Alternative cutting edge, least invasive, treatment of cancer prostate:
Robotic HIFU treatment at MPUH Nadiad (STUDY RESULT)
HIFU (High Intensity Focused Ultrasound) treatment of prostate cancer is currently an approved therapy in Europe, Canada, South Korea, Australia, and many other places. HIFU treatment may be performed as a minimally invasive (least invasive) option, with low morbidity and simple post-treatment management.
Muljibhai Patel Urological Hospital (MPUH), Nadiad was the first hospital in India to install a Robotic HIFU. HIFU treatment was given to a wide spectrum of carcinoma prostate patients in MPUH and found to be safe. The treatments were performed by a second-generation Ablatherm® Robotic HIFU unit. The efficacy is early to be commented, though early results are encouraging. From January 2009 to September 2010, 30 patients with prostate cancer were enrolled; all had transurethral resection of the prostate (TURP) before transrectal HIFU treatment during the same session. Procedural safety was analyzed at 3 months. Follow up consisted of 3 monthly prostate specific antigen (PSA) levels and trans rectal biopsy if indicated. All the patients had a minimum follow-up of 6 months. A mean prostate volume of 26.9 ± 8.5 cm3 was treated in a mean time of 115 ± 37.4 minutes. There was no intraoperative complication. The postoperative pain visual analogue score (VAS) at day 0 was 2.1±1.9 and at day 1 was 0.4±0.8 on a scale of one to ten. Mean duration of perurethral catheter removal was 3.9 days. Average follow up duration was 10.4 months (range 6 to 20 months). Mean time to obtain PSA nadir was 6 ± 3 months with a median PSA nadir value of 0.3 ng/ml. 2 patients had positive prostatic biopsy in the localized (high risk) group. HIFU, a minimally invasive therapy for prostate cancer, was safe in carcinoma prostate patients. The short-term results were efficacious in localized disease. The low complication rates and favorable functional outcome support the planning of further larger studies. The present study suggests the possible application of HIFU in patients with locally advanced or high-risk prostate cancer. The present oncological data are promising, although they must be regarded as preliminary and needing reassessment over a longer follow-up. A further potential advantage of HIFU treatment in high-risk patients might be the possibility of a second treatment if there is clinical local recurrence, with morbidity rates lower than those of other salvage therapies. As in patients with localized prostate cancer, HIFU was a safe treatment, with low complication rates even in those with locally advanced or high-risk prostate cancer. Specifically, there were no adverse events associated with the bladder or rectum.