non-invasive prostate cancer treatment

Q: How long does a HIFU treatment take?

A: HIFU is performed as an outpatient procedure (patients do not need to be hospitalized). The procedure is performed at an outpatient facility and patients go home shortly after they have their HIFU therapy. The duration of the procedure depends on the amount of tissue that needs to be treated. On average, each treatment will take about three hours.

Q. How Do I choose a prostate cancer specialist?

A. When choosing a prostate cancer specialist, it is important to choose a specialist who is not only experienced but also one that is not biased. A urologist who only offers surgery, or a urologist who only performs HIFU or a radiation oncologist who only offers IMRT may have inherent biases as to what they offer.

By assembling leading doctors who provide all the different therapeutic options for men with prostate cancer, the Prostate Cancer Institute of LA has been created to provide patients the most advanced and comprehensive treatment options available without the inherent biases, as prostate surgery, HIFU, radiation, active surveillance and hormonal therapies are all offered, by our leading experts.

Q: Do I need to have a catheter after the HIFU procedure?

A: Placement of a catheter depends on the amount and location of the tumor that is being treated. Some patients will not need a catheter while others will need a catheter for an average of about five days.

Q: Will I have much pain after a high intensity focused ultrasound procedure?

A: The majority of men do not complain of pain after a HIFU procedure.

Q: When can I return to my normal activities?

A: Men will typically not have restrictions after a HIFU procedure. As some men will need to have a urinary catheter for a few days after their procedure, a few days of “taking it easy” (not exercising or engaging in strenuous activities) is recommended.

Q: Is every man with localized prostate cancer a candidate for this treatment?

A: No. HIFU is a good option for men whose prostate size and anatomy are suitable for HIFU therapy. Typically, the tumor location should be less than 4cm from the HIFU probe and no longer than 42mm in length. The presence of calcifications in the prostate and the health of the rectum are also key factors in determining who is and who is not a candidate.

Q: Are all HIFU machines the same?

A: The leading manufacturers of HIFU machines are Sonablate and Ablatherm. After extensive research, we strongly recommend the Sonablate technology for its improved versatility, depth of penetration, safety, and outcomes.

Q. How do I know if I am a candidate for HIFU focal therapy.

A. Accurate identification and localization of the cancer are key. For this reason, we use MRI imaging of the prostate and we use prostate mapping techniques when we do our prostate biopsies. With these techniques, we can accurately identify the extent and location of the prostate cancer. Once we have localized the tumor, it’s easy to treat it with HIFU.

Q. What if I have had my prostate biopsy done elsewhere?

A. In these situations, we check your biopsy results to make sure the diagnosis is accurate. Then we look at your prostate imaging (MRI and ultrasound images) to make sure they are to our standards. We then review the biopsy techniques that were used to make sure they were thorough enough and to our standards. If the imaging and biopsy techniques were adequate, then you can be scheduled for HIFU focal therapy. If the biopsy and imaging techniques are not satisfactory, we will let you know what else is needed so that we can have accurate information on the type, extent, and location of your prostate cancer. Knowing the location and extent of the cancer is KEY for HIFU focal therapy.

Q. How is whole gland HIFU performed?

A. First, a man’s candidacy has to be assessed. If a man has been diagnosed with prostate cancer, we first make sure that the cancer has not spread outside the prostate. If the cancer is limited to the prostate, then we assess the size of the prostate to make sure it is suitable for a HIFU treatment. Smaller glands are typically better suited for HIFU treatments. The gland needs to be less than 4 cm in height and 4.2 cm in length. This assessment is done by a simple prostate ultrasound. During the ultrasound evaluation, we also make sure that there are no dense prostate stones, which can block the HIFU ultrasound waves.

Q. What if a man’s prostate is larger than the recommended dimensions for a HIFU procedure?

A.In these situations, we determine if we can shrink the size of the prostate using medications or by performing an outpatient procedure called a TURP, where the prostate size is easily reduced, allowing most men to become candidates for a HIFU procedure.

Q. What if a man has a lot of prostate stones? Can he have HIFU?

A.It depends. Most men can have their prostate stones easily removed through an outpatient procedure called a TURP. With a TURP, the stones are often times easily removed, creating an open pathway for the HIFU waves to do their job. Once the stones are removed, HIFU can then be performed for most men.

After undergoing a thorough evaluation and meeting the HIFU criteria, men are scheduled for a HIFU procedure. The procedure is easy and well tolerated. Anesthesia is provided during the procedure, so no discomfort is felt. During the procedure, the prostate and the critical structures in and around the prostate are mapped out. The HIFU waves are then precisely targeted to the prostate and the areas of interest. Given the precision of HIFU, the critical structures such as the nerves that control erections and the muscles that control urination can be preserved, thereby allowing men to enjoy excellent outcomes after their HIFU procedure.

HIFU is an outpatient procedure, so men go home the same day. Most men do not complain of any discomfort and go back to their normal routines quickly after a HIFU procedure.

What is the typical follow up after a HIFU?

A.We like to get a prostate MRI one week after the HIFU procedure to ensure that the procedure outcomes are excellent. Thereafter, men are monitored with PSA tests (a blood test), occasional rectal examinations and possibly MRIs of the prostate over time.

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Contact Ultrasound Prostate Cancer Treatment Experts in LA

To best determine if high intensity focused ultrasound therapy (also known as magnetic resonance guided focused ultrasound) is the right choice for you, please contact the Prostate Cancer Institute of LA today. Through various tests and screening methods, our team can advise you on the best course of cancer treatment and HIFU cost.

To find out if HIFU Focal Therapy is right for you, contact us at 310.341.2557.

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