HIFU stands for High Intensity Focused Ultrasound. The treatment consists of aiming ultrasound energy into the prostate cancer from a probe in the rectum (back passage). The treatment is given with an anaesthetic over a single session as a day case.
Although only 5 year data is available there is evidence to suggest that it is as effective as surgery or radiotherapy with a much lower number of side effects such as impotence and incontinence. The procedure can be performed with minimal impact to the patient. The energy can be delivered accurately to within 2mm, this means that it is possible to give nerve sparing treatment and hence preserve erections. Similarly if the treatment has pierced the prostate capsule as seen on the CT/MRI scan extra energy can be delivered to this area. The procedure is new but has been approved for use in primary (untreated) prostate cancer and prostate cancer which has come back after radiotherapy by the National Institute of Clinical Excellence in the UK. Rates of impotence appear to be lower than other treatments (radiotherapy, brachtherapy and surgery). Rates of persist ant incontinence are also in the lowest group (lower than surgery and as low as radiotherapy and brachytherapy).
Below is the planning image that the surgeon uses to target the energy into the prostate. On the left hand side of the screen is the prostate in cross section from side to side, on the right hand side is the prostate shown in cross section from front to back.
The small red lines are the position of each treatment. The surgeon plans the treatments taking each slice of the prostate at a time (as shown below). This treatment plan is replayed before treatment so that the surgeon can check that the whole gland has been covered.
As the treatment is delivered the surgeon monitors the changes in the prostate itself to ensure that the tissue is destroyed. The power is varied for each treatment position to maximise the effect and minimise any unwanted effects.
I have undergone training at the Royal College of Surgeons (London), with Mr Simon Brewster at the Churchill, Oxford and Mr Mark Emberton of the Institute of Urology, Middlesex Hospital and UCH. More information is available here and at the National Institute of Clinical Excellence.
The treatment is available in Derbyshire at the both the Nuffield hospital and our new 'Super Hospital'. Derbyshire Hospitals are an NHS foundation trust and the treatment is therefore available for NHS patients from around the country on the basis of choose and book. We provide a full range of treatments for prostate cancer at our teaching hospital with a catchment area of over 1 million patients. On the basis of returns to our specialty organisation The British Association of Urological Surgeons we are the 3rd busiest department in the country.
If you wish to have your treatment on the NHS at the King's Treatment Centre and experience diffculties locally then please get in touch. We will perform the necessary checks with your primary care trust to ensure that your surgery can go ahead.
Please see further details on prostate cancer treatments here
To watch a video explaining HIFU click below. You will need to turn up the volume as the sound level is unfortunately rather low.