The HEALTH | November-December . 2024

UPM Teaching Hospital leads prostate cancer innovation with groundbreaking TMA

This breakthrough makes UPM the first institution in Malaysia and Southeast Asia to offer this cuttingedge treatment , providing new hope for patients seeking minimally invasive alternatives to traditional therapies such as surgery and radiotherapy .

A GROWING CONCERN

Prostate cancer is the second most common cancer affecting men globally and ranks third in prevalence among Malaysian men . Prof Dato ’ Dr Khairul Asri , Head of Urology at UPM , emphasised the importance of early detection , which can be achieved through a simple Prostate Specific Antigen ( PSA ) blood test .

Diagnostic accuracy can be further improved using MRI imaging and targeted biopsies . However , in Malaysia , 50 to 60 per cent of men are diagnosed with prostate cancer at an advanced stage , where treatment options are more limited , and outcomes are less favourable .

Prof Khairul stressed the need for men , particularly those over 50 or younger individuals with a family history of prostate or breast cancer , to discuss PSA testing with their healthcare providers .

Early-stage prostate cancer often presents no symptoms , making screening critical . In contrast , symptoms such as frequent urination , blood in the urine , dribbling , and back or bone pain are more commonly associated with advanced stages of the disease .

The TMA device , which is mobile and easy to carry , consists of a microwave generator attached to the Koelis Trinity device , which is used for prostate mapping and targeted intervention , like a GPS .

Dr Vincent Khor performing targeted microwave ablation therapy for a patient with localised prostate cancer .

COMPREHENSIVE APPROACH

Since the establishment of the Putra Prostate Centre in 2020 , HSAAS has positioned itself as a one-stop centre for prostate cancer care in collaboration with the National Cancer Institute in Putrajaya .

The hospital has been at the forefront of innovative treatments , offering pioneering techniques such as MRI-US fusion prostate biopsy , transperineal prostate biopsy under local anaesthesia , REZUM water vapour therapy for benign prostate enlargement , and high-intensity focused ultrasound ( HIFU ) focal therapy .

Moreover , HSAAS is one of the few public hospitals in Malaysia equipped to offer robotic surgery for prostate cancer , significantly enhancing precision and recovery outcomes .

Through its collaboration with the National Cancer Institute , the hospital ensures patients have access to comprehensive care , including radiotherapy and advanced diagnostic imaging using PSMA ( prostate-specific membrane antigen ) PET / CT scans .

FOCAL THERAPY

Traditional treatments for prostate cancer , such as surgery and radiation , often come with significant side effects , including incontinence and erectile dysfunction .

To address this , HSAAS has introduced focal therapy , a less invasive option for early-stage prostate cancer that offers improved quality of life for patients post-treatment . In September 2023 , the hospital launched this service using HIFU technology to provide more precise and less disruptive treatment .

One patient who underwent the HIFU procedure at HSAAS shared his experience : “ I was diagnosed with prostate cancer a few months ago , and the news was quite overwhelming because I am still young , and I am not willing to live my life with incontinence and erectile dysfunction .

“ When I learned about the HIFU treatment option , I was relieved to know that there was a less invasive choice available . I recovered fast and experienced minimal discomfort after that . I am hopeful that this treatment will lead to a cancer-free future without debilitating side effects that often accompany conventional treatments .”

INTRODUCING TMA TMA is the latest addition to the range of focal therapies available at HSAAS , offering a promising new option for patients diagnosed with early-stage prostate cancer .

This procedure involves precise needle ablations using microwave energy , guided by advanced MRI-US software fusion technology with an organ-based tracking mechanism . Clinical studies in France and Hong Kong have shown impressive results , with a cancer cure rate of up to 90 per cent and excellent safety profiles .

Prof Dr Hamidon Basri , the hospital ’ s director , shared : “ We are proud to be the first hospital in Malaysia and Southeast Asia to offer this advanced treatment .

“ Our goal is to provide patients with the most effective and least invasive treatment options , and this procedure is a testament to our commitment to that mission .”

INTERNATIONAL COLLABORATION

The introduction of TMA at HSAAS is part of a Phase II clinical trial , a collaborative effort with the Chinese University of Hong Kong ( CUHK ).

Prof Dr Intan Hakimah , Deputy Dean ( Academic ) from the Faculty of Medicine and Health Sciences at UPM , highlighted the importance of international partnerships in advancing medical research .

“ UPM is dedicated to advancing medical research , particularly in the field of cancer treatment , through collaborations and cutting-edge technologies . This partnership with CUHK exemplifies our commitment to fostering international collaborations that drive forward-thinking solutions in healthcare and medical science .”

Dr Vincent Khor , the lead investigator on the TMA project , expressed his enthusiasm : “ This procedure is a gamechanger for prostate cancer treatment . It combines the precision of advanced imaging technology with the effectiveness of microwave energy , making it a promising option for patients diagnosed with stage 1-2 prostate cancer .”

According to Dr Khor , patients who undergo TMA can expect shorter hospital stays , less postoperative pain , and a lower risk of complications compared to traditional surgical methods .

PROMOTING AWARENESS

The urology team at HSAAS encourages men to engage in conversations about prostate cancer screening with their healthcare providers , underscoring the importance of early detection for successful treatment outcomes .

While conventional treatment methods remain essential , the availability of focal therapies like TMA and HIFU at HSAAS represents a new era of precision medicine that prioritises patient well-being and quality of life . – The HEALTH