As with other treatments for prostate cancer, the answer is YES for some people and unfortunately “No” for others. Each treatment — from hormone therapy to radiation to surgery/outright removal to freezing (cryotherapy) — has a different set of benefits and risks.

HIFU (high-intensity focused ultrasound), a heat technique recently approved by FDA in 2015, is being used to treat localized prostate cancer. The procedure requires no surgeries (as the name suggests) and transmits waves and destroys the area of the prostate with cancer but saves the remainder of the prostate.

There are some things you may want to know when/before considering HIFU:

• You can’t have HIFU if your cancer has spread to other parts of your body (advanced cancer)
• Whole prostate HIFU treatment takes about 3 hours. Focal HIFU takes 1 to 2 hours.
• Patients with enlarged prostate are not considered eligible for HIFU treatment, and the treatment can take up to 10 hours to perform.
• HIFU had been approved by other countries where more than 50,000 men had been treated with the procedure, while in America, it was initially blocked for approval by the FDA

Pros of HIFU:

• There’s less down time and pain (no lengthy hospital stay, can go home right after the procedure)
• It has fewer side effects as compared with radiotherapy or surgery (a study showed 1-2% of the HIFU patients experiencing long-term incontinence, and just 15% erectile dysfunction whereas the stat is 30-60% for surgery)
• It is best suited for patients with early stage of prostate cancer. In a study by University College Hospital in UK that followed 625 men between 2004-2015 with localized, non-metastatic tumors: 93% of patients who underwent HIFU alone to remove their prostate tumor were still cancer-free and did not need any surgery or radiotherapy 5 years after treatment.
• Other treatments are still an option because if HIFU isn’t effective and the cancer returns, your doctor can pursue other options, including surgery.

Cons of HIFU:

• The cost of a HIFU procedure can range from $15,000 – $25,000. Medicare only covers the actual operational costs of the approved facility and you are responsible for the rest of the costs. Almost no commercial insurance provider covers even the facility costs associated with treatment of prostate cancer using HIFU (though recently in March 2018, a major U.S insurer, CIGNA, has agreed to cover HIFU costs for treatment of radiorecurrent prostate cancer).
• Not all hospitals offer treatment due to its recent approval.
• Erectile dysfunction, urinary retention, incontinence are among the side effects faced by patients after undergoing HIFU
• Effectiveness and safety of HIFU over a long term (preferably a 10-year follow-up and outcome) have not been proven

Whether you choose HIFU or not, just keep in mind that there are no active form of treatments without known adverse effects and health risks. And while almost all men diagnosed with lung cancer die of it, only 1 in 41 (or 2%) men will die of prostate cancer. Although prostate cancer can be very serious and some people will need treatments, some function just well on active surveillance.

As for HIFU, this is the article that inspires today’s blogpost:  New Prostate Cancer Treatment Is A Real Life Saver.