A high-intensity focused ultrasound (HIFU) procedure is a new technique approved by the FDA to remove prostate tissue. Though it hasn't been approved for the treatment of prostate cancer in the U.S., it is being used in clinical trials to treat it.Researchers are still figuring out how well it works and what the side effects are.
You may hear your doctor call it "minimally invasive," which means a surgeon doesn't have to cut you open. Men with cancer that hasn't spread beyond the prostate may get the surgery. Your doctor may suggest it either before you've tried other treatments or after radiation therapy that didn't help. It can also be done if the cancer comes back to your prostate. It's not used when your cancer has spread to other parts of your body.
HIFU is only useful to treat a single tumour or part of a large tumour. It can't be used to treat tumours that are more widespread. This means that HIFU is not suitable for people with cancer that has spread to more than one place in their body.
HIFU is sometimes used to treat the following cancers:
Because the prostate is positioned deep within the pelvis, you have HIFU for prostate cancer by putting an ultrasound probe (transrectal probe) into your back passage. You have it under a general anaesthetic or spinal anaesthetic. From that position, the ultrasound can direct beams more accurately at the prostate.
Research has shown that HIFU for prostate cancer is safe. But we still need more research about whether it is as good as other treatments in the longer term and about its possible side effects.
The National Institute for Health and Care Excellence (NICE) has issued guidelines for the treatment of prostate cancer. These guidelines say that men should have HIFU for prostate cancer as part of a clinical trial.
You might be offered HIFU instead of surgery or radiotherapy for localised prostate cancer.
Doctors have used it for cancer that has just been diagnosed, or for cancer that has come back in the prostate after earlier treatment. This is known as salvage treatment.
Your doctors should make sure that you know:
✔ what is involved in having the treatment
✔ that we don't know everything about side effects yet
✔ that we don't fully understand how long term effects of HIFU compare to other treatments
✔ what other treatment options there are
Doctors must monitor everyone who has HIFU. This is so that we can learn more about side effects and long term benefits.
You sign a consent form to say that all these things have been explained to you before you have treatment.
Reseachers are interested in looking at HIFU for early and advanced kidney cancer.
Researchers have looked at HIFU for primary liver cancer (hepatocellular cancer, HCC) and cancer that has spread to the liver (secondary liver cancer).
More research is needed to see if using HIFU for primary liver cancer is better than standard treatments.
Researchers also want to find out if HIFU is helpful in combination with other treatments for primary liver cancer. And to see if HIFU helps control symptoms for advanced disease.
Doctors outside the UK have used HIFU to help pain and other symptoms in people with advanced pancreatic cancer. It is not being used to cure pancreatic cancer.
Surgery is still the first choice of treatment for people with pancreatic cancer that has not spread to other parts of the body.
Outside the UK doctors are interested in treating people with bladder cancer with HIFU. At the moment, if the cancer comes back these doctors use surgery as standard treatment.
People who have been treated with HIFU so far have had very few side effects.
It may cause some discomfort or pain for 3 to 4 days afterwards. It may also cause soreness around the back passage, but this is mild and doesn't last long. It's unusual for the soreness to be ongoing or severe.
A few people have problems passing urine. This might include leakage of urine or the need to pass urine more often and suddenly.
And most men are able to have erections after this treatment but a few may have problems.