High Intensity Focused Ultrasound (HIFU)
What is HIFU?
High Intensity Focused Ultrasound is a technique that is non-invasive and aims to retain good quality of life for the patient. It is suitable for locally confined prostate cancer T1 or T2. It is not suited for men with an enlarged prostate, although hormone treatment may be first recommended to reduce its size. HIFU can be undertaken as a primary treatment with curative intent, though it is normally used to treat recurrence after radiotherapy.
What does the treatment involve?
The treatment is done under a spinal (epidural) or general anaesthetic and lasts about two hours. A probe, which emits an ultrasound beam, is placed in the back passage.The tightly focused beams raise the temperature of the prostate tissue to destroy the cancer cells in the targeted area without damaging the surrounding tissue. The process is repeated until the cancerous cells have been destroyed. As the prostate swells immediately after the treatment, a catheter needs to be inserted and remains in place for up to two weeks.
Results obtained in treating the whole prostate have not been ideal. However, HIFU offers the option of treating just the part of the gland where the cancer is localised to a particular area, called Focal HIFU. Precisely locating the cancer can nevertheless be difficult despite modern diagnostic techniques. The many trials looking at this approach which, although not proven, may offer advantages to some patients. NICE supports the procedure as being safe, although the effect on quality of life and long-term survival is unproven.
Advantages and disadvantages