Additional treatment options for Prostate Cancer
Dr. Mehran Movassaghi explains the benefit of HIFU Focal One treatment for prostate cancer.
High Intensity Focused Ultrasound (HIFU) provides clinicians more treatment options for prostate cancer using concentrated ultrasound to destroy tumor cells, while improving localization of the disease and preserving healthy surrounding tissues.
Using Focal One®, a medical device designed specifically for the treatment of prostate cancer, treatment combines HIFU technology and imaging fusion software. The treating urologist can view detailed 3D images of the prostate then draw a precise contour around the affected tissue, targeting only that portion of the prostate. This promotes improved post-treatment results with reduced side effects by avoiding the healthy areas of the prostate. With Focal One®, the urologist can customize the procedure for each patient and for each clinical condition.
Can prostate cancer be managed?
Typically, there are 3 ways to manage prostate cancer. Because prostate cancer is slow-growing, it may not have a significant impact the wellbeing of most men for the remainder of their lifetime. For these conditions, active surveillance (watchful waiting) may be recommended, giving the patient and the doctor more time to assess the progression of the disease and consider options for treatment.
When more significant treatment is recommended, it may include surgery or radiotherapy, or both. These treatments tend to be a final procedure, where the treatment plan is designed to eliminate the progression and spread of cancer cells without the need for additional treatment. Recent innovations, such as with robotic surgery for prostate, reduces recovery time while retaining function, but can still produce some side-effects. Other advancements exist in radiotherapy devices, which has vastly improved treatment delivery methods and clinical outcomes.
HIFU treatment provides an additional treatment option that is designed to bridge the gap between active surveillance and the more significant treatments, such as radical prostatectomy (removal of the prostate gland using surgery). HIFU Focal One® treatment consists an ultrasonic probe that scans the entire prostate structure then focuses sound waves at only the cancerous portion of the prostate from within the rectum.
Sound waves are conducted into a small point which creates heat and destroys the targeted tissue, causing the cancer cells to wither over time. Treatment is delivered without damaging the healthy surrounding structures, which includes nerves, blood vessels, and other soft tissues, which are important to maintain bladder control and erectile function.
Is HIFU treatment using Focal One® safe and effective?
HIFU therapy is a newer treatment option that received market clearance in June, 2018. More than 45,000 men around the world with localized prostate cancer have received the HIFU procedure, which has demonstrated its effectiveness to reduce the need for further treatments. In Europe, where the first generation HIFU system originated and was used for whole prostate treatment, researchers published many peer-reviewed studies of the use of HIFU for whole gland ablation with positive results. Prostate Cancer treatment is considered “focal” when a part of the gland is spared from treatment.
Although focal HIFU treatment is available for localized prostate cancer, studies in Europe have demonstrated its safety and efficacy. In 2013, the Journal of Urology published a German study of 704 patients treated with HIFU, in which co-investigators concluded that long-term follow-up with HIFU therapy demonstrated a high overall rate of cancer specific survival (99%) and 10-year salvage treatment-free, meaning these patients did not require additional treatment for cancer after 10 years. Urologic surgeons in the US typically seek at least 10 years of data to establish focal HIFU therapy as a standard treatment.
111 Patients Treated with HIFU
|95%||Absence of Clinically Significant Cancer|
|89%||Radical Treatment-free Survival|
|78%||Erectile Function Preservation|
Long-term studies and clinical data are not yet available and this therapy is only appropriate for select prostate cancers. However, the arrival of the Focal One® treatment system, by EDAP TMS, is significant because of the degree of precision with which the cancer can be treated in the prostate, sparing healthy tissue and reducing side-effects of treatment. The advantage of HIFU is in how recurrence is managed. If cancer returns, patients can can repeat the HIFU procedure or choose to undergo surgery or radiation. In other words, HIFU does not preclude a secondary treatment, whereas the two conventional treatments, surgery and radiation, if unsuccessful, cannot be repeated.
Our Primary Goal is Cancer Cure
Overcoming cancer is our goal. Also critically important is how your recovery is measured, such as with the level of post-treatment incontinence or erectile function. Therefore, the treatment plan will consider the most optimal delivery of focused ultrasound so that side effects are always minimized. HIFU is a reliable treatment option for prostate cancer because it relies on first-hand visualization and real-time data.
In order for HIFU to be recommended, testing, imaging scans, and a definitive diagnosis are required. Patients are made to be as comfortable as possible prior to the procedure, and under most circumstances, placed under general anesthesia. This is important because the prostate can be treated more effectively if it is completely stationary. The HIFU procedure can take up to 4 hours, while some treatments may be completed in just in 60 minutes. The Providence Saint John’s Health Center is one of only 87 HIFU authorized centers in the US.
Like many treatments for prostate cancer, we know you have questions. Treatment can be a life-changing endeavor that can alter how the body functions. Our duty is to guide you or your family member through this process and make sure you are 100% comfortable with our recommendations.
Call our office today and learn more about this innovative procedure and our highly experienced urologists. HIFU is a safe and effective procedure that has helped to improve clinical outcomes and quality-of-life for many of our patients.
The Focal One® HIFU device is the first medical apparatus designed specifically for focal treatment of Prostate Cancer. It has been developed with the last evolutions of HIFU technology and imaging fusion software to answer all the specificities of prostate cancer focal treatment.
By combining imaging and treatment technologies, Focal One® brings together the most ideal requirements for focal therapy including, accurate and MR-fused imaging, precise and efficient therapeutic HIFU energy, treatment validation imaging, all within a non-invasive approach.
Benefits of Focal One® treatment
- Precise treatment delivery to the tumor site
- Preservation of the patient’s quality of life
- Possibility to perform any other treatment if needed after Focal One® treatment
See Focal One videos
- (1) Crouzet S et al. Eur Urol. 2014 May;65(5):907-14. https://pubmed.ncbi.nlm.nih.gov/23669165/
- (2) Ganzer R et al. BJU Int. 2013 Aug; 112(3):322-9. https://pubmed.ncbi.nlm.nih.gov/23356910/
- (3) Rischmann et al.; Eur Urol 71,n°2 (Feb 2017): 267-73. https://pubmed.ncbi.nlm.nih.gov/27720531/