their treatment either fails to eradicate their cancer or causes side effects such as erectile dysfunction.
"Research like this is a potential win-win, as it aims to increase the number of men being cured while at the same time reducing the number needing further treatment or suffering from reduced sexual function.
"We at Prostate Cancer UK believe research into treatments which cure more and harm less is crucially important.
"That’s why we will continue to fund research of this type now and in the future."