Norfolk and Norwich hospital pioneers special shield during treatment for prostate cancer

Prostate cancer specialists from the radiotherapy department at Norfolk and Norwich University Hospitals Foundation Trust are thought to be the first in the world to use an innovative technique to help patients receiving treatment for prostate cancer.

Some patients receiving radiotherapy for prostate cancer will have their treatment split into two parts. The first stage of killing the cancerous cells uses high dose rate (HDR) brachytherapy. The second part is delivered by external beam radiotherapy (EBRT), which is carried out over a number of appointments.

During both stages, it is possible for healthy tissue to be damaged. By inserting a shield known as a hyaluronic acid rectal spacer, it is possible to protect neighbouring tissues from the potential damage caused by EBRT. The rectal spacer insertion is usually carried out under local anaesthetic, one to two weeks prior to treatment.

However, the trust says that in June the brachytherapy team became the first team to insert a hyaluronic acid rectal spacer during HDR brachytherapy treatment.

The composition of other spacing devices has prevented their use during HDR brachytherapy treatment, as they limit the visibility of ultrasound imaging, which is key for monitoring this type of brachytherapy treatment. The hyaluronic acid spacer does not interfere with ultrasound signals, which means the prostate gland and surrounding organs can be seen fully after the implant has been inserted. This allows the implant to be inserted during the HDR procedure without reducing image quality for the radiotherapist placing the needle.

Consultant clinical onco-logist Dr Jenny Nobes said: “This is great news for our patients as it reduces the amount of tissue damage to the surrounding area, potentially reducing side effects, and lowers the amount of time they have to spend in the hospital.

“The insertion of the implant immediately before an HDR procedure can not only reduce the number of appointments a patient has to have, but can also enable the treatment team to plan in real time and better position needles, which again is better for our patients.”

Picture: Oncology registrar Dr Stephanie Brown, consultant clinical oncologist Dr Jenny Nobes, advanced therapeutic practitioner (prostate brachytherapy) Sam Worster, senior therapeutic radiographer Oliver Burn and lead clinical scientist Vicki Currie.

Published on page 3 of the October 2021 issue of RAD Magazine.