The High Intensity Focused Ultrasound (HIFU) prostate cancer treatment is becoming very popular around the world.
In this treatment method, the doctor uses high intensity ultrasound waves to kill the cancer cells. He or she points the ultrasound waves at the tumor . In just a few seconds, the temperature in that spot rises up to 190 degrees Fahrenheit (90 degrees Celsius). This sudden heat kills the cancer cells.
FDA approved HIFU prostate cancer treatment systems
By now, 2019, the FDA (US) has approved 3 treatment systems for focused ultrasound. Also, the US insurance program, Medicare, has plans to cover this treatment in the near future.
Risks of prostate cancer surgery vs Focused Ultrasound
Prostate cancer is one of the most common forms of cancer in men. In the early stages, the doctor will probably give medication to treat the illness. However, if the cancer tumor grows, the patient may need surgery to make sure the cancer won’t spread. Unfortunately, there are some risks with prostate cancer surgery. This kind of surgery could easily cut the nerves for erection and make the patient impotent.
Also, the bladder sphincter may get damaged during conventional prostate surgery. (This would be problem, because you need the bladder sphincter to control the flow of urine and not pee your pants.)
However, with the modern HIFU treatment, these things have changed for the better. The success rate of HIFU prostate cancer treatment is the same as for other surgeries, but the risks of having side effects are much less.
HIFU prostate cancer treatment without hospitalization
Another great advantage of the HIFU treatment is, that the patient will not have to stay in hospital and will be able to go home the same day. Most patients will even be able to go back to the office the next day.
Altogether, this means that the total costs of having a focused ultrasound prostate cancer treatment could be less than traditional cancer surgery. Just think about all additional costs and also time away from the job.
You could say that there are many reasons why this treatment method became very popular very fast, with both patients and doctors.
One of the great things of using focused ultrasound is that it is very precise and does not come with the negative effects of traditional surgery procedures. The treatment is radiation-free and there will be no blood loss.
HIFU not suitable for spread out cancer
Unfortunately, focal ultrasound therapy is only useful if the prostate cancer has not yet spread out. Also, the doctor will look at the PSA score of the patient. A PSA of more than 20, would mean that the prostate is simply too big for a HIFU treatment. In that case, the doctor will advise to try a different form of treatment first, in order to see if that would help shrink the prostate.
Focal therapy versus removing the prostate
Depending on how much the cancer has grown, the doctor can choose to remove all of the prostate or just the tumor alone. Focal ultrasound treatment has even less risks for side effects.
To take out only a tumor, the doctor will use MRI (Magnetic resonance imaging) during the treatment. The doctor only treats the tumor, while staying away from important areas like the nerves for erection and for controlling the bladder.
General or local anaestesia during HIFU therapy
Before the treatment, the doctor will talk with his patient about the choice of anaesthesia. It is very important that the patient does not move during the treatment.
Obviously, if the patient moves while the ultrasound is on, this could damage the nerve needed for erection or other important parts of the urinary tract. This is why the doctor may prefer to give general anaesthesia, so the patient will be asleep and completely still through the entire treatment.
In some cases, the doctor may decide that it is better for the patient to stay awake. In that case, the patient will have local anaesthesia to keep him comfortable during the treatment. This will help the patient to keep still and not make any kind of movement during the treatment.
The HIFU procedure
Before treatment, the patient should not eat or drink for a period of 6 to 12 hours. After having an enema to empty and clean the bowels, the treatment starts.
The patient receives the chosen anesthetic and the doctor will insert a tube into the penis for the urine to pass during the treatment. When everything is ready, a probe is pointed at the prostate through the patient’s anus.
The whole process takes anywhere from 1 to 4 hours. After the procedure is completed, the patient will need some time to recover. After he has rested a bit, in most cases he will be able to walk out of the hospital by himself.
Pain after HIFU treatment cancer treatment
The patient may still feel some pain after the anesthetic from the treatment wears off. He may feel pain near the spot between the anus and the scrotum. This is because there could be some swelling in the treated area, causing more or less pain. Some over-the-counter painkiller will often be enough to help the patient get through this, until the pain calms down.
Side effects of Focused ultrasound
Although a treatment with focused ultrasound is very different from the traditional form of cancer surgery, it still could have some side effects. Unfortunately, even if the treatment is done with the help of neurovascular bundle detection software, it is still possible that a patient will suffer from erectile dysfunction after the treatment.
There also could be a problem with leaking urine. However, in most patients these side effects will disappear by itself after some time. Nevertheless, if you have any of these side effects, you should go and talk with your doctor. He or she can see if it is possible to help you with medication.
Will the cancer come back after focused ultrasound therapy?
After a prostate tumor has been removed, there is always a chance that the cancer comes back. This is why it is important to screen for prostate cancer after a successful HIFU treatment.
If the cancer is back, the prostate will start to become bigger again. This will lead to higher levels of PSA. If there is any sign of cancer, the doctor will be able to advise immediate treatment in order to stop it from getting worse.