High-intensity focused ultrasound (HIFU) is a relatively new method of prostate cancer treatment. Initially, it was used in several clinics in Germany and France, and only at the beginning of this century it became widespread in Europe and Asia. The information on success rates of high-intensity focused ultrasound therapy identifies about 16,000 treated prostate cancer patients.
HIFU for prostate cancer treatment
The use of radical prostatectomy in the medical treatment of prostate cancer is not always possible, as most cases of the disease occur in patients of older age groups. The development and improvement of alternative, high-tech methods of treating patients with prostate cancer is an urgent issue of modern urology. One of these methods is high-intensity focused ultrasound (HIFU) for prostate cancer. The essence of the technique is based on the effect on the tissue of the prostate gland of high-intensity focused ultrasound (HIFU) – waves with a frequency of 3 MHz.
Observations indicate that high-intensity focused ultrasound (HIFU) in patients with prostate cancer is an effective, minimally invasive, safe method of medical treatment with a low number of complications, which makes it possible to recommend it for use in prostate cancer patients with poor health conditions.
High-intensity focused ultrasound (HIFU), is used in cases when the radical prostatectomy is not possible. In addition, it can be used as a life-saving therapy for relapses (the recurrence of a tumor after other prostate cancer treatments). The method is not recommended for patients who have had rectal surgery. In this case, there is a possibility of rupture of the intestinal wall and the appearance of fistulas.
High-intensity focused ultrasound (HIFU) is most effective when the prostate is small. With a volume of over 30 сс., first, transurethral resection or laser enucleation of the prostate is performed.
High-intensity focused ultrasound (HIFU therapy) in patients with prostate cancer is an effective, minimally invasive, safe medical treatment that rarely causes complications.
Types of HIFU for prostate cancer
Whole-prostate HIFU. Whole-prostate HIFU treats the whole prostate and takes about three hours. It may be suitable for men who have prostate cancer that needs treating more than one area of their prostate.
Focal HIFU. Focal HIFU treats a smaller area of the prostate and takes from one to two hours. It may be suitable for men who have cancer that needs treating in only one area of their prostate.
The surgeon will treat the areas of cancer and a small area around them. So, less of the healthy tissue is damaged during focal HIFU compared to whole-prostate HIFU. Some men who have focal HIFU have only one area of cancer in their prostate.
Other men have another area of cancer in their prostate that is not treated on purpose. This cancer is not treated because it is less likely to spread (low-risk cancer) and it may not cause any problems. These men will have regular examinations to keep an eye on the cancer.
With focal HIFU, there is a small risk that some areas of cancer that do need treating may be missed because it doesn’t treat the whole prostate. If this happens, there are further procedures that can be done in order to get rid of or control the cancer.
How is HIFU for prostate cancer carried out?
The essence of the method of HIFU (high-intensity focused ultrasound) is to affect prostate cancer tissue with focused ultrasonic waves with a frequency of 3 MHz. The high intensity of the waves and the concentration of radiation at one point cause a thermal effect and the phenomenon of cavitation: the destruction of the gland tissue occurs. Subsequently, in 3-6 months, the necrotic prostate tissue, including the capsule, is replaced by fibrous tissue.
There are two systems that cause similar effects in the prostate gland – "Ablatherm" by "EDAP TMS S.A." (France) and "Sonablate" of "Focus Surgery Inc." (USA). Due to a number of the advantages, the first system has become more widespread in the world.
The HIFU prostate cancer therapy undergoes as follows.
Under spinal anesthesia, an endorectal probe is inserted into the body of the patient who lies on the right side. The probe combines an ultrasound scanner and an ultrasound emitter. The doctor can see images of the prostate on the monitor and treatment starts. Through successive "shots", which allow reaching a temperature of 85°C within a few seconds with a lesion zone 19-28 mm long and 1.7 mm wide, the entire prostate tissue is treated layer by layer.
The duration of the procedure ranges from ten minutes to several hours and almost directly depends on the volume of the prostate gland. Due to the prostate edema in the postoperative period, the bladder is usually drained with the help of catheterization for several days.
Indications for high-intensity focused ultrasound (HIFU)
The indications for the HIFU therapy are:
- Localized prostate cancer
- Relapse after radical prostatectomy or radiation therapy
- Locally advanced and generalized prostate cancer in combination with hormonal therapy
Absolute contraindications are:
- History of rectal fistula
- Stenosis, rectal amputation
Relative contraindications are:
- Volume of the prostate more than 40 cc.
- Prostate calcifications
- Severe bladder obstruction
To reduce the volume of the prostate gland, eliminate bladder obstruction, and remove gland stones, transurethral resection of the prostate is performed beforehand.
Side effects and benefits of HIFU
After high-intensity focused ultrasound (HIFU), the following complications were noted: temporary urinary retention, which disappears in pharmacotherapy administration; ejaculation disorders, and erectile dysfunction.
One of the most serious complications of high-intensity focused ultrasound (HIFU) therapy is the urethrorectal fistula formation. This complication occurs relatively rarely, but it is the most severe one due to a sharp decrease in the quality of life and the need for complex, long-term, and often ineffective medical treatment.
The advantages of high-intensity focused ultrasound (HIFU), as a method of treating prostate cancer are as follows:
- Absence of damage to the skin
- Treatment in one session
- No risk of bleeding
- High accuracy of the intervention
- Constant visualization of the treatment process
- Possibility to repeat the procedure in case of treatment failure
- Treatment can be performed in patients with recurrent disease after radical prostatectomy and radiation therapy
Elderly patients with aggravated somatic status receive minimally invasive, effective treatment so that they can return to their usual everyday life, without taking hormonal therapy and without any physical or other restrictions. The only necessary follow-up test in this case is the periodic determination of the PSA (prostate specific antigen) in the blood. Therefore, this focused ultrasound treatment method allows the patient to maintain not only health but also the quality of life.
The use of radical treatments for prostate cancer is not always possible and desirable. And there are several reasons for this:
- The majority of patients have concomitant pathology, specifically diseases of the cardiovascular and pulmonary systems (75-80% of all cases of prostate cancer occur in men over 65), so they cannot tolerate the radical prostatectomy.
- Conducting radiation therapy requires special equipment and the premises prepared in a certain way.
- Radical methods of treatment have a certain percentage of severe complications.
- Patients do not always seek to undergo invasive interventions, which, of course, is prostatectomy. Due to this, the development and improvement of alternative, high-tech methods of treating patients with prostate cancer, one of which is HIFU therapy, is an urgent issue of modern urology.
The cost of HIFU for prostate cancer treatment
With Booking Health services, you can undergo HIFU therapy for prostate cancer at an affordable price. The cost of the procedure varies in different countries. We can arrange a trip for treatment at a fair price. The cost of HIFU treatment abroad goes as follows:
- Germany – from 16,700 EUR
- Turkey – from 13,500 EUR
- India – from 11,400 EUR
Where can I undergo HIFU treatment abroad?
Among foreign hospitals, the best success rates in HIFU treatment for prostate cancer are demonstrated by:
- University Hospital of Ludwig Maximillian University of Munich, Department of Adult and Pediatric Urology. The department ranks among the TOP German departments specializing in prostate cancer treatment. It is certified as the Prostate Cancer Center according to the standards of the German Cancer Society. This fact confirms the credibility of the department in the field and the high success rates in prostate cancer treatment.
- Medipol Mega University Hospital Istanbul, Department of Adult and Pediatric Urology. The department offers a full range of diagnostics and treatment of genitourinary diseases in boys and men. Particular attention is paid to the surgical treatment of prostate cancer. The treatment of this pathology is also carried out using an innovative technique – high-intensity focused ultrasound (HIFU).
- Primus Super Speciality Hospital New Delhi, Department of Adult and Pediatric Urology, Nephrology. The department provides an accurate diagnostics and effective treatment of a wide range of genitourinary diseases in boys and men, kidney disease in men and women. All procedures are carried out in strict accordance with standardized international protocols.
How can I undergo high-intensity focused ultrasound (HIFU) therapy abroad?
The self-organization of high-intensity focused ultrasound (HIFU) treatment abroad can be overwhelming. It requires specific knowledge and experience in medical tourism. It is safer, easier, and less stressful to shift some responsibility onto a medical tourism agency.
Booking Health is the largest and most transparent medical tourism agency in the world. Medical treatment abroad is arranged due to the direct cooperation with leading foreign hospitals.
Booking Health provides the following services:
- Selection of treatment program and medical facility
- Communication with the clinic
- Providing the favorable overall cost of treatment procedures
- Translation of medical documents
- Help in applying for a visa for the patient and accompanying person
- Flight and accommodation booking
- Interpreting services
To undergo prostate cancer treatment abroad for a reasonable price, please leave a request on our website. The medical tourism coordinator will contact you during few hours and provide you with further information.