HIFU major step forward fight against prostate cancer

Technology advancement has given us a revolutionary treatment for men battling against prostate cancer - high intensity focused ultrasound (HIFU). Although it’s only available in a few hospitals across the UK, the results are looking extremely promising and can offer men a non-invasive treatment option with a speedy recovery.

Top consultant urologist, Mr Tim Dudderidge, is one of very few surgeons who can perform HIFU routinely at Southampton General Hospital. He explains what the treatment is exactly and how this can transform the lives of many men battling this disease.

What is high intensity focused ultrasound (HIFU) treatment?

HIFU is an innovative treatment to treat prostate cancer in men, it has been in use since 2005 when I first started working with it alongside colleagues in London. The process uses high-frequency ultrasound energy to target and directly destroy cancer cells in the prostate. It’s minimally invasive and avoids the need for surgery, making the recovery time much quicker than surgery.

The patient is given a general anaesthetic for the treatment and whilst asleep, a surgeon inserts a probe into the rectum. A beam of ultrasound energy is targeted into the prostate. It acts in such a targeted way that the selected tissue heats to 80C without harming the surrounding tissue.

Real-time images are used during the procedure which allows the physician to deliver the ultrasound energy to the focal points in the prostate gland. The whole procedure usually lasts around 2 hours, depending on the size of the tumour and prostate. The patient can go home on the same day the treatment is given.

A catheter is needed for around 7 days to drain urine. There is very little pain after so the patient can return to normal life very quickly afterwards.

Who is this treatment suitable for?

You may be suitable for this type of treatment if your cancer is localised, meaning it hasn’t spread to surrounding tissues. If it has, this treatment wouldn’t be very effective. Ideally, all significant cancer should be on one side and leaving the other side free to be left untreated. Sometimes in patients, cancer returns but fortunately, this treatment can be repeated.

How effective is it compared to conventional treatments?

Although conventional treatments can be very effective in treating tumours, patients normally experience more side effects when having surgery or radiotherapy. Side effects can include impotence and incontinence. With HIFU, the side effects are much less common and we believe the treatment is just as effective. Studies have shown that with HIFU, 90% of men treated preserved their sexual and urinary functions.

Radiotherapy blasts the whole prostate rather than just the tumour. Sometimes, the prostate has to be removed completely which causes various side effects and patients could spend weeks in the hospital. With HIFU, the patient can leave on the day of treatment.

HIFU uses sound energy, so unlike radiotherapy, the procedure can be repeated without harming or destroying perfectly healthy tissue. Thanks to MRI technology and target biopsy, we can understand the location of cancer and healthy tissue to help target the areas that need treatment.

Are there any side effects?

There are some side effects just like with any treatment, however, not as many as surgery or radiotherapy would cause. Some of the most common side effects include urinary infection, going too often or blockage problems. Erectile dysfunction occurs in roughly a quarter, less than for men having surgery, and incontinence is very rare. You are more likely to have side effects if you’ve had more than one HIFU treatment or you’ve undergone previous treatment on your prostate.

As this is a new treatment, we still don’t know the long term success rate compared to surgery or radiotherapy. However, it is already clear to us that patients suffer fewer side effects overall, there is less damage to the prostate nerves and men can return to their normal life quickly afterwards.

Mr Tim Dudderidge is a highly trained consultant urologist based in Southampton and Winchester. To book an appointment with him, visit his Top Doctor's profile and check his availability.