Men diagnosed with prostate cancer who pursue a treatment option typically undergo treatment of their entire prostate gland. Cancer removal is typically performed surgically (open, laparoscopic or robotic prostatectomy), with radiation (IMRT, Brachytherapy), or with cryotherapy (freezing of the prostate). While these modalities can be effective with varying success rates, all have the potential of causing erectile dysfunction and urinary dysfunction ranging from urinary frequency, urinary urgency, obstructive voiding symptoms to complete urinary incontinence.
High Intensity Focused Ultrasound (HIFU) is changing the way men with prostate cancer are being treated. HIFU is an outpatient treatment modality that can similarly treat the entire prostate gland with curative intent. As with other, above-mentioned, modalities, HIFU is very effective for treating prostate cancer. However, because of its precision, high intensity focused ultrasound can have superior outcomes in regards to erectile function and urinary symptoms as compared to surgery, radiation therapy or cryotherapy.
Most patients who choose to undergo HIFU to treat their prostate cancer, do so with the aim of treating their cancer while trying to maximizing preservation of their normal sexual and urinary function. The other advantages of HIFU are that it is performed as an outpatient (not requiring hospitalization) and it has almost no down time. HIFU treatment for prostate cancer typically takes about three hours to complete.
As with any treatment modality, the treating physician’s expertise and experience are of paramount importance. The urological experts at Prostate Cancer Institute of LA are some of the most experienced cancer treatment specialists in the country.
Frequently Asked Questions
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 are the outcomes of HIFU vs. Surgery and Radiation Therapy?
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.
Q. What happens after the evaluation is completed?
A. After undergoing a thorough evaluation and meeting the HIFU criteria, men are scheduled for a HIFU procedure. The HIFU 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.
Q. 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.
Q. What are the quality of life outcomes with whole gland HIFU?
To learn more about HIFU treatment, visit Medscape.com.
See a Prostate Cancer Specialist in Los Angeles Today
For more information, contact one of our urologists at (310) 341-2557.
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