HIFU for Prostate Cancer Treatment
High Intensity Focused Ultrasound Treatment or HIFU is an effective treatment option for prostate cancer treatment. It uses high-energy sound waves to destroy prostate cancer cells instead of dangerous radiations. Unlike radiation, HIFU is very precise and doesn’t damage the tissues surrounding the cancerous zone.
HIFU was first used to treat prostate cancer around 1997. Since then, this already safe technology has gone through many improvements and become even safer.
How Does HIFU Work?
HIFU works on the principle that when high frequency sound waves are concentrated on body’s cancerous tissues, they heat up and kill those tissues. When it comes to prostate cancer, the cancer is generally located deep within the pelvis. And so, doctors use HIFU prostate cancer treatment by using a transrectal ultrasound probe, and from this position, the ultrasound waves are aimed directly and accurately at the prostate cancer, effectively destroying it.
Why Used HIFU for Prostate Cancer?
There are several advantages of HIFU for treating prostate cancer:
- It is a truly minimally invasive procedure since the body cavity is not entered.
- Since there are no incisions, the bleeding is negligible.
- HIFU is performed in an outpatient setting and doesn’t require getting admitted in the hospital.
- It can be repeated if required, especially if the disease reappears locally.
- It is very precise, and so there is minimal damage to surrounding tissues. As a result, common side-effects of surgeries and other procedures, such as incontinence and erectile dysfunction are far less likely.
- HIFU is often used when radiation therapy fails.
HIFU Prostate Cancer Treatment: Frequently Asked Questions
HIFU is performed under spinal or general anesthesia and typically takes around 3 hours in all. During the procedure, a small probe which is inserted into the rectum, generates and emits the ultrasound energy that is targeted and focused very precisely at the cancerous prostate.
The doctor monitors the procedure throughout using real-time ultrasound images to maximize prostate cancer destruction and minimize injury to vital tissues.
HIFU can be used for treating:
- Patients who have been newly diagnosed with localized low grade prostate cancer
- Patients with recurrent prostate cancer who have had a failed radiation therapy
- Patients above the age of 70 years
- Patients with multiple co-morbidities
- Locally advanced disease in combination with hormonal treatment
Some patients report that they did not require any medication after this procedure, while others do take some medication for a few days after the treatment.
Patients are given pain medication while in the hospital depending upon the amount of discomfort they are experiencing. Usually low dose tramadol is adequate. Sitting in a tub of warm water is also helpful for any rectal discomfort or pelvic cramping.
Spinal or epidural anesthesia is required during HIFU so that the patient can remain comfortable and still throughout. If the machine detects any movement, treatment stops immediately. This is one of the safety mechanisms offered by Ablatherm HIFU used at Centre for Robotic Surgery – High Intensity Focused Ultrasound Treatment Center in India, and its programming and treatment is very precise.
As is true with all treatments for prostate cancer, certain side effects can occur after HIFU treatment. These may include:
- Difficulty in urination
- Pain in the treated area
- Urethral stricture
- Bladder outlet obstruction
- Urinary tract infection
- Erectile dysfunction
- Rectal wall injury and/or uretero-rectal fistula
However, such complications are quite less compared with surgeries and other types of treatments.
A catheter is required for 3 days following HIFU as there will be swelling and edema of the treated prostate. The catheter is used to drains the urine from the bladder until the swelling of the prostate subsides. About 90% patients can normally pass urine after the catheter is removed. However, if this doesn’t happen then an extra 7 days of catheterization is required.
Urinary incontinence is classified as grade 1, 2, or 3, depending on the severity of the incontinence. Grade 1 is minimal stress incontinence which occurs only occasionally and occurs with severe straining. Grade 3 is severe or complete incontinence. After HIFU, Grade 1 incontinence occurs in less than 5% of cases. Grade 2 and 3 incontinence are very rare after HIFU, and occur in less than 1% of cases performed as the primary treatment for prostate cancer. After failed radiation therapy or failed brachytherapy (radioactive seeds) up to 8% of patients will have Type 3 incontinence following salvage therapy with HIFU.
Many patients experience temporary erectile difficulties and it is not possible to predict what the final result might be for several months post treatment. The use of pharmaceutical agents at any time can assist with the quality of erectile function.
Every treatment, surgery, radiation or High Intensity Focused Ultrasound (HIFU), has a recurrence rate. There is no medical treatment that is 100% guaranteed. Re-treatment rates also vary based on whether a patient is eligible for, and chooses, a “nerve sparing” procedure. The benefit of High Intensity Focused Ultrasound (HIFU), unlike any other treatment, is that it does not limit future options. Should cancer recur, High Intensity Focused Ultrasound (HIFU) can be repeated or a patient can have the choice of surgery or radiation. Surgery and radiation cannot be repeated.
We invite you to book a personal appointment with our experts in case you wish to discuss High Intensity Focused Ultrasound (HIFU) and other prostate cancer treatments offered by CRS.