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Focused Ultrasound Prostate Cancer Treatment

Pain Relief And Recovery Time

How High Intensity Focused Ultrasound Treatment Works for Prostate Cancer Works

After the treatment, your rectal area may feel tender but this should ease quickly. Please continue to take painkillers as directed by the hospital if you need them. You may also be given a course of antibiotics to take home.

You are likely to have scrotal swelling and this can affect your ability to pass urine. You may have a urethral catheter in place for three to 14 days to help drain urine from your bladder. You may also notice some blood in your urine for up to eight weeks. After the catheter is removed, you may feel the need to pass urine more frequently and urgently for up to six weeks. You may also feel a burning sensation on passing urine for up to eight weeks.

Hifu Allows 91% Of Patients To Avoid Radical Prostate Cancer Treatment For 2 Years

The results suggest the minimally-invasive procedure is an acceptable alternative to immediate surgery or radiation.

High-intensity focused ultrasound ablation of the prostate showed adequate short-term prostate cancer control, indicating the minimally-invasive procedure is an acceptable alternative to immediate surgery or radiation, according to new research from USC Urology, Keck Medicine of USC.1

Among 100 patients with prostate cancer who received HIFU, 91% were able to avoid radical treatment for at least 2 years, according to the retrospective analysis, which was published in the Journal of Urology. Also, nearly three-fourths of patients did not experience treatment failure, and there was a 100% continence preservation rate.

“This positive data empowers urologists to use focal HIFU ablation to effectively address prostate cancer without the intrinsic side effects of radical treatments,” first author Andre Abreu, MD, urologic surgeon with Keck Medicine and an assistant professor of clinical urology and radiology at the Keck School of Medicine of USC, stated in a press release.2″We hope this study encourages prostate cancer patients to talk to their doctor about all potential treatment options to ensure that they receive a personalized care plan that addresses their individual needs.”

References

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Are There Any Drawbacks Or Potential Risks Involved In Using This Technology Or Taking This Approach To Treating Prostate Cancer

As discussed earlier, although focal HIFU treatment is available for localized prostate cancer and studies in Europe have demonstrated its safety and efficacy, there are no long term follow up data in the US at this time. Urologic surgeons in the US will need at least 10 years of data to establish focal therapy as a standard treatment.

However, with HIFU, if the patients cancer returns he can undergo radical surgery or radiation, or repeat HIFU. In other words, HIFU does not preclude a secondary treatment, whereas the two conventional treatments, if unsuccessful, cannot be repeated, and secondary treatment options are limited and come with a risk of debilitating side effects.

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What Kinds Of Results Have You Seen With This Technology Thus Far Either In Clinical Studies Or In Early Roll Out Stages How Encouraging Have The Results Been So Far

More than 45,000 men around the world with localized prostate cancer have gone through the HIFU procedure. In Europe, where the first generation HIFU system originated and was used for whole prostate treatment, researchers published positive peer-reviewed studies of the use of HIFU for whole gland ablation.

In 2013, the Journal of Urology published a German study of 704 patients treated with HIFU, in which co-investigators concluded that long-term follow-up with HIFU therapy demonstrated a high overall rate of cancer specific survival and 10-year salvage treatment-free rates of 98% in low-risk, 72% in intermediate-risk, and 68% in high-risk patients.

One must still understand that focal therapy is a very new treatment option, especially with this particular ablation device, the Focal One, only receiving market clearance in June of 2018. Long-term studies and clinical data are not yet available and this therapy is only appropriate for select prostate cancers. However, the arrival of the Focal One by EDAP TMS is significant because of the degree of precision with which the cancer can be treated in the prostate sparing healthy tissue and reducing side-effects of treatment.

How Does Hifu Therapy Work

What is HIFU?

HIFU is a focal therapy technique that targets a specific area of the prostate rather than the whole gland.

High-intensity sound waves target the tumor through an ultrasound probe inserted into the rectum. The surgeon controls the probe with a robotic arm that moves in millimeters.

Dr. Klein says HIFU relies on our ability to localize tumors in the prostate using MRI and targeted biopsy, which builds on our prior experience of doing fusion biopsies. He says this way of treating prostate cancer has the potential to effectively treat prostate cancer in some men while causing fewer side effects.

HIFU uses better imaging, better biopsies, and better ways of mapping out whats going in the prostate. But he says its only for about 10% to 15% of all prostate cancer patients.

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Who Can Be Treated With High

High-intensity focused ultrasound is approved by the Food and Drug Administration for the ablation of prostate tissue. Who the best candidates are for HIFU is somewhat debated by urologists.

HIFU can be considered:

  • As an alternative option to monitoring for patients who have early stage prostate cancer.
  • As an alternative to or follow up to radiation or surgery or other failed treatment for tumors that are small and confined to an area of the prostate.

Who Is A Good Candidate For Hifu

Men with cancer that has not spread beyond the prostate are the best candidates for HIFU. Dr. Kasraeian may recommend HIFU as the first course of action or following radiation therapy, depending on your needs and condition. During a consultation at our practice, Dr. Kasraeian will determine your candidacy for the treatment and inform you of other potential treatment options based on your needs.

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High Intensity Focused Ultrasound For Prostate Cancer

High Intensity Focused Ultrasound is a minimally-invasive ablation which can be used for cases of localized prostate cancer. Ultrasound waves are focused with extreme precision instantly and effectively destroying the targeted cells within the prostate. The ultrasound waves are delivered via a probe which is inserted into the rectum. The duration of the HIFU procedure is one to three hours and can be performed under general or spinal anesthesia.

The procedure requires only a short hospital stay and has a low complication rate. The prostate tissue will be destroyed by the thermal effect of HIFU , therefore there is no radiation involved.

Who should undergo HIFU?

Your urologist may recommend HIFU if you require treatment for localized prostate cancer for the first time and wait a minimally invasive treatment.

Are there reasons why, or circumstances in which HIFU procedure is not a possible option?

Almost none this type of procedure is not the most appropriate for men with very large prostates but if the prostate is slightly enlarged, a TURP can be performed to reduce the size of the gland so that the HIFU procedure is made possible. In some cases, HIFU is not recommended for men who have experienced hardening of the rectal wall due to previous cancer treatments.

Is HIFU FDA approved?
How does HIFU work?
Procedure
Why is catheterization needed?
Is the HIFU procedure painful?
What happens after treatment?
What long-term follow up is required?
The Benefits

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What Is Hifu Treatment

HIFU – High Intensity Focused Ultrasound

High intensity focused ultrasound is sometimes used as a treatment for early prostate cancer or prostate cancer that has come back after radiotherapy. It is given as part of a clinical trial, so it is only available in some hospitals in the UK.

HIFU treatment is given under a general or spinal anaesthetic. A probe is gently passed into the back passage . The probe makes a high-energy beam of ultrasound. This heats the affected area of the prostate and destroys the cancer cells. The probe is surrounded by a cooling balloon. This means the high-energy beams are only given to the areas with cancer in them and normal prostate tissue is protected.

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High Intensity Focused Ultrasound : A Prostate Cancer Treatment

There is a new treatment option for patients with prostate cancer that is confined to the organ, and not spread to other areas of the body. High Intensity Focused Ultrasound is a minimally invasive, out-patient, and radiation-free procedure that patients can undergo in a few hours and return home the same day. This advancement in the treatment of prostate cancer is making it possible for patients with earlier stages of the disease to maintain their quality of life without surgery. Even if the prostate cancer returns, no matter what form of treatment was previously used, High Intensity Focused Ultrasound can be used again for localized treatment. The use of HIFU also does not rule out other treatment options for recurring cancer.

Sonablate HIFU Procedure

There are several forms of High Intensity Focused Ultrasound : . Standard HIFU Procedure: Ablation of the entire prostate gland. . Focal HIFU Therapy: Targeted only to the area in the prostate gland where the tumor is located. . Salvage Treatment: Option for patients with a recurrence of prostate cancer.

During the procedure, Tissue Change Monitoring Software allows surgeons to monitor the prostate tissues reaction to the ultrasound waves in real time and make any alterations when needed. The precision of the Sonablate HIFU allows for flexibility in the procedure, making it possible for physicians to offer a customized treatment plan tailored to each patients diagnosis.

How Hifu Is Performed

On the day of your procedure, the healthcare staff will get you comfortable. The procedure typically uses the following steps:

  • A thin tube is passed through your penis into your bladder to drain the urine
  • The probe for HIFU is inserted into your rectum
  • The high-intensity ultrasound is used to destroy the cancer cells
  • The doctor looks at a screen to ensure that it is properly placed
  • The probe may be moved around to target more than one area
  • The probe and catheter are removed

Depending on the area being targeted, it takes one to three hours to perform most HIFU procedures. After a short while in recovery, you can usually go home.

When you are diagnosed with prostate cancer, your doctor may present more than one treatment option to you. Learning more about HIFU ensures that you have a general understanding so that you can work with your doctor to determine if it is a viable treatment option.

At UCI Urology, our prostate cancer specialists are compassionate and experienced in selecting the best treatment or combination of treatments for each situation.

UCI Urology – Orange

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How Does Hifu Work

If you’ve ever used a magnifying glass to reflect the sun’s rays and start a tiny fire or burn a hole into a leaf, you already have an idea of how HIFU works. Instead of light rays, though, HIFU uses sound waves that a doctor points through the wall of your rectum — the bottom part of your large intestine. They’ll direct the waves at your cancer cells.

The sound waves heat up to temperatures as high as 90 C and can kill cancer cells in just a few seconds. Doctors use magnetic resonance imaging and ultrasound imaging to find out exactly where the tumor is and where to point the sound waves.

How Do I Know If Hifu Is The Right Treatment For My Prostate Cancer

FDA Fully Approves Non

Depending on the stage and prognosis of oneâs prostate cancer, different treatment options may be recommended or required by your oncologist. If screened for and diagnosed in the early stages of development, many men with prostate cancer can benefit from non-invasive tactics like high-intensity focused ultrasound. Individuals with more advanced cases may require invasive surgery or radiation treatment. However, with proactive and regular screenings, it is entirely possible to begin effectively treating prostate cancer before it progresses to such an extreme point.

If you are still curious about high-intensity focused ultrasound or other forms of prostate cancer treatment, please contact HIFU Prostate Services today by visiting us online or by calling 1-877-884-4438.

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How Does Hifu Help Treat Prostate Cancer

This minimally invasive prostate cancer treatment uses sound waves to target cancer cells through the wall of the rectum. Using MRI and ultrasound imaging, Dr. Kasraeian will determine where exactly to direct the sound waves before beginning the treatment. The sound waves will heat to around 90 C during the treatment, effectively destroying cancer cells while avoiding harming the surrounding skin.

What Is The Prostate And How Common Is Prostate Cancer

The prostate is a reproductive gland in men. It is located in front of the rectum in the lower part of the intestine. It is about the size of a walnut and produces fluid that makes up semen.

Prostate cancer is very common in men in the United States. One in five men will be diagnosed with prostate cancer.

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Focal High Intensity Focused Ultrasound For Prostate Cancer

Submitted: June 23rd 2014Reviewed: February 10th 2015Published: October 28th 2015

DOI: 10.5772/60267

  • Department of Urology, Free University of Brussels , Brussels, Belgium
  • Department of Urology, Free University of Brussels , Brussels, Belgium
  • Alexandre Peltier

  • Department of Urology, Free University of Brussels , Brussels, Belgium
  • Roland van Velthoven

  • Department of Urology, Free University of Brussels , Brussels, Belgium
  • DOI: 10.5772/60267

    The Principle Rationale Of Tissue Preservation Is Harm Reduction And Functional Preservation

    Video of HIFU Prostate Cancer Treatment Procedure

    Adverse events affecting the urinary tract are reported in 2-58% of whole gland HIFU therapy in the literature. Rectal toxicities ranged from 0 to 15%. Erectile dysfunction is reported in 0 to 39% of cases . Toxicity rates are believed to be lower after focal therapy. In our case series, 31 consecutive patients with unilateral organ confined prostate cancer were primarily treated by hemiablation HIFU. Early self-resolving LUTS were the most common complications and no rectal toxicities were reported. The strategy was well tolerated in the genitourinary functional domains: all patients were pad free continent despite a high number of apical lesions and only 25% of men in our cohort of relatively elderly patients who were potent preoperatively reported having ED post hemiablation. The procedure could possibly be delivered in an ambulatory care setting .

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    What Are The Advantages And Disadvantages Of Hifu

    What may be important for one person might not be so important for someone else. If youre thinking about having HIFU, speak to your doctor or nurse before deciding whether to have it. They can help you choose the right treatment for you. Take time to think about whether you want to have HIFU.

    Advantages

    • HIFU doesnt involve any cuts to the skin or needles, apart from a needle in your hand to give you a general anaesthetic.
    • Focal HIFU can treat small areas of cancer while causing little damage to nearby tissue, nerves and muscles.
    • You only need a short hospital stay you can usually go home on the same day as your treatment.
    • Recovery is usually quick and most men return to their normal activities within two weeks.
    • HIFU is less likely than surgery to cause erection or urinary problems.
    • You may be able to have HIFU if your cancer has come back after radiotherapy.
    • You may be able to have HIFU again if your cancer comes back after your first HIFU treatment. This isnt the case with all treatments.
    • You may also be able to have other treatments after HIFU if your cancer comes back, such as surgery or radiotherapy.

    Disadvantages

    • In the UK, HIFU is only available in specialist centres or as part of a clinical trial. You may need to travel a long way to your nearest treatment centre.
    • Compared with other treatments, we dont know how well it works in the longer term .
    • As with other treatments, you may get side effects, such as erection and urinary problems.

    What Happens During The Procedure

    It usually takes 1 to 4 hours. Before it starts, you’ll get an enema to make sure your bowels are empty. You won’t be able to eat or drink anything for 6 hours before the operation.

    You will get anesthesia and shouldn’t feel any pain during the procedure. The doctor will thread a small tube called a catheter through the head of your penis and into your bladder to catch urine during the procedure.

    Your doctor will put an ultrasound probe into your rectum. It’s a small instrument like the ones used for prostate biopsies. The probe may have one or two crystals inside. Sound waves from a crystal bounce back to a computer to make a picture of the prostate gland. This will show where to send the sound waves. A crystal sends focused sound waves through the rectal wall and into the gland. An MRI might be used to keep track of the treatment.

    After the procedure is done and the anesthesia wears off, you can usually go home. The doctor may leave the catheter in for a week, and you will make an appointment to have it taken out.

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    What Are The Advantages Of High

    Advantages of high-intensity focused ultrasound include:

    • It requires no surgical incisions into the body and doesnât use radiation.
    • It can exactly target diseased tissue, leaving non-targeted healthy tissue unharmed.
    • It is an outpatient procedure with a short recovery time. You can usually return to work or normal life in about 24 hours.
    • It reduces the risk of urinary incontinence and erectile dysfunction compared with surgery or radiation therapy.

    What Are The Cons Of Hifu Therapy

    Prostate Cancer

    Its not right for everyone

    HIFU is typically used only for localized prostate cancer . Its best suited for men who are in the early stages of prostate cancer. In more advanced stages when the cancer has moved beyond the prostate, HIFU therapy isnt effective.

    Its relatively new

    As a treatment for prostate cancer, HIFU has been in use for a little less than two decades outside of the United States.

    In the U.S., the Food and Drug Administration approved HIFU for prostate-related treatment in October 2015. Dr. Klein says its important to note that this method is FDA approved for ablating prostate tissue. It is not FDA approved for treating prostate cancer, specifically. Thats an important distinction, he says.

    Its not widely available

    Because of the fairly recent FDA approval, not all hospitals offer the treatment. Dr. Klein says there are only a few sites in the United States that have the most modern devices for delivering HIFU.

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