If you have localized prostate cancer, you should know that a relatively new treatment — high intensity focused ultrasound (HIFU) therapy — may help you avoid surgery or radiation therapy. HIFU also produces fewer side effects than those common in more traditional treatments.
Cleveland Clinic is a non-profit academic medical center. Advertising on our site helps support our mission. We do not endorse non-Cleveland Clinic products or services. Policy
Some men are hesitant to talk to their doctors about their health and health concerns. This is especially true when it comes to prostate cancer, though it is the second leading cause of cancer-related deaths in men.
The potential side effects of prostate cancer treatment include erectile dysfunction (ED) and incontinence — other health topics that you might rather not discuss.
But it’s a good idea to ask your doctor about HIFU, especially because it may help you avoid those side effects.
Urologist David Levy, MD, explains the basics about HIFU therapy, and he discusses the pros and cons of using it to treat prostate cancer.
How does HIFU therapy work?
HIFU is a focal therapy technique that targets a specific area of the prostate rather than the whole gland.
High-intensity sound waves target the tumor through an ultrasound probe inserted into the rectum. The surgeon controls the probe with a robotic arm that moves in millimeters, Dr. Levy says.
“The probe heats to 80 Celsius and kills the cancerous tissue,” he says.
What are the pros of HIFU therapy?
1. There’s less down time and pain
There’s no lengthy hospital stay after the HIFU treatment.
“HIFU is an outpatient procedure,” Dr. Levy says. “It generally lasts about an hour and, once a catheter is in place, the patient can go home.”
You typically won’t need pain medications after HIFU because it isn’t as invasive as other treatments, he says. It doesn’t involve a surgical incision or radiation.
2. It has fewer side effects
Many men worry that they’ll lose the ability to get an erection after prostate cancer treatment, Dr. Levy says. The inability to control the bladder is another common side effect of more traditional treatments.
However, men who opt for HIFU are less likely to have ED or urinary incontinence after the procedure.
3. Other treatments are still an option
If HIFU isn’t effective and the cancer returns, your doctor can pursue other options, including surgery.
Some treatment options such as radiation therapy generally aren’t used a second time because of the increased risk for negative side effects.
What are the cons of HIFU therapy?
1. It’s not right for everyone
HIFU is typically used only for localized prostate cancer (cancer that hasn’t spread outside the prostate). It’s best suited for men who are in the early stages of prostate cancer. In more advanced stages when the cancer has moved beyond the prostate, HIFU therapy isn’t effective.
2. It’s relatively new
As a treatment for prostate cancer, HIFU has been in use for a little less than two decades outside of the United States.
In the U.S., the Food and Drug Administration (FDA) approved HIFU for prostate-related treatment in October 2015. (The approval was for use in prostate tissue removal and not specifically for prostate cancer treatment.)
3. It’s not widely available
Because of the fairly recent FDA approval, not all hospitals offer the treatment. While the treatment won’t take long, you may need to travel to find a specialist who performs HIFU therapy.
The bottom line: Have the conversation
HIFU is a relatively new treatment option in the U.S., but is widely used in Europe for more than 15 years with positive results, Dr. Levy says.
“HIFU has an 86 percent, 5-year success rate in Europe for low-stage prostate cancer. And close to 80 percent of those treated have remained free of cancer for seven years,” he says.
So if you have a prostate cancer diagnosis, HIFU therapy is one option you should discuss with your doctor.