High intensity focused ultrasound (HIFU)

HIFU uses high frequency ultrasound waves to heat and destroy cancer cells in the prostate. You may be suitable for this treatment if your cancer is thought to be contained within the prostate gland (localised prostate cancer), and you have:

a Gleason score of 7 or lower, and
a PSA of less than 15ng/ml, and
a small prostate gland (less than 40mls).

It may be more suitable for men with other health problems because it is less invasive than surgery (radical prostatectomy) to remove the prostate.

HIFU is a relatively new treatment and we do not know very much about how effective it is at treating prostate cancer in the long term or how it may affect your everyday life. Because of this, HIFU is not widely available as a first treatment and may be available as part of a clinical trial. It is occasionally used to treat cancer that has come back after radiotherapy (recurrent prostate cancer).

What other treatments are available?

What are the advantages and disavantages?

Advantages

HIFU treatment is not as invasive as radical prostatectomy, brachytherapy or cryotherapy.
It requires a short hospital stay of less than 24 hours.
The treatment can be repeated if necessary.

Disadvantages

HIFU is currently only available in a few centres around the UK as part of a clinical trial.
HIFU may be as effective at controlling prostate cancer as some other treatments. However, because it is a relatively new treatment and the technology is still developing, we do not know how effective it is in the long term (beyond five years).
There is a risk of side effects including urinary problems and erectile dysfunction. Read our HIFU online fact sheet for more information on side effects. You will need a catheter to help you pass urine for up to two weeks after treatment.

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What does treatment involve?

If you have a large prostate gland, you may have hormone therapy to shrink the gland before starting treatment, or a trans-urethral resection of the prostate operation (TURP) to remove excess prostate tissue.

You will have either a general anaesthetic so that you are asleep during the treatment, or an anaesthetic injection into your spine so that you cannot feel anything in your lower body.

The surgeon inserts an ultrasound probe into your back passage (rectum). The probe gives out a series of high intensity ultrasound beams, which heat up prostate cells in a specific area and destroy them. Treatment takes two to three hours.

After your HIFU treatment you will have regular appointments with your specialist team to check your PSA level and monitor any side effects.

You can read more about what treatment involves in our HIFU online fact sheet.

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What are the side effects?

The most common side effects are problems passing urine, erection problems, ejaculating no semen or less than usual, and bowel problems. There is no way of knowing which of these you will get, or how bad they will be. You can ask your specialist team for more information on the risk of side effects. They should be willing to show you the results of the treatments which they have carried out and put you in touch with other men who have had the treatment.

You can read more about side effects in our HIFU online fact sheet.

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Questions to ask your doctor or nurse

Will I need a TURP before my HIFU treatment?
Will I need hormone therapy before my HIFU treatment?
What are the chances of short term and/or long term side effects with this treatment?
How will I know if the treatment has worked?
What should my PSA level be after treatment and when will you be checking it again?
If my PSA does not fall or if it continues to rise, what other treatments are available?

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