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Shahram Shawn Gholami, M.D.

Internationally recognized expert
in Robotic Surgery

performed thousands of laparoscopic and robotic
procedures since 2000. Learn more about Dr. Gholami

 

High Intensity Focal Ultrasound (HIFU)

Prostate cancer is the most common cancer in men and may cause it to enlarge, resulting in symptoms such as difficulty in urinating, frequent urination, and blood in the urine.

Current treatments include surgery to remove the whole prostate or radiotherapy, both of which can effectively treat the cancer but often causes side effects such as incontinence and impotence.

A new prostate cancer treatment that involves heating the tumor with highly-focused ultrasound may mean that men with prostate tumors can be treated without an overnight stay in hospital and avoid the distressing side effects associated with current therapies.

What is HIFU and How Does it Work?

High intensity focused ultrasound is a newer type of prostate cancer treatment. The treatment is given using a machine that gives off high frequency sound waves that deliver a strong beam to a specific part of the prostate cancer. Some cells die when this high intensity ultrasound beam is focused directly onto them.

HIFU is only useful in treating a single tumor or part of a larger tumor. It can’t be used to treat tumors that are more widespread in the body, and therefore it is not suitable for people with cancer that has spread to more than one place in their body.

High intensity focused ultrasound (HIFU) for prostate cancer is carried out under a spinal or general anesthetic. With the patient lying on his right side, an endorectal probe – incorporating an ultrasound scanner and a HIFU treatment applicator – is inserted. This allows the target area to be monitored and defined before being treated.

The probe emits a beam of ultrasound, which is focused to reach a high intensity in the target area. Absorption of the ultrasound energy creates an increase in temperature, which destroys the tissue within the focal area. A cooling balloon surrounding the probe protects the rectal mucosa from the high temperature. A urethral or suprapubic catheter is used after the procedure.

Because the prostate is positioned deep within the pelvis, the ultrasound can direct beams more accurately at the prostate. Results from trials so far show that HIFU may be as successful in treating prostate cancer as treatment with radical prostatectomy or radiotherapy.

What are the Advantages of HIFU?

People who have been treated with HIFU have had very few side effects. It may cause some pain for 3 to 4 days after the procedure and /or sore skin in the treated area, but this is unusual. Some additional advantages of focal HIFU include:

  • reduced treatment time;
  • fewer side effects, particularly incontinence and erectile dysfunction;
  • outpatient procedure general performed under local or general anesthesia that is completely radiation free;
  • no incisions or blood loss and recovery is quick;
  • can be repeated, if necessary and be used as a salvage therapy if other prostate cancer treatment options fail;
  • no harm to any tissue surrounding the targeted focal point.

Are There Any Known Disadvantages?

Disadvantages of this approach mainly impact cure rates. Prostate cancer is generally regarded as a multi-focal disease, i.e. present in more areas than detected on biopsy and usually not confined to a single area of the prostate. In recommending focal therapy, one presupposes that disease not detected by biopsy is clinically insignificant and may never become clinically significant in the patient’s lifetime. This fact is unproven by any long-term follow up studies but does have intuitive appeal based on the slow growth rate of most prostate cancers.

If you feel that you may be a candidate for HIFU for treatment of prostate cancer – or if you’d like to explore other emerging prostate cancer therapies – call our off today to schedule an appointment to discuss all of your options.

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