What is a HIFU procedure for prostate cancer?


What is a HIFU procedure for prostate cancer?

One of the newest ways to treat prostate cancer is a treatment called high-intensity focused ultrasound or HIFU is a technique using powerful precision focused sound waves to destroy cancerous tissue found in the prostate gland while leaving healthy tissue alone.

This technique uses powerful precision focused sound waves to destroy cancerous tissue found in the prostate gland while leaving healthy tissue intact. It was approved by the FDA in 2015 and was the first ultrasound system for the ablation of prostate tissue in the United States making it one of the newest ways to treat prostate cancer.

This revolutionary high tech approach to treating prostate cancer is noninvasive and has been under development for more than 30 years.  In 1995, is when HIFU was first used in Europe to treat prostate cancer and has also been used in Asia, Mexico, and the Caribbean.   

Since the prostate is deep within the pelvis, HIFU uses a probe called a rectal transducer placed into the rectum that gives out a beam of high-intensity focused ultrasound waves into the prostate.  Advanced 3D ultrasound imaging allows HIFU which is robotically controlled to deliver the focused beam of ultrasound waves into the prostate gland so that the targeted prostate tissue can be destroyed.  Since the ultrasound beam is highly focused and precise, this avoids any damage to neighboring structures such as the bladder, rectum, external urinary sphincter, and neurovascular bundles that control erectile function.  HIFU is performed under anesthesia in an outpatient setting.  Patients will require catheter drainage of the bladder for approximately 1-2 weeks but recovery is usually rapid since there are no incisions to heal.

The technology of HIFU has also been used in other types of cancer such as breast, liver, kidney, pancreatic and bone. 

Initially blocked for approval

Questions surrounding the safety, lack of information and deficiencies had been the holdup of FDA approval in the past. HIFU had been approved by other countries where more than 50,000 men had been treated with the procedure.  This was forcing some men to travel outside the United States seeking HIFU treatment available in other countries but not in the US. 

But since FDA paved the way for use of HIFU for men with prostate cancer, this is another welcomed option of a noninvasive procedure which can selectively target and treat tumors in this area. 

Use of HIFU has certain specifications

HIFU may not be for every man who is diagnosed with prostate cancer.  Like any cancer diagnosis, there needs to be an individualized care plan to best meet the needs of the patient.  Eligibility for HIFU depends on whether a man has low-grade cancer that has not spread outside the prostate gland and if this is a recurrent prostate cancer after radiotherapy. 

Men who may not be good candidates for HIFU are those with enlarged prostate or older men who may not be able to tolerate surgery. Men diagnosed at the earliest stage of prostate cancer (Gleason score of 6) should consult with their doctor if HIFU could be a viable option. 

Good results with HIFU presented at annual AUA meeting

At the 2016 American Urology Association (AUA) annual meeting, it was presented that results of a multi-institutional prospective study showed that 94% of men with early stage prostate cancer treated with HIFU had eradication of all clinically significant cancer in the area treated. 

Other results showed that 87 of 101 cases (86%) had complete ablation of all cancer in the prostate.  When the men were followed up 2 years later, 89% were still alive without radical therapy.  Almost 100% of the men had resolved any urinary incontinence and about 80% had preserved erectile function. 

Advantages and disadvantages of HIFU

The advantage of HIFU is it is minimally invasive, with a minimal hospital stay and few side effects.  The disadvantage is possible scarring of the prostate and it is costly. 

With any procedure there can be possible complications and side effects and to recognize everyone responds differently to varying forms of treatment.  The decision to use HIFU or not is between the patient and his doctor to decide.  Weighing the pros and cons is an important step before any decision is made on using HIFU for treating prostate cancer.