Am I a Candidate?
You are a candidate for HIFU treatment if you have a diagnosis of prostate cancer based on a biopsy. The stages of cancer that are treatable by HIFU are the same stages that are treatable by surgery or radiation with the exception that curative treatment is only possible in surgery, radiation, or HIFU if you have reasonably localized disease as determined by biopsy and staging tests.
In other words, if your cancer extends to that portion of the prostate called the seminal vesicles, or outside the prostate, your case would qualify as a stage T3. In stage T3, patients have limited cure rates because the cancer has spread outside the prostate. Treatments for such patients are only done for local control. The disease should be locally controlled and reduced in size, or it may cause problems such as pain, bleeding, and inability to urinate. Also, if you answer yes to one or more of these questions, then you may qualify as a candidate to try HIFU for prostate cancer:
Do you have prostate cancer?
- Are you qualified to have surgery or radiation for localized disease?
- Are you too old for surgery, or have medical conditions that preclude surgery, unable to have radiation because you have already had it or do not want it?
- Are you on active surveillance for prostate cancer (monitoring) but want a minimally invasive procedure that can relieve the anxiety and burden of living with this diagnosis and not getting treated?
- Is your disease is growing or PSA increasing while on monitoring?
- Do you have prostate cancer and want a treatment with fewer side effects than those suggested by previous doctors?
- Do you have elevated PSA levels, but have not been diagnosed with prostate cancer?
- Have you been treated for prostate cancer, but the treatment failed?
- Do you want to have a minimally invasive procedure with little to no side effects to treat your prostate cancer?
—Is HIFU for Me?
This treatment option is popular because it targets only cancer, not the entire prostate. The best way to know if this approach is the right one for your situation is to talk with our experts.
—Will My Insurance Cover The Cost?
At the time, this procedure is self-pay. We will work with you to discuss your options with your insurance company, and they may or may not pay a portion of the cost. The procedure has been approved by the FDA in the United States, and insurance coverage is expected in the next 12 to 24 months. Some insurance companies are covering it after the procedure on a case-by-case basis. More companies are expected to provide coverage as demand keeps increasing.
—How Long Will I Be In The Hospital?
With the HIFU treatment plan, no overnight stay is required. You will be able to go home within 2 hours after the procedure. However, since you will be administered anesthesia, you are required to travel with someone.
—Who Makes The Machine?
There are two companies: a US manufacturer called Sonacare Medical located in North Carolina and EDAP, a French company.
—How Long Does The Procedure Take?
The treatment usually ranges from one to three hours, depending on the size of your prostate and your specific situation.
—Is The Procedure Done Under An Anesthetic?
Yes, anesthesia is required because the HIFU treatment works with millimeter precision and not even the slightest movement is allowed. Your anesthesiologist will decide what is best for you. Since there is no cutting off body tissue and no loss of body fluids, anesthesia is light. Many patients breathe on their own.
—Do Some Patients Require Repeat Treatment?
There is no medical procedure that is 100% guaranteed. Therefore, some patients do require repeat treatment. The advantage of using HIFU is that it does not limit any future treatment options. Should treatment be necessary again, HIFU can be repeated, or a patient can choose surgery or radiation. Surgery and radiation cannot be repeated, however.
—Why Does HIFU Have Lower Chance Of Impotence?
The HIFU probe consists of two probes, one within the other. The imaging probe is of high quality, and it demonstrates the neurovascular bundle, which contains the nerves of erection. The entire length of the bundle can be seen throughout it and can avoid damaging nerves. Many times we can treat one side of the prostate (semi or focal HIFU) if the cancer is diagnosed in its early stages. When Hemi treatment is done many times, the impotence rates are similar to men who receive no treatment.
—How Is HIFU Different After Radiation Failure?
Patients who have radiation failure get HIFU with lower power. The Ablatherm machine that we use has the lowest incidence of rectal injury and has preset power for HIFU in post-radiation failures.