High-Intensity Focused Ultrasound (HIFU)
High-intensity focused ultrasound (HIFU) kills cancer tissue in the prostate with heat generated by focused ultrasound waves. The treatment may offer improved urinary and sexual function to some prostate cancer patients.
HIFU procedure
During HIFU treatment, the patient is put under general anesthesia. The doctor then places an ultrasound probe in the rectum and takes an image of the prostate. Data from the image is used to create a three-dimensional model of the prostate. This confirms the exact location, size and shape of the tumor.
The doctor then uses the HIFU system to help plan treatment. Once the plan is final, the probe, under robotic control, releases focused, high-energy sound waves to the tumor. These waves increase the temperature in the area, heating and killing cancer cells. Healthy nearby tissue is left almost entirely undamaged.
HIFU can cause swelling of the prostate, so the doctor places a temporary urinary catheter into the bladder at the end of the procedure. This lets the bladder drain until swelling goes down. The catheter is removed one to two weeks later, when the patient is more likely able to empty his bladder.
Follow-up after HIFU involves testing the patient’s PSA levels and MRI exams of the prostate. Some patients undergo a prostate biopsy to confirm that the tumor has been destroyed.
Advantages of HIFU
HIFU is a minimally invasive procedure. It does not require any incisions or a hospital stay.
The treatment is designed to kill only the targeted areas of the prostate. By limiting damage to surrounding healthy tissue, HIFU may offer the patient better urinary and sexual function compared to other treatments.
HIFU is typically offered to patients with early-stage prostate cancers that are low- to intermediate-risk. The tumor must be visible on MRI. It must be confined to the prostate and be confirmed to contain prostate gland cells.
HIFU side effects
Most side effects of HIFU are mild and go away on their own in four to six weeks.
Many patients initially experience mild, temporary symptoms such as difficulty emptying the bladder, an urgent need to urinate and blood in the urine.
When Howard Walton visited his primary care doctor in August 2022, she was concerned his prostate-specific antigen (PSA) levels were rising too quickly. Later that month, Howard saw his urologist, who found that his PSA levels had risen significantly since he’d last seen Howard.
Howard’s urologist ordered a biopsy, and the results showed he had prostate cancer. He met with doctors at an Ohio hospital; they discussed two options: radiation therapy or surgery. Howard and his wife were already planning to spend the winter with their daughter in Houston, so instead of waiting to start treatment until they were back in Ohio, Howard told his urologist he wanted to go to MD Anderson. He called and got an appointment with John Ward, M.D., in November.
Another treatment option: high-intensity focused ultrasound
At his initial appointment, Ward suggested Howard might be a candidate for high-intensity focused ultrasound (HIFU), a treatment that uses heat generated by focused ultrasound waves to kill cancer tissue in the prostate. Patients who have early-stage prostate cancer with an MRI-identified tumor are typically good candidates for HIFU.
During HIFU treatment, the patient is put under general anesthesia before the doctor places an ultrasound probe in the rectum and takes an image of the prostate. Data from the image is used to create a three-dimensional model of the prostate to determine the exact location, size and shape of the tumor. The probe, under robotic control, then releases focused, high-energy sound waves to the tumor to heat and kill cancer cells.
Howard had never heard of HIFU, but after Ward described the procedure, he was convinced it would be the best option instead of radiation therapy.
“I found the idea of a one-time treatment much more preferable than six or seven weeks of radiation every day,” Howard says. “My mind was made up. I was convinced that if I was eligible, that's what I wanted to have done.”
‘Best decision’ to undergo HIFU
After undergoing an MRI, Howard was determined to be eligible for HIFU. He underwent the procedure in December and went home the same day. At the end of the procedure, Ward inserted a Foley catheter, a soft tube that continuously drains urine from the bladder into a drainage bag. It was removed a week later.
Howard calls undergoing HIFU "the best decision” for him. Even though Ward cautioned that a recurrence of the cancer was possible, Howard says Ward’s confidence in the procedure convinced him to choose HIFU over other treatment options.
“Dr. Ward exuded confidence, and I could feel that,” Howard says. “It made me more comfortable. Everyone I saw in connection with the procedure was so professional, kind and courteous. I have told more people, especially men, how common prostate cancer is. I tell them, ‘If you get prostate cancer, call MD Anderson. There’s no place like it.’”
Request an appointment at MD Anderson online or call 1-877-632-6789.