HIFU uses high frequency ultrasound waves to heat and destroy cancer cells in the prostate.

 

HIFU is one of the treatments that's used for prostate cancer which hasn't spread outside the prostate gland (localised prostate cancer).

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

HIFU is newer than some of the other treatments for prostate cancer. We don't know as much about how well it works and about the risk of side effects in the long term. Because of this, it's only available in specialist centres in the UK or as part of a clinical trial.

 

What other treatments are available?

 

 

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What are the advantages and disavantages?

An advantage for one person might not be for someone else. Talk to your doctor or nurse about your own situation.

Advantages

  • HIFU has fewer risks than surgery, so it might be suitable for men with other health problems.
  • You only need a short hospital stay - less than 24 hours.
  • HIFU may be an option if the cancer comes back after treatment with external beam radiotherapy (EBRT). This isn't the case with all treatments.

Disadvantages

  • In the UK, HIFU is only available in specialist centres or as part of a clinical trial.
  • Compared with other treatments, we don't know as much about how well HIFU works in the long term.
  • As with other treatments, there is a risk of side effects including urinary problems and erectile dysfunction.

What does treatment involve?

If you have a large prostate gland, you may have hormone therapy to shrink it before starting treatment, or a transurethral resection of the prostate operation (TURP) to make the prostate smaller.

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 high intensity ultrasound waves, which heat up prostate cells and destroys them. Treatment of the whole prostate gland takes up to three hours.

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

What are the side effects?

Like all treatments, HIFU can cause side effects. These affect each man differently, and you might not get them all.

The most common side effects are urinary problems and difficulty getting and keeping an erection (erectile dysfunction).

Ask your doctor or nurse for more information about side effects. They should be able to show you the results of the treatments they have carried out and put you in touch with other men who've had the treatment.

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 can I manage any side effects I get?
  • How will I know if the treatment has worked?
  • What should my PSA level be after treatment and when will you check it again?
  • If my PSA doesn't fall, or if it continues to rise, what other treatments are available?

References

  • Full list of references used to produce this page  

    1. BUG, BAUS and BPG, MDT (Multi-disciplinary Team) Guidance for managing prostate cancer, 2nd Edition, November 2009.

    2. Ahmed HU, Freeman A, Kirkham A et al. Focal therapy for localized prostate cancer: A phase 1 / 2 trial. J Urol. 2011; 185(4): 1246-55.

    3. Ahmed HU, Hindley RG, Dickinson L et al. Focal therapy for localised unifocal and multifocal prostate cancer: a prospective development study. Lancet Oncology 2012; 13: 622-632.

    4. NICE (2012). Focal therapy using high-intensity focused ultrasound for localised prostate cancer.

    5. Lukka H, Waldron T, Chin J et al. High-intensity focused ultrasound for prostate cancer: a systematic review. Clin Oncol. 2011; 23:117-127.

    6. Rebillard X, Soulie M, Chartier-Kastler E et al. High-intensity focused ultrasound in prostate cancer; a systematic literature review of the French Association of Urology. BJU Int 2008; 101 (10): 1205-13.

    7. Cordeiro ER, Cathelineau X, Thüroff S et al. High-intensity focused ultrasound (HIFU) for definitive treatment of prostate cancer. BJUI 2012; 110: 1228-1242.