HIFU stands for High Intensity Focused Ultrasound which is a new technique for treating prostate cancer. Ultrasound has been used for medical imaging (such as ante-natal scans) for decades, but recently the technology has been developed so that it can be used for treatment as well as diagnosis.
Follow the links on the right for detailed information about the procedure.
In HIFU, the ultrasound beam is focused onto a small area of diseased prostate, in much the same way that you can focus the energy of the sun with a magnifying glass; the diseased area is then heated to 80-90°C and destroyed. The heat is carefully targeted to avoid damaging the surrounding tissue. In particular, the nerves that control erectile function are spared.
As prostate cancer can be a disease that progresses very slowly, it is important to consider the outcome over a long period of time and, importantly, how much of a difference the treatment makes to survival. Patients are also concerned about the side effects of treatment, both in the short and long term.
We now have data on patients who have been followed up over five years. There are various ways to quantify whether a treatment has been successful. Studies generally consider biochemical progression and some also carry out a prostate biopsy after treatment. ‘Biochemical progression’ simply means ‘has the PSA gone up since treatment?’. A rise in PSA after treatment may indicate that disease is still present. It is also important to consider short and long term side effects: in the short term, the time that a patient stays in hospital and the risk of complications and in the long term, the major issues are incontinence and impotence.
Results available so far show that HIFU is effective at treating prostate cancer; one large study reports 92% of patients had a PSA of less than 1ng/ml (i.e. no biochemical progression) and 93% had negative prostate biopsies over the course of follow up (an average of 22 months). This is comparable with results for radical prostatectomy. Data so far suggest that approximately 20% of men will have erectile dysfunction. However, the equipment and techniques have advanced since these figures were reported and it is expected that the current figure will be lower. Incontinence is seen in less than 1% of men.
Advantages:
Possible Side-Effects:
Erectile dysfunction can occur in some men. Other side effects such as incontinence, urethral strictures, epididymitis and rectourethral fistulas are rare.
We assess suitability for HIFU on an individual basis, but broadly speaking it is most suitable for patients with non-metastatic, non-aggressive disease who fulfil the following criteria:
You may or may not know all of these details. If you have had a prostate biopsy before, your urologist should be able to tell you some of them. If not, we can arrange the relevant tests for you.
If you are interested in HIFU, please contact our office on 020 7224 5089 and we can arrange an appointment for you with one of our surgeons.
The HIFU treatment is carried out at the Princess Grace Hospital in central London. If you have private health insurance, you will need to contact your insurance company.