NCMA Healthy Insights
by Michael J. Lazar, MD
Prostate cancer is the leading form of solid organ cancer in the U.S. and the fourth most common form of cancer in the world. According to the U.S. National Institutes of Health, the U.S. had more than 27,000 deaths in 2009 due to prostate cancer, which usually strikes older men. Those who have been diagnosed with prostate cancer and have explored treatment options have been faced with some difficult choices. Which treatment is likely to be most effective? Which has the fewest associated risks? What are the side effects?
Traditional treatments include: radiation therapy, surgery, freezing the cancerous gland, hormonal therapy and chemotherapy. Physicians base treatment recommendations on many factors such as tumor size, spread of the disease and the patient’s medical status and history. Fortunately advances in research and technology have produced another non-invasive option with relatively few side effects: High Intensity Focused Ultrasound, or HIFU. As with other treatment options, urologists carefully screen patients before recommending this option to make sure they are an appropriate candidate for HIFU.
HIFU treatment is advanced medical technology that uses ultrasound to rapidly and precisely apply heat at a level that is lethal to prostate tissue. It destroys the entire prostate gland or focuses only on the cancerous portion of it. This highly localized treatment leaves the surrounding tissue unharmed.
With this quick, non-surgical outpatient procedure, patients usually have a spinal anesthesia. Because the procedure is performed without an incision, patients do not experience blood loss, typically regain normal mobility within only a few hours of treatment with minimal discomfort usually treatable without pain killers, and can return to normal activity within a few days. With HIFU, the negative side-effects of traditional treatments are greatly diminished. Since there is less damage to the surrounding area, such as the muscle controlling urine flow and the nerves controlling erections, negative side effects are minimized, and patients can return to a normal lifestyle.
The oncological results of HIFU are broadly comparable to radical prostatectomy, but the patient benefits outweigh those of other treatment options. In addition, HIFU is the only non-invasive prostate cancer therapy that uses clean (or non-ionizing) energy, allowing patients to repeat treatments if necessary without collateral tissue damage.
With Sonablate® 500 technology, developed by Focus Surgery, Inc. of Indianapolis, Indiana, the doctor is able to obtain real-time ultrasound images of the prostate and surrounding areas. From these images, the surgeon determines precisely where the High Intensity Focused Ultrasound energy will be delivered. The technology then allows the surgeon to visually direct the treatment and destroy the targeted gland or selected portions. This is the only non-radiation technology that requires no direct contact with the target organ.
HIFU technology has been extensively studied and has advanced to point that it effectively represents the next generation of prostate cancer treatment. No other form of treatment allows the surgeon the control to so precisely pinpoint the targeted area and effectively ablate it without damaging the surrounding tissue.