LONDON — A new clinical trial for an innovative prostate cancer treatment promising fewer side effects than traditional surgery has launched in the United Kingdom, offering hope to men facing the disease. The therapy, known as Aquablation, uses a robotic-assisted high-pressure water jet guided by artificial intelligence and real-time imaging to precisely remove cancerous tissue while sparing surrounding nerves and muscles. Backed by the government-funded National Institute for Health and Care Research (NIHR), the trial aims to determine if Aquablation performs as well as or better than the standard radical prostatectomy, which involves removing the entire prostate gland.
The trial, sponsored by U.S.-based Procept BioRobotics, is taking place across seven countries and will recruit 280 patients globally, all diagnosed with early-stage, localized prostate cancer who have opted for surgical intervention. In the UK, the study is being conducted at four leading centers: The Royal Marsden, Guy's and St Thomas' NHS Foundation Trust, The Royal Free London NHS Foundation Trust, and Norfolk and Norwich University Hospitals NHS Foundation Trust. Participants must have cancer confined to the prostate or just outside it, making them eligible for curative surgery but at risk of complications like infection, erectile dysfunction, and urinary incontinence from conventional methods.
Aquablation represents a less invasive alternative to the radical prostatectomy, which has long been a cornerstone treatment for localized prostate cancer. Surgeons using this technology map the prostate in real time with ultrasound, identifying and targeting only the cancerous areas. By avoiding damage to nerves linked to erectile function and muscles connected to the bladder, experts anticipate a reduction in post-operative side effects that can significantly impact quality of life.
"For men with prostate cancer confined to the prostate, curative options are excellent, however we are becoming increasingly focused on the side effects of the cancer treatment and how we can embrace new technology to maintain a man's quality-of-life following their surgery," said Philip Charlesworth, a consultant urological surgeon at The Royal Marsden. He emphasized the trial's focus on Aquablation's robotic approach to cancer removal while preserving continence and sexual function.
Charlesworth described the initiative as "an incredibly exciting prospect for the future of prostate cancer care." He added that positive outcomes could introduce "an alternative surgical treatment option for patients with localised prostate cancer across the globe." The therapy is already in use at some centers for treating benign prostatic hyperplasia (BPH), a non-cancerous enlargement of the prostate, suggesting a foundation for its application in oncology.
Prostate cancer remains one of the most common cancers among men, with Prostate Cancer UK estimating that about one in eight men will develop it in their lifetime. According to the charity, 58,218 men were diagnosed with the disease in England last year, marking an almost 9 percent increase from 2023. These figures underscore the urgency of advancing treatments that balance efficacy with minimal disruption to daily life.
Current options for localized prostate cancer extend beyond surgery to include active surveillance, where low-risk cases are monitored closely without immediate intervention, and radiation therapy. However, for many patients, surgery remains the preferred route for a potential cure, prompting researchers to refine techniques like Aquablation to address its drawbacks. The NIHR's involvement signals strong governmental support for evidence-based innovations in cancer care.
The launch of this trial comes amid broader discussions about prostate cancer management in the UK, particularly regarding screening programs. Last month, scientific advisers to the government recommended against routine screening for the vast majority of men, citing that it would "likely cause more harm than good" due to risks like overdiagnosis and unnecessary treatments outweighing benefits for the general population.
Instead, the committee proposed targeted screening every two years for men aged 45 to 61 with BRCA1 and BRCA2 genetic mutations, which elevate prostate cancer risk significantly. Health Secretary Wes Streeting expressed surprise at the decision, highlighting ongoing debates within health policy circles. Despite this, pressure for a national screening program continues to build, fueled by high-profile advocates.
Olympian Sir Chris Hoy and former Sky News presenter Dermot Murnaghan, both recently diagnosed with advanced prostate cancer, have publicly called for expanded screening. Similarly, former Prime Minister Lord Cameron has supported the campaign following his own treatment for the disease. These voices have amplified calls for better early detection, even as experts weigh the evidence.
The Aquablation trial builds on existing research into robotic and AI-assisted procedures in urology, reflecting a global trend toward precision medicine. Procept BioRobotics, the trial's sponsor, has been developing the technology since its inception, with initial applications in BPH treatment showing promise in reducing complications. The international scope of the study, involving centers in the UK and beyond, aims to generate robust data applicable worldwide.
Patients in the trial will undergo randomized assignment to either Aquablation or standard surgery, with outcomes tracked for efficacy in cancer removal and side effect profiles. Recruitment began recently, with the UK sites poised to enroll a significant portion of the 280 participants. Officials at the participating NHS trusts expressed enthusiasm for contributing to what could be a paradigm shift in prostate cancer surgery.
While the trial's results are years away—expected to inform future NHS guidelines and potential approvals—the initiative highlights the UK's role in pioneering cancer therapies. For the estimated 12,000 men diagnosed annually in England alone, advancements like Aquablation could mean preserving not just lives, but also the aspects of life that matter most. As research progresses, it intersects with parallel efforts to refine screening and awareness, painting a multifaceted picture of progress against this pervasive disease.
In the context of rising diagnoses, the trial's focus on quality-of-life preservation resonates deeply. Prostate Cancer UK has long advocated for innovations that mitigate treatment burdens, and this study aligns with that mission. Whether Aquablation ultimately joins the arsenal of standard options remains to be seen, but its debut in clinical testing marks a hopeful step forward.
Looking ahead, the NIHR and Procept BioRobotics plan to monitor long-term data from the trial, potentially paving the way for broader adoption if superior outcomes are confirmed. For now, men considering surgery for localized prostate cancer have one more avenue to discuss with their physicians, as the medical community edges closer to personalized, less invasive cures.