Aquablation trial begins in the UK to test lower-side-effect prostate cancer surgery

Aquablation trial begins in the UK to test lower-side-effect prostate cancer surgery

A groundbreaking Aquablation trial for localized prostate cancer has officially started in the United Kingdom, aiming to determine whether this robotic, image-guided waterjet procedure can offer effective cancer control with fewer side effects than traditional radical prostatectomy.

Supported by the National Institute for Health and Care Research (NIHR) and sponsored by Procept BioRobotics, the multicentre study plans to recruit around 280 patients worldwide, including several leading UK hospitals. Participants will all have early-stage prostate cancer and have already opted for surgical treatment.

What is Aquablation and how it works

Aquablation is a minimally invasive, robotic-assisted therapy using a high-pressure waterjet and real-time ultrasound mapping to remove cancerous tissue while preserving surrounding nerves and muscles. This precision approach aims to reduce the risk of side effects such as erectile dysfunction and urinary incontinence, which are common complications following conventional prostate surgery.

The procedure has previously been used for benign prostatic hyperplasia (BPH) and is now being tested for cancer treatment in this first-of-its-kind trial in the UK.

UK hospitals leading recruitment

The Royal Marsden NHS Foundation Trust in London became the first European hospital to recruit a patient for the trial. Other UK centres include:

• Guy’s and St Thomas’ NHS Foundation Trust
• Royal Free London NHS Foundation Trust
• Norfolk and Norwich University Hospitals NHS Foundation Trust

Over 25 centres globally are participating, reflecting the international scope of the study.

Expert insights: prioritizing quality of life

Philip Charlesworth, consultant urological surgeon at the Royal Marsden, highlighted the significance of the trial:

“For men with prostate cancer confined to the prostate, curative options are excellent; however, we are increasingly focused on reducing the side effects of treatment while maintaining a man’s quality of life. Aquablation has the potential to preserve urinary and sexual function while effectively removing cancerous tissue.”

The trial will rigorously compare outcomes of Aquablation vs radical prostatectomy, measuring both cancer control and patient-reported quality-of-life metrics.

Context: prostate cancer screening debate

The launch comes amid ongoing discussions in the UK about prostate cancer screening. The UK National Screening Committee recently issued a draft recommendation limiting routine PSA testing, citing risks of overdiagnosis and overtreatment. Screening is currently recommended primarily for men with BRCA1 or BRCA2 mutations, who are at higher risk.

While screening guidelines continue to evolve, the Aquablation trial represents an important advance in offering less invasive, nerve-sparing treatment options for men diagnosed with localized prostate cancer.

Implications for patients

If proven effective, Aquablation could become a widely available alternative to traditional surgery, offering men cancer control with fewer complications and improved post-operative quality of life. Patients, clinicians, and researchers worldwide are watching closely, as the results could redefine surgical standards for localized prostate cancer.

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