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HIFU: A January 2009 expert overview
Every newly diagnosed patient wishes to have his prostate cancer eliminated with (ideally) absolutely no
adverse effects of treatment. This may prove to be the case for some patients treated with high-intensity
focal ultrasound (HIFU). For the majority, however, there will be at least some side effects of treatment.
And for a few those side effects will be serious.
There is no form of active therapy (whether described as
“invasive” or not) available today that does not come with known and reasonably well-defined risks for adverse
effects, most commonly associated with at least temporary incontinence and erectile dysfuction, but sometimes
with more serious problems.
For appropriately selected patients, when used by physicians who have significant experience of this technique, urologists believe that HIFU will, in time, and with high quality, supportive data, come to be acknowledged as an important, effective, and safe form of first line treatment.
HIFU also has potential as a form of “focal therapy” for early stage, low risk, localized prostate cancer (although available data on such use of HIFU is very limited)
A group of respected experts has addressed the available data related to the clinical use of prostate cancer techniques
Writing about HIFU, they state:
- HIFU has been used widely in Europe for complete ablation of the prostate, especially in elderly men who are unwilling or unable to undergo radical therapy.
- For low- or intermediate-risk cancer, the short- and intermediate-term oncologic results have been acceptable but need confirmation in prospective multicenter trials (which are now under way).
- Whole gland therapy with transrectal ultrasound guidance has been associated with a high risk of acute urinary symptoms, often requiring transurethral resection before or after HIFU.
- Adverse effects on erectile function seem likely after a therapy that depends on heat to eradicate the cancer, but erectile function after HIFU has not been adequately documented with patient-reported questionnaires.
- HIFU holds promise for focal ablation of prostate cancer.
- Focal use of HIFU should reduce the adverse sexual, urinary, and bowel effects of whole gland ablation.
- New techniques are being developed to allow HIFU treatment under real-time guidance using magnetic resonance imaging, which could improve the precision and reduce the adverse effects further.
NOTE: Issues on this site regarding prostate cancer and treatment options, are provided for
information only, and are not meant to substitute for the advice of your own physician or other medical professional.
Prostate-Report.org does not endorse any specific product, service or treatment.
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