What Is HIFU?
HIFU stands for High Intensity Focused Ultrasound. It is a procedure where sound waves are focused into a single beam and then used to target regions of the prostate gland where cancerous cells have been detected. The targeting is done with an MRI or Magnetic Resonance Imager, and allows the HIFU device to destroy only cancerous cells with little effect on healthy tissue.
HIFU is not a surgical procedure and therefore does not require an overnight stay in hospital. As an out-patient, you would arrive in the morning and then be given a local spinal anesthetic. Although rare, you may also be given a general anesthetic to put you under.
While lying on your side, a probe is inserted into your rectum until it is adjacent to your prostate. With targeting information provided by the MRI, the focal point of the sound wave is centered on the diseased cells within the gland. The pulse emitted by the probe heats the targeted area to as high as 85°C, destroying the cancerous tissue through a process called coagulation necrosis. This is repeated until all the cells affected by the cancer have been targeted and heated. To treat the entire prostate gland typically takes up to 3 hours.
A temporary catheter is inserted to deal with the expected urinary leakage that most patients report immediately after treatment. Other common temporary side effects are mild bleeding at the beginning of your urine stream and a frequent need to urinate. These symptoms are expected to last up to 2 weeks.
Discharge is the day of the treatment and you can return home able to eat regular foods. You would receive a prescription for antibiotics and will show up for a follow-up exam in 2 weeks.
HIFU treatments are available only for patients with cancer that is confined to the prostate gland. Research is continuing on more advanced cancers, but the cure rate on men with T1 and T2 stage prostate cancer is in excess of 90%.
A study conducted over 5 years at the University of Regensburg in Bavaria concluded that HIFU treatments were effective in permanently eradicating prostate cancer. 93% of cases treated in this period reported no return of cancerous cells after 22 months.
Where HIFU treatments were targeted to avoid the nerve entering the prostate, 80% of patients reported that their sex lives were unaffected by the procedure. One third of patients whose prostate nerve had to be targeted during the treatment still managed to escape symptoms of impotence afterward.
Other side effects such as urinary incontinence or blockage of the urethra were limited to less than 10% of the patients treated during this study.
In addition, none of the men studied reported any decline in their quality of life after the procedure was carried out.
The conclusion of this study was that HIFU prostate cancer treatment can provide a cure for men whose cancer is confined to the prostate gland.