Prostate cancer is the number one cancer affecting men in North America. It is expected that 250,000 men in the U.S. and 25,000 men in Canada will be diagnosed with the disease this year. Traditionally, surgery or radiation are performed to combat prostate cancer. However, in the past 2 decades, great progress has been made with new, non-surgical, non-invasive treatments. One of the most promising ones gaining popularity is HIFU – or High Intensity Focused Ultrasound.
High Intensity Focused Ultrasound
HIFU is a process that came into being in 1994 after 5 decades of research. It uses ablation, which is the removal of material through evaporation, to destroy cancerous cells in the prostate.
A pulse of focused sound waves is directed at an area of the prostate. The targeting is done using an MRI and so is very accurate. Diseased cells are isolated by the MRI and the ultrasound pulse heats them to as high as 80°C.
The heat destroys the tissue it contacts and the cancer is eradicated from the immediate area. The affected area is very small, only a few cubic mm, so the surrounding healthy tissue is unaffected. By retargeting each area where cancerous cells have been growing, all of the diseased cells can be eradicated with one 2-3 hour treatment with Ablatherm HIFU.
In cases where the entire prostate is cancerous, the HIFU device can target the entire gland in about 3 hours.
What Does It Entail?
A HIFU treatment is done on an outpatient basis so no hospital stay is required. You would be given a local spinal anesthetic and be sedated intravenously.
While lying on your side a probe is guided into your rectum since the prostate is located under the bladder in front of the rectum. It is the probe that is the source of the focused ultrasound pulse. The probe is positioned next to your prostate and then the surgeons begin the process of targeting and eliminating any diseased tissue.
Because no hospital stay is required for HIFU treatments, you are released the day of the procedure. From the first day you have no dietary restrictions resulting from the treatment. Of course, any dietary plans prescribed by your physician should still be followed.
After the treatment is completed, it is expected that your prostate will swell, causing pressure which will compress your urethra. A urinary catheter is put into place until the swelling goes down. From experience, doctors expect this to last about 14 days.
You are given an antibiotic prescription and will be scheduled for a follow-up appointment in 2 weeks.
After the 2 week period has passed, the catheter is typically removed. At this point the swelling in your prostate should have receded and normal urinary activity should be possible.
From this point on, your recovery will be measured and monitored by your doctor. Your PSA level, that is your Prostate Specific Antigen level, will be tested approximately every three months. This is done to ensure that your cancer has not relapsed and begun to grow once more.
The side effects from HIFU treatments were studied in detail at the University of Regensburg in Bavaria. The patients were monitored for a period of 5 years. The study concluded that side effects were minor.
- Total urinary incontinence < 1%
- Mild to moderate urinary incontinence 5%
- Blockage of the urethra 8%
- Sexual impotence with nerve-sparing procedure 20%
- Sexual impotence without nerve-sparing procedure 66%
The nerve-sparing procedure refers to the nerve that enters the prostate gland. Where no cancer was detected in the nerve tissue, the nerve was spared and only 20% of those patients suffered from impotence afterward.