HIFU or high intensity focused ultrasound, was cleared by the FDA for prostate tissue ablation in October 2015. However, even before then, many men with the prostate disease were investigating it as a treatment option and were wondering what exactly HIFU is and how it works.
Although HIFU was only recently approved for us in the U.S. for prostate disease, HIFU technology has previously been used successfully since the 1970s to treat other malignancies, including liver, kidney, breast, and pancreatic cancer. Early results of HIFU’s application for prostate cancer treatment show approximately 86 percent of men treated with HIFU, a non-invasive prostate treatment, were free of prostate cancer after treatment.
HIFU creates heat by focusing ultrasound waves to ablate tissue without harming neighboring, non-infected tissue. When the sound waves come together they create a focal point, and they produce temperatures high enough to destroy prostatic issue and cancerous cells.
Think about it this way, many have seen a magnifying glass converge the rays of the sun to burn a hole in a leaf. In that example, the magnifying glass acts as a transducer. The light waves pass through the magnifying glass and then are focused to a specific point. At that point, the temperature is elevating very rapidly and a hole is burned in the leaf. However, if you pass your hand between the magnifying glass and the leaf it wouldn’t burn your hand. Your hand would only be harmed if you put it at the focal point.
HIFU works in a similar way, only sound waves are used and there is probe that contains the transducer. The energy converges at a focal point and anything outside that area is virtually unharmed.
Unlike radiation, HIFU energy is “clean” energy and can pass through tissue surrounding the prostate without causing ill effects to the tissue it passes through. Additionally, HIFU technology uses real-time imaging and allows doctors to specifically target areas within the prostate to be treatment, making it very targeted and precise. Lastly, a physician delivering HIFU can actively monitor the progress during treatment and make adjustments as needed based on how the tissue responds. This targeting also increases the HIFU’s success since doctors can receive immediate feedback on the procedure as they complete the operation.
When patients are diagnosed in the early stages of prostate cancer, traditional treatments—like radiation and surgery—can be more detrimental than no treatment at all because many patients with small, low-grade tumors do not need radical treatment. Radiation and surgery can leave patients with sexual and urinary difficulties.
However, with the advancements in HIFU, patients with localized prostate cancer can seek care low rates of impotence and minimal side effects. Also, older patients, whose bodies may not react positively to radiation, can employ HIFU to manage their prostate cancer due to the treatment’s minimally invasive techniques and direct targeting.
More prostate cancer patients are choosing HIFU because it is a minimally invasive procedure that can be performed on an outpatient basis. Patients typically do not need to be hospitalized and return home the same day of their procedure. For many patients, the ability to heal in the comfort of their own homes is an enormous benefit. Additionally, since HIFU is minimally invasive, there is little to no blood loss and there is less risk for complications after treatment such as urinary incontinence and erectile dysfunction.
When it comes to managing prostate cancer, HIFU offers an advantageous middle ground between active surveillance and radical treatments.