Treating prostate cancer with high-intensity ultrasound

The HIFU procedure is an alternative to major surgery and radiation

For years, men with localized prostate cancer often had two main treatment choices besides active surveillance: radiation therapy or surgery. Both are beneficial options, but they can cause side effects. Now there’s another choice at Nazareth Hospital that may help reduce those risks.

High-intensity focused ultrasound (HIFU) uses sound-wave energy to destroy cancer cells. This may allow some men to avoid a major operation (radical prostatectomy) or radiation treatments.

“While surgery and radiation have a more proven history of treating prostate cancer, HIFU has a much lower risk of sexual dysfunction and virtually no risk of incontinence,” says Francis Schanne, MD, a urologist at Nazareth Hospital.

Some men are so fearful of these potential side effects that they may avoid treatment altogether.

“HIFU is a great alternative for those patients,” Dr. Schanne says.

Who is a candidate for HIFU?

To be eligible for HIFU, a man must have prostate cancer that has not spread beyond the prostate. And his prostate must not be very large.

HIFU has lower risks than surgery and radiation, but it isn’t risk-free. Men can still have erectile dysfunction and urinary problems after HIFU. And while HIFU has been around for about a decade, it is less proven than surgery or radiation as a prostate cancer treatment.

If you are considering HIFU, you and your doctor will discuss its potential benefits and risks.

What to expect

HIFU is performed under general anesthesia. The doctor inserts an ultrasound probe into the rectum to map out the treatment area on a display screen. Next, much stronger ultrasound energy is focused on small areas of prostate tissue. This precise energy destroys the cancer cells by heating them.

After the procedure, you will need a catheter for a few days so you can urinate. You can resume your usual activities within two weeks.

“There’s usually not much pain,” Dr. Schanne says.

About 10% to 20% of men may have a blockage of the urethra, or difficulty voiding, which may require a second treatment with medications or surgery.

Men will have follow-up PSA (prostate-specific antigen) blood tests to help monitor the success of their HIFU treatment.