High Intensity Focused Ultrasound, or HIFU, is an FDA-approved, minimally invasive procedure for the treatment of prostate cancer that offers personalized treatment and significantly reduced side effects. HIFU uses non-ionizing ultrasonic waves to heat tissue without the need for any incisions. HIFU can be used to increase blood or lymph flow or to destroy tissue such as tumors. The technology is similar to ultrasonic imaging, but instead of pulsed waves, lower frequency and continuous waves are used to achieve the required thermal doses.
With the High Intensity Focused Ultrasound (HIFU) technique, it is aimed to treat only the cancerous area instead of removing the entire prostate. The aim of this technique is; It is the approach of not removing the glands around the prostate, not closing the channels coming from the testicles, not affecting the sexual life and urinary incontinence of the patient.
The mechanism by which HIFU targets, burns, and destroys diseased prostate tissue is similar to the way the sun's light rays pass through a magnifying glass, making a clear hole at an intersection in the middle of an opposite leaf. HIFU uses sound waves instead of light as an energy source. Instead of a magnifying glass, a transducer is used. The focusing effect of the transducer allows high sound pressures to be delivered to a focal point without causing unwanted damage to other tissues. The temperature of the tissue in the focus will rise to 65 to 85 °C and will destroy the diseased tissue with coagulation necrosis. HIFU beams focus precisely on a small area of diseased tissue and locally store a high level of energy in that area. In ultrasound used for diagnosis, this heat is not negligible since the sound waves are not focused on a single point. In the HIFU method, each sonication (individual ultrasound energy accumulation) treats by burning a precisely defined part of the targeted tissue. For this, it intervenes in 0.2 mm tissue sections by making very precise calculations. Sound waves aimed at the prostate tissue rapidly increase the tissue temperature, destroying only cancerous lesions and do not harm the healthy surrounding tissue.
Ultrasound energy or sound waves are transmitted to the prostate via a spoon-shaped applicator placed from the anal region (rectum). Sound waves are focused on desired points within the prostate, identified by MRI (magnetic resonance imaging) and confirmed by ultrasound. The intrarectal position of the applicator is monitored in 3D and instantaneously. This real-time imaging is essential for safe and accurate noninvasive targeting and therapy monitoring.
Your PSA level is expected to reach its lowest level a few months after HIFU. After HIFU treatment, PSA control is done at 3- to 6-month intervals.
There are some situations where this treatment is not recommended. Which are:
Among the wide variety of treatment alternatives for prostate cancer, focal treatments are the non-invasive answer. In this regard, it is in competition with local radical treatment (prostatectomy) and wait-and-see approaches, which are included in the treatment guidelines.
HIFU is a current treatment method that is applied as a local treatment in primary prostate cancer, a salvage treatment after radiotherapy and surgical failure, and a supportive treatment in locally advanced prostate cancer.
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It would be ideal to be in Istanbul a few days before the treatment, if your doctor did not inform you otherwise.
Patients generally stay in the hospital for about 3–4 days. Since the radiotherapy treatment will take 30 days, you should plan your vacation accordingly.
91% of patients are able to delay aggressive prostate cancer therapy for two yearsby the way of HIFU. The outcomes imply that the minimally invasive technique is a viable substitute for urgent surgery or radiation.
Small cancerous lesions can be treated with focal HIFU with little harm to the surrounding muscles, nerves, and tissue. You just require a brief hospital stay and can typically leave the same day you receive therapy. Most men resume their regular activities within two weeks after a quick recovery.
The most frequent adverse reactions to HIFU for prostate cancer are protracted voiding dysfunction and retention brought on by edema, necrosis, or obstruction of the bladder outlet. Combination therapy (TUR-P+HIFU) lessens these side effects, enhancing postoperative quality of life.
The median time to recurrence after HIFU was 16 months. According to the results of the MRI-biopsy, 56% of the patients had in-field recurrence, 21% had out-of-field recurrence, and 23% had both types.
HIFU is not a safe treatment choice for patients with high-risk prostate cancer, according to the data. Long-term outcomes from a new trial show that radical prostatectomy is more successful than whole gland high-intensity focused ultrasound (HIFU) therapy for treating prostate cancer (PCa), except in men with low-risk illness.
Due to the non-invasive characteristics of the procedure—no needles are used, and nothing penetrates the skin surface—patients say that it is not very painful.
HIFU is a non-invasive method that achieves tumor cell necrosis without the need for radiation or surgical removal. It does this by using precisely delivered ultrasonic energy.
Just to be clear, surgery is still an option for ex-HIFU patients, but due to the increased technical complexity caused by scarring around the prostate, the procedure must be performed by a qualified surgeon. Such a procedure is known as a salvage prostatectomy.
Prostate-specific antigen (PSA) nadir values after whole-gland HIFU ranged from 0.4 to 1.95 ng/mL, and the median time to PSA was 2.4 to 5.4 months. After HIFU, the rate of positive biopsies ranged from 4.5% to 91.1%.
The prostate is not removed during therapy; instead, the targeted cells are destroyed utilizing HIFU (High Intensity Focused Ultrasound) or electroporation (NanoKnife) technology.