HIFU

If therapy is required for only one area of the prostate, High-Intensity Focused Ultrasound (HIFU) is a method that uses high frequency ultrasound to treat prostate cancer.

Who is suitable for HIFU treatment?

If you have localised prostate cancer, in other words the cancer has not progressed outside of your prostate and your risk of spreading is low to medium, HIFU may be a good option for you.

If your prostate cancer has progressed to the region immediately outside of it (locally advanced prostate cancer), has begun to spread outside of your prostate, or has a high chance of doing so, HIFU may be a possibility for you. However, compared to men with localised disease, you may have a higher chance of your cancer returning following therapy. If you have advanced prostate cancer, which is cancer has spread to other parts of your body, HIFU is not a possibility.

Additionally, HIFU can be used to treat cancer that has returned following radiation therapy or prior HIFU (recurrent prostate cancer).

Before your treatment

You receive HIFU treatment as an outpatient in hospital. This means that you can usually leave the hospital on the day you have HIFU. You can have an MRI scan before the treatment. This is to find out the exact location of the cancer so that doctors can plan your treatment.

You will have an enema to empty your bowel. An enema is a fluid-filled sac with a nozzle that you put in your back passage (anus). This causes you to empty your bowels. You usually have to stop eating for 6 hours before the procedure, but you can still drink fluids. You stop drinking 4 hours before. Your doctor will ask you to sign a consent form to say that you agree to the treatment. This is a good time to ask any questions you have.

During HIFU

In the operating room, under general anaesthesia, you have HIFU. This indicates you are dozing off and won’t be feeling anything. A little tube called a cannula is inserted into a vein in the back of your hand.

Through the urethra, your surgeon inserts a small catheter into your bladder. The tube that exits the body from the bladder carrying pee is called the urethra. Your pee is drained via the tube. It’s called as a urinary catheter. An HIFU probe is inserted by your surgeon into your rectum, or back channel. High-intensity ultrasonic waves produced by this probe have the ability to eradicate prostate cancer cells. The prostate is reached by the high-intensity ultrasound waves passing through the back tube.

The probe creates an image on a screen and functions as an ultrasound as well. This is the target area for your surgeon. To treat every cancer cell, they rotate the HIFU probe. The whole prostate HIFU treatment takes about 3 hours. HIFU on a smaller area (focal HIFU) takes 1 to 2 hours. When you are fully awake you go back to the ward to rest.

After your treatment

When you recover from anaesthesia, you can usually go home the same day. You can not drive home after a general anaesthetic. This is because it takes some time for the anaesthetic to wear off.

You may have a catheter to drain the urine for up to a week. If you go home with a catheter, your nurse will teach you how to care for it. They will arrange for it to be removed.

What happens afterwards?

You will have follow-up examinations with your doctor or nurse at the hospital. This is  sually called follow-up. The purpose of this:

To check how your cancer is responding to treatment cope with any side effects of treatment will give you the chance to raise any concerns or ask questions.

You will have a PSA test every three to six months for the first few years to check how well HIFU is working. Your PSA level is likely to reach its lowest level a few months after HIFU. You may also have a prostate biopsy to check whether your prostate cancer has been successfully treated. You may also have an MRI scan to check whether your treatment is working as intended. If you have focal HIFU, you may have deliberately untreated low-risk cancer in another part of the prostate. You will have regular tests to monitor the untreated cancer. These may include PSA tests, MRI scans and prostate biopsies.

Your PSA level should fall after HIFU and stay low afterwards. If your PSA level keeps rising, it may be a sign that the cancer has come back. If this happens, your doctor may recommend that you have further tests, such as an MRI scan and biopsy. Sometimes they may also recommend other types of screening, such as a CT scan or bone scan to see if the cancer has spread to other parts of your body. If you need other scans, your doctor or nurse will tell you more about them.

If your cancer comes back after HIFU, you may receive other treatments aimed at getting rid of or controlling it. You may be offered them:

More HIFU

External Beam Radiotherapy

Cryotherapy

Surgery (Radical Prostatectomy)

Hormone Therapy

Or your doctor may recommend monitoring your cancer instead of treating it immediately.