Role of HIFU in Prostate Cancer

High-Intensity Focused Ultrasound (HIFU)

HIFU stands for High-Intensity Focused Ultrasound, is a type of ultrasound that uses high-frequency ultrasound energy to heat and destroy cancer cells in the prostate. HIFU is newer than some of the other treatments for prostate cancer. There are two types of HIFU treatment. Whole-prostate HIFU treats the whole prostate. Focal HIFU treats a smaller area of the prostate.

●     HIFU might be suitable for you if your cancer is contained inside your prostate.

●     It’s sometimes an option if your prostate cancer has started to break out of your prostate, or has spread to the surrounding area.

●     It’s not an option if your cancer has spread outside your prostate to other parts of your body.

●     It can also be used to treat cancer that has come back after radiotherapy (recurrent prostate cancer). This is called salvage HIFU.

The recovery time is short which usually takes one or two weeks. The stay required in the hospital is a short one. You can go home on the same day depending on your treatment. The advantage of HIFU is apart from a needle in your hand to give the general anaesthetic, it doesn’t involve any cuts to the skin or needles. In rare cases, if your cancer comes back after your first HIFU treatment, you still may be able to have HIFU again. Surgery and Radiotherapy are other options of treatment after HIFU if your cancer comes back.

Treatment

Depending on the size of the prostate, you might be suggested to go for other treatments before HIFU. If you have a large prostate, the following treatments could be offered to you:

• Hormone therapy is sometimes given for two to three months before HIFU. This can make the prostate smaller, and make cancer easier to treat.
• Transurethral resection of the prostate (TURP) is an operation to remove prostate tissue and improve the flow of urine. This operation is sometimes used before HIFU to reduce the risk of some urinary problems after the treatment.

Before the treatment starts, you will be asked not to eat or drink for at least six hours before. On the morning of your treatment, you’ll be given an enema (liquid) to empty your bowels which will be put inside your back passage (rectum). You will have a general anaesthetic so that you’re asleep during the treatment. However, if you aren’t able to have a general anaesthetic for some health reasons, you may be able to have a spinal (epidural) anaesthetic so that you can’t feel anything in your lower body. You will also be given some medicine (a sedative) to make you sleepy. You may have a catheter (a thin tube) put in at the start of the treatment to drain urine out of your bladder. This catheter is passed into your bladder, either through the penis or through the wall of your abdomen. The surgeon will place a probe inside your back passage (rectum). The probe gives out a beam of high-intensity ultrasound energy, which travels through the wall of the back passage into the prostate. The probe is surrounded by a cooling balloon so that the heat doesn’t damage your back passage. The beam treats one small area of the prostate at a time, almost the size of a grain of rice. He will move the beam around so that it heats and destroys the cancer cells. The probe also uses ultrasound to create images of the prostate while the surgeon is treating it. This helps him target cancer so that less of the healthy tissue is damaged.

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