In 2012, approximately 242,000 men in the U.S. and another 25,000 in Canada will be diagnosed with prostate cancer. The median age of diagnosis is 67. With prostate cancer being so prevalent, finding treatments that are effective without significant side effects is the focus for many urologists. A newer prostate cancer treatment that is continuing to gain favor and results is HIFU – or High Intensity Focused Ultrasound.
Localized Prostate Cancer
Localized prostate cancer is cancer that is completely within the confines of the prostate gland. This is also known as T1 or T2.
T1 is a term used by medical professionals to describe prostate cancer in its very early stages. At this point the tumors are so small they have not begun to cause any signs or symptoms. T2 is used to describe cancer that, while it is still confined to the prostate gland, the signs and symptoms have begun to make themselves known.
HIFU Prostate Cancer Treatment
HIFU uses focused ultrasound as a means to heat and destroy cancer tissue. Focused just as a laser is focused, sound waves strike the targeted tissue and heat it. The targeting is done with an MRI scan.
The ultrasound pulse that destroys the tissue it strikes has a very small area of effect; only a few cubic millimeters. The tissue affected can no longer grow or multiply, but healthy tissue right next to it is left untouched.
Healthy tissue remaining in the prostate post-treatment is still able to function, grow and multiply as normal. This gives the patient a very good chance of a full recovery from the cancer.
One Day Treatment
HIFU is a non-invasive procedure done on an out-patient basis. A local and a general anesthetic are given while the patient lies on his side. After the anesthetic has taken effect, a rectal probe is inserted until it is right up next to the prostate gland. An MRI scans the area of the prostate gland and the tumors inside it are isolated and targeted.
After the targeting information is collected, the HIFU device sends pulses of focused ultrasound at the tissue affected by the cancer. A few cubic mm at a time, the diseased tissue is heated to 80°C and destroyed. Once heated, the tissue is dead and will no longer grow. To treat the entirety of the prostate gland takes approximately 2 to 4 hours.
A catheter is put into place to deal with urinary incontinence which is expected to affect the patient for about 2 weeks.
Once the patient has recovered from the effects of the anesthetic, he is sent home with no dietary restrictions and an antibiotic prescription to last for 2 weeks until the follow-up appointment.
Immediate Side Affects
The prostate will experience some swelling immediately after treatment and some mild leakage may occur. In addition to the incontinence, there may be some mild bleeding at the beginning of urination and the patient may feel an urgent need to urinate. These symptoms are temporary and are expected to last about 2 weeks.
At the follow-up appointment, the catheter is removed and blood samples are taken to test for PSA levels. Doctors expect your PSA levels to be elevated for the first 3 to 6 months after which they are expected to level out and become normal.
The HIFU procedure has been available in Europe for more than a decade and was approved by Health Canada in 2003. It is currently undergoing evaluation by the FDA in the United States, and approval is expected in 2013. Research data on the Ablatherm HIFU procedure has shown it to be an effective and safe treatment option for organ confined prostate cancer, with fewer significant side effects.