Is HIFU for Prostate Cancer worth the hype?

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‘Yes it is!’ says Mr Alan Doherty, consultant Urologist at the Birmingham Prostate Clinic. ‘But it has to be done properly with precision diagnostics and good patient counselling to explain the advantages and disadvantages of the treatment.’

High-Intensity Focused Ultrasound (HIFU) is a non-invasive treatment for prostate cancer that uses focused ultrasound energy to selectively target and destroy cancerous tissue within the prostate gland. HIFU works by delivering high-frequency ultrasound waves to the prostate, raising the temperature within the targeted area to the point where the cancer cells are destroyed, while sparing the surrounding healthy tissue.

Mr Doherty continues: ‘HIFU is one of many technologies that offer targeted ‘Focal Therapy’. Focal Therapies can be an alternative to Whole Gland Therapies, such as radiotherapy or surgery, which are the conventional treatment approach in an attempt to cure men of prostate cancer.’

During the procedure, a specialised ultrasound probe is inserted into the rectum to reach the prostate gland. The probe emits ultrasound waves that converge and focus at the tumour site, generating intense heat within the targeted area. The precise nature of HIFU allows for accurate targeting of cancerous cells while minimising damage to nearby structures, such as nerves and blood vessels.

The effectiveness of HIFU in prostate cancer treatment has been extensively studied, and clinical trials have shown promising results. HIFU has been found to be particularly effective in treating localised prostate cancer, where the disease is confined to the prostate gland and has not spread to other areas of the body.

Studies have demonstrated that HIFU can achieve cancer control rates comparable to those of traditional treatments such as surgery and radiation therapy, with low rates of cancer recurrence. Additionally, HIFU has been shown to have a favourable side effect profile compared to surgery or radiation, with lower rates of urinary incontinence and erectile dysfunction.

However, it is important to note that the long-term outcomes of HIFU are still being evaluated, and the treatment is typically recommended for carefully selected patients based on specific criteria. Factors such as the stage and aggressiveness of the cancer, the patient’s age and overall health, and individual preferences are taken into account when determining the suitability of HIFU as a treatment option.

Post treatment surveillance is often more extensive after a focal therapy than with whole gland treatments. Post treatment MRIs are needed, as well as regular PSA measurements. Should an ‘infield’ or a new ‘out of field’ cancer recurrence be identified, then conventional treatments usually can still be offered.

Like any medical procedure, HIFU does carry potential risks and side effects. These can include temporary urinary symptoms such as frequency, urgency, and difficulty urinating, as well as rectal discomfort. In rare cases, more severe complications such as urinary strictures, bladder neck contracture, or rectal injury may occur, but these are relatively uncommon.

It is essential for individuals considering HIFU as a treatment option for prostate cancer to consult with an experienced urologist or oncologist who can provide comprehensive information and guidance based on their specific situation. They can help weigh the potential benefits and risks of HIFU and determine if it is the most appropriate choice for the individual’s prostate cancer management.


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