Noninvasive Approach For Ablation Of Prostate Cancer

A technique known as HIFU (high intensity focused ultrasound) has appeared as noninvasive approach to manage prostate cancer via ablation. FDA has granted approval for HIFU to be used an alternative for surgery and radiation procedures for the treatment of prostate cancer in certain cases. Patients that qualify the eligibility criteria of this procedure received results that are equivalent to those of radiotherapy but with a significantly lower risk of side effects.

The waves in this procedure plays a major role in energizing the localized tissues to a temperature of up to 80C causing a marked decline in the pressure of tissue by up to 20,000 to 30,000 bars. This results into coagulative necrosis and eventually leads to tumor death. HIFU results are consistent due to robotic accuracy and precision which provides the focal beam with a width of 1.7 mm. The beam of this width is the reason why HIFU prevents the damage to the normal tissues and promotes life quality once the treatment is done.

HIFU is dependent on the robotic technique that is controlled by the computer. The procedure is performed under anesthesia (general) with the use of an ultrasound probe which is trans-rectal. Since the procedure is minimally invasive, therefore:

• No cuts are required to be made
• No added analgesics (painkillers) are required

Perks Of HIFU

While the procedure is being carried out by repeated imaging of prostate gland and can be obtained by means of mp-MRI (static multiparametric magnetic resonance imaging) and real-time ultrasound. This gives following benefits:

• Assists the surgeon in the assessment of the location and size of the tumor
• Increases the ablation of disease
• Protects the surrounding normal tissues from being targeted as well
• Protects surrounding structures like neurovascular bundles, rectal wall and urinary sphincter

HIFU is associated with fewer side effects that are more likely to happen in case of surgery or radiotherapy.

Research On HIFU

Crouzet et al, back in 2012 conducted a study based on 803 participants that were being offered treatment at 6 French centers. The study took in consideration the biochemical disease-free survival (DSF) of 5 and 7 years in case of patients with low, moderate and high risk. The study concluded that if the patients were chosen carefully for the procedure, HIFU could yield best results with reduced risk of morbidity associated with the procedure.

Results

As it is already known that in America prostate cancer has become the second most commonly occurring cancer in men with almost 161,360 new cases each year. Annually nearly 26,730 men die from prostate cancer. Even with the excellent treatment results, the procedure associated morbidities are inevitable particularly impotence and urinary incontinence.

Studies suggest that HIFU has opened new doors for the morbid-free treatment of prostate cancer. Overall effectiveness of HIFU is considered a step forward with fewer complications involved in the technique. With the accurate selection of eligible patients, HIFU can not only provide curative treatment for prostate cancer but also help promote quality of life.

References

• Kennedy, J. E., Ter Haar, G. R., & Cranston, D. (2014). High intensity focused ultrasound: surgery of the future?. The British journal of radiology.
• Heidenreich, A., Bastian, P. J., Bellmunt, J., Bolla, M., Joniau, S., van der Kwast, T., ... & Mottet, N. (2014). EAU guidelines on prostate cancer. Part 1: screening, diagnosis, and local treatment with curative intent—update 2013. European urology, 65(1), 124-137.