High-intensity focused ultrasound (HIFU)
High-intensity focused ultrasound (HIFU) is a treatment for prostate cancer that uses high-frequency ultrasound energy to heat and destroy cancer cells in the prostate. During treatment, a probe is placed in the rectum to allow ultrasound energy to travel into the prostate. The two types of HIFU are focal HIFU and whole-prostate HIFU.
Who is a Candidate for HIFU?
HIFU may be a treatment option under the following conditions:
The cancer hasn’t spread beyond the prostate
The risk of spread is low or medium
HIFU isn’t recommended for patients with advanced prostate cancer or a large prostate.
Benefits of HIFU
Compared to other treatments for prostate cancer:
HIFU doesn’t require any incisions.
Focal HIFU can treat small areas of cancer without causing significant damage to nearby tissue, nerves, and muscles.
HIFU requires a short hospital stay; patients can typically go home on the same day of the procedure.
Recovery is quick and most patients can resume normal activities within two weeks.
- HIFU is less likely than surgery to cause problems with erection or urination.
- Patients may undergo HIFU if their cancer returned after radiotherapy.
- Patients may be treated with HIFU again if their cancer comes back after the first HIFU treatment.
- HIFU may be done in combination with other treatments, such as surgery or radiotherapy, if the cancer returns.
What to Expect During Treatment
After the patient has arrived, they will be given an enema to empty their bowels. This makes it easier to see clear images of the prostate. For six hours before the HIFU treatment, the patient will need to avoid eating or drinking.
The medical team will administer general anesthesia before treatment can begin. During treatment, the patient will lay on their back with the legs apart. A catheter may be inserted to drain urine out of the bladder. A catheter is a thin tube passed through the penis or abdomen into the bladder.
To begin treatment, the surgeon will place a probe into the patient’s rectum. The probe will emit a beam of high-intensity ultrasound energy that will travel through the wall of the rectum into the prostate. Each beam treats one small area of the prostate at a time, about the size of a grain of rice.
The HIFU machine will move the beam around, heating and destroying the cancer cells in the treatment area. The probe simultaneously sends ultrasound waves to create images of the prostate. This will help the surgeon target the cancer and avoid harming healthy tissue, such as the urethra.
The probe is surrounded by a cooling balloon so that the heat doesn’t damage the rectum.
Patients with a large prostate may also undergo a transurethral resection of the prostate (TURP) or laser treatment to remove prostate tissue and improve the flow of urine, reducing the risk of urinary problems. This treatment may be done after HIFU, also under general anesthesia. After HIFU treatment, patients may have pain between the testicles and rectum and need to take pain medication.
