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HiFU Team

High Intensity Focused Ultrasound

Why has my doctor not told me about the procedure?

Simply put, most U.S. physicians have not been trained to perform HiFU and are unlikely to have access to a machine. Also, because Medicare only partially pays and commercial insurances largely do not pay for the procedure, many Urologists find it difficult to explain the economics of this treatment even though erectile dysfunction, incontinence and surveillance all have costs, both economic and physical.

Finally, many Urologists and institutions have invested millions of dollars into Radiation machines that are a direct alternative to HiFU treatment. They may be hesitant to advise a treatment that would devalue those investments. With prostate cancer, as much as any other similar diagnosis, you will most likely be offered the treatments that your doctor feels comfortable providing and getting additional opinions is critical.

Prostate Cancer is not a simple or single disease. Although over 300,000 men are diagnosed with the disease, only about 10% will dies from the disease and there is a real concern that men are being overtreated. So, if your doctor thinks that you would not fare well with complications or that you are too old or sick to benefit from treatment you may not be steered towards treating your prostate cancer.

How well will HiFU work?

Data in regards to HiFU has been collected over the last 20 years. To understand your specific cancer we encourage you to visit the following site to get your 10 year mortality and results after radical prostatectomy.
https://www.mskcc.org/nomograms/prostate/pre_op

We generally counsel patients that HiFU is about 90% as effective as radical surgery. Balancing your desire for cancer cure versus concerns about functional side effects will greatly impact your decision regarding prostate cancer treatment.

The following articles will give you all the efficacy information and side-effect information you would need for a decision.


Read Peer Reviewed Articles

  • Focal Treatment for Unilateral Prostate Cancer Using High-Intensity Focal Ultrasound: A Comprehensive Study of Pooled Data” – Albisinni et al. – Journal of Endourology 2018: https://pubmed.ncbi.nlm.nih.gov/29790383/
  • Comparing High-Intensity Focal Ultrasound Hemiablation to Robotic Radical Prostatectomy in the Management of Unilateral Prostate Cancer: A Matched-Pair Analysis” – Albisinni et al. – Journal of Endourology 2017: https://pubmed.ncbi.nlm.nih.gov/27799004/
  • Focal High Intensity Focused Ultrasound of Unilateral Localized Prostate cancer: A Prospective Multicentric Hemiablation Study of 111 Patients” – Rischmann et al. – European Urology 2017 – https://pubmed.ncbi.nlm.nih.gov/27720531/
  • Focal High-intensity Focused Ultrasound Targeted Hemiablation for Unilateral Prostate Cancer: A Prospective Evaluation of Oncologic and Functional Outcomes” – Cordeiro Feijoo et al. – European Urology 2016 – https://pubmed.ncbi.nlm.nih.gov/26164416/
  • Hemi salvage high-intensity focused ultrasound (HIFU) in unilateral radio-recurrent prostate cancer: a prospective two-centre study” – Baco et al. – British Journal of Urology International 2013 – https://pubmed.ncbi.nlm.nih.gov/24930692/
  • Whole-gland Ablation of Localized Prostate Cancer with High-intensity Focused Ultrasound: Oncologic Outcomes and Morbidity in 1002 Patients” – Crouzet et al. – European Urology 2014 – https://pubmed.ncbi.nlm.nih.gov/23669165/
  • Evolution and outcomes of 3 MHz High intensity focused ultrasound therapy for localized prostate cancer over 15 years” – Thueroff et al. – Journal of Urology 2013 – https://pubmed.ncbi.nlm.nih.gov/23415962/
  • Fourteen-year oncological and functional outcomes of high-intensity focused ultrasound in localized prostate cancer” – Ganzer et al. – British Journal of Urology International 2013 – https://pubmed.ncbi.nlm.nih.gov/23356910/
  • Salvage high-intensity focused ultrasound (HIFU) for locally recurrent prostate cancer after failed radiation therapy: Multi-institutional analysis of 418 patients” – Crouzet et al. – British Journal of Urology International 2017 – https://pubmed.ncbi.nlm.nih.gov/28063191/
  • Locally recurrent prostate cancer after initial radiation therapy: Early salvage high-intensity focused ultrasound improves oncologic outcomes” – Crouzet et al. – Radiotherapy and Oncology 2012 – https://pubmed.ncbi.nlm.nih.gov/23068708/
  • A prospective study of salvage high-intensity focused ultrasound for locally radiorecurrent prostate cancer: Early results” – Berge et al. – Scand J Urol Nephrol. 2010 – https://pubmed.ncbi.nlm.nih.gov/20350272/
  • High-Intensity Focused Ultrasound for the Treatment of Prostate Cancer: A Review” – Chaussy et al. – Journal of Endourology 2017 – https://pubmed.ncbi.nlm.nih.gov/28355119/
  • HIFU as salvage first-line treatment for palpable, TRUS-evidenced, biopsy-proven locally recurrent prostate cancer after radical prostatectomy: A pilot study” – Asimakopoulos et al. – Urologic Oncology 2010 – https://pubmed.ncbi.nlm.nih.gov/21292508/
  • Salvage Radiotherapy After High-Intensity Focussed Ultrasound for Recurrent Localised Prostate Cancer” – Riviere et al. – European Urology 2010 – https://pubmed.ncbi.nlm.nih.gov/20598436/

HiFU vs. Active Surveillance

Why would I choose HiFU over Active Surveillance (Watchful Waiting), Robotic Prostate Cancer Removal,
or Radiation (either external bean, Cyberknife, or radiation seeds)?

Watchful Waiting or Active Surveillance is an excellent choice for patients with small volume prostate cancer or those with poor health or those wanting to avoid all sexual and urinary side effects of treatment. Unfortunately, this treatment strategy involves, repeat biopsies, regular lab draws and doctor visits and the anxiety shared between you and your loved ones.


Carefully weigh and balance the risks.

We will generally advise our patients who have Prostate Cancer localized to the prostate who are interested in treatment to carefully weigh the risks of each choice and balance the risks with the expected cure rate. Men who have aggressive cancer and a long life expectancy will generally be advised to have a radical robotic prostate removal. However, many men, even with advanced cancer, would rather proceed with HiFU to preserve sexual and urinary function even though additional treatment may be required in the future.

Many of our patients are advised against radiation for several reasons:

  • Most patients deemed appropriate for radiation are excellent HiFU candidates.
  • The side effects of radiation, including developing other cancers, may not be seen for many years
  • HiFU can be done in several hours in one visit
  • HiFU can be used to treat only the part of the prostate affected by cancer
  • Surgical removal of the prostate remains a possibility after HiFU
  • Radiation can be kept as a treatment for salvage if the cancer return

The HIFU prostate tissue ablation procedure is designed to preserve quality of life

Prostate care treatments can alter patients’ quality of life in terms of pelvic comfort, urinary continence, sexuality and values. Today’s treatment options are not only about curing or prolonging life: they also aim at reducing the comorbidities of the disease and the side effects of treatments, to fight against possible sequelae. HIFU treatment is also a perfect alternative to active monitoring and radical treatment by surgery or radiotherapy. Being effective in a minimally invasive manner, it preserves the quality of life of patients by removing the psychological stress that active surveillance can represent for the patient.