A new surgical technique known as NeuroSAFE is offering new hope to men undergoing prostate cancer surgery, nearly doubling the chances of preserving erectile function without compromising cancer treatment, researchers say. The innovative method, detailed in a study published on March 24 in The Lancet Oncology, helps surgeons retain the delicate nerves that run along the outer layers of the prostate, which play a crucial role in erectile function. In addition to preserving these nerves, the technique includes a real-time pathological assessment to ensure that all cancerous tissue is removed, reducing the risk of recurrence.

How NeuroSAFE Works

Traditional prostate cancer surgery poses a significant risk of impotence and incontinence, two common side effects that can impact a patient’s quality of life. While robotic-assisted surgery has improved precision, one of the key challenges surgeons face is determining whether sparing the nerves could leave behind cancer cells. This uncertainty often leads doctors to err on the side of caution, sacrificing the nerves to ensure complete cancer removal.

NeuroSAFE addresses this challenge by allowing surgeons to check for remaining cancer cells during the operation itself. The procedure involves removing the prostate gland while carefully preserving as much surrounding nerve tissue as possible. Once the prostate is extracted, it is flash-frozen, and tissue samples are immediately analyzed by a pathologist. If cancerous cells are detected near the nerves, surgeons can decide to remove additional tissue. If no cancer is found in the nerve areas, the operation proceeds with the nerves intact.

This real-time decision-making process ensures that the patient receives the most effective cancer treatment while maximizing the chances of retaining erectile function.

Clinical Trial Results Show Promising Outcomes

The effectiveness of NeuroSAFE was tested in a clinical trial across five hospitals in the United Kingdom. The study involved 344 men diagnosed with prostate cancer who were scheduled for prostate removal. Half of the participants underwent standard surgery, while the other half received the NeuroSAFE technique.

One year after surgery, 39 per cent of men who underwent NeuroSAFE had either no or mild erectile dysfunction, compared to just 23 per cent of those who had standard surgery. Severe erectile dysfunction was observed in only 38 per cent of NeuroSAFE patients, whereas 56 per cent of those who had traditional surgery reported severe impairment.

The technique did not increase the risk of incontinence, and patients who did experience urinary control issues recovered faster with NeuroSAFE than with standard surgery.

Expert Insights and Future Prospects

Dr Greg Shaw, a consultant urologist at University College London Hospital and a key researcher in the study, emphasized the benefits of NeuroSAFE, stating, “Our results show that by using NeuroSAFE, nearly twice as many men don’t have to face potentially life-changing erectile dysfunction after prostate surgery. The procedure requires expertise, but it is not expensive, especially considering the significant benefits it offers patients.”

Dr Ricardo Almeida-Magana, a research fellow at University College London, highlighted that NeuroSAFE provides a level of certainty that traditional methods lack. “Surgeons typically rely on MRI scans, digital rectal exams, and biopsy results to decide whether to spare nerves. While these methods provide guidance, NeuroSAFE offers real-time certainty, expanding the possibility of nerve-sparing surgery for more patients without compromising cancer control,” he explained.

However, experts caution that NeuroSAFE may not be suitable for all patients. “Many men can already have nerve-sparing surgery using standard robotic techniques,” Shaw noted. “But for younger patients or those who wouldn’t normally qualify for nerve-sparing procedures, this method gives them a better chance to maintain their quality of life.”

The Need for Further Research

While the initial findings are promising, researchers stress that further studies are needed to assess the long-term cancer outcomes of patients treated with NeuroSAFE. Continuous monitoring and additional trials will help determine the durability of its benefits in preventing cancer recurrence.

For now, the introduction of NeuroSAFE represents a significant step forward in prostate cancer surgery, giving patients greater hope for a full recovery with fewer life-altering side effects.

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