HIFU for prostate cancer

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Outpatient Prostate Cancer Treatment using HIFU Tissue Ablation: A minimally invasive treatment option with low risk of side effects 

Prostate Cancer and Non-Invasive Treatment Option 

Approximately 1 in 8 men will be diagnosed with prostate cancer in their lifetime. That is a shocking statistic many people are unaware of. Furthermore, African American men are nearly twice as likely to be diagnosed and die from prostate cancer compared to Caucasian men. It is the most common, non-skin cancer, found in men and the American Cancer Society estimates 268,490 cases will be diagnosed in the U.S. this year alone. 

Prostate cancer is highly curable when caught in the early stages before it has spread to other organs. It can be diagnosed at much earlier stages due to a simple blood test called PSA (Prostate Specific Antigen) which is provided annually by a primary care physician or urologist. The key to successful treatment is early detection. When caught early, there are many treatment options for prostate cancer with high cure rates. 

One of the most advanced treatments, HIFU, or High Intensity Focused Ultrasound, is being offered at The University of Toledo Medical Center by Dr. Puneet Sindhwani. A 2018 study published by European Association of Urology reported five-year HIFU results that showed a 98% metastasis-free survival rate with 98% of the patients maintaining urinary continence similar to pre-treatment(1). Dr. Sindhwani offers a variety of prostate cancer treatments, but HIFU allows him to use recent advancements in diagnostic imaging to customize each HIFU treatment to the patient. “Until HIFU was cleared by the FDA in late 2015, prostate cancer treatments were primarily surgery and radiation with some serious side-effects on sexual function and urine control. HIFU is one of the most significant advancements in the treatment of prostate cancer over the past twenty years,” commented Dr. Sindhwani. “The outpatient HIFU treatment is bloodless and uses focused ultrasound to destroy the prostatic tissue. The two to three hour HIFU treatment is very appealing to many men as it allows them to return to their normal lifestyles within a couple days. HIFU is the only treatment that I can tailor to the patients individual needs and I can appropriately contour the gland as well as detect and avoid the normal tissue, sphincter muscle and nerves. This gives my patients a greater chance of preserved erectile function and prevention of urinary incontinence.” 

What is HIFU for Prostate Cancer? 

HIFU is a minimally invasive, outpatient procedure that uses ultrasound energy to heat and destroy cancerous tissue in the prostate. It is radiation-free and bloodless, and studies show that the risk of side effects, such as erectile dysfunction and urinary incontinence, are significantly lower with HIFU than with surgery (radical prostatectomy) or radiation(2). 

HIFU is delivered using a medical device called the Sonablate. The Sonablate probe contains transducers which emit ultrasound energy that provides an image of the prostate; it can also be focused to a central point, where the temperature is raised rapidly, causing cell destruction. This works in the same way that sunlight can be focused to burn a hole in a leaf. The procedure is performed under general anesthesia, so this does not cause discomfort to the patient. 

The Sonablate system allows doctors to obtain a real-time image of the prostate and plan exactly where they want to deliver the HIFU energy, thus destroying the targeted tissue. The physician also receives immediate feedback to confirm the targeted prostatic tissue has been eliminated. The precision of the HIFU system allows the physician to see the nerve bundles that control sexual function and to avoid harming these critical structures. 

Unlike surgery, which requires the physician to remove the entire prostate, HIFU enables the patient to receive whole gland treatment, hemi-ablation or a focal treatment. If there is only cancer on one side of the prostate, the physician and patient can determine if only the cancerous portion of the prostate is treated. HIFU is often referred to as the “lumpectomy for men”. “I can tailor the treatment to the patient’s needs and individualize it” said Dr. Sindhwani. “After more than two decades of experience treating prostate cancer, I have learned how to balance cancer control and maintaining quality of life, in a given patient. HIFU offers the ultimate flexibility in designing a personalized treatment plan that fits a given patient’s cancer. ” 

Recovery After HIFU 

HIFU is an outpatient procedure that typically lasts two to three hours, depending on the size of the prostate. After a brief recovery from general anesthesia at the surgery center, patients return home to recover more comfortably. Most patients are routinely back to work in a couple of days and typically able to resume normal activities within a week. 

Additionally, if for some reason there is a recurrence of prostate cancer, HIFU does not exclude patients from having any other treatments. This also means that, while not common, HIFU may be repeated if necessary. If a man chooses to have HIFU, he is not limiting himself to pursuing other treatment options down the road. 

Who Qualifies for HIFU? 

While only a physician can determine whether you qualify for HIFU, typically men with a prostate gland of less than 40 grams with localized prostate cancer (meaning the tumor has not spread outside of the prostate gland) are the best candidates for HIFU. The other information that physicians usually look at to determine if you qualify for HIFU, is your PSA level and Gleason score. 

Anyone interested in HIFU for localized prostate cancer should speak with a doctor about his specific diagnosis and whether it would be a good treatment option in his case. To schedule a HIFU consultation with Dr. Sindhwani, call 419-473-3446. 

The University of Toledo Medical Center 

Since 1964, The University of Toledo Medical Center has offered the highest level of healthcare to northwest Ohio. As a community-focused teaching hospital, we’re building on a deep-rooted foundation of service and excellence in healthcare. We are UTMC. We are open for you. Visit utmc.utoledo.edu for more information. 

(1) Guillaumier S, et al. A Multicentre Study of 5-year Outcomes Following Focal Therapy in Treating Clinically Significant Nonmetastatic Prostate Cancer. Eur Urol (2018). 

(2)High Intensity Focused Ultrasound Hemigland Ablation for Prostate Cancer: Initial Outcomes of a United States Series. The Journal of Urology. Vol. 204, 741-747, October 2020.

419-473-3446 • www.HIFUProstateServices.com