Video: HIFU and Prostate Cancer: What You Need to Know

Helpline Questions | Transcription

Hi, I'm Dr. Scholz. A common question we get at the PCRI is "What is HIFU?" 

High Intensity Focused Ultrasound. 

This is a form of treatment to destroy sections of the prostate gland to try and cure prostate cancer. HIFU has sort of hit the market by storm because the FDA approved it recently for management of prostate cancer, and HIFU can be used to either to try and treat the whole prostate gland or a section of the prostate gland in what we call "focal therapy." 

So, is this a marvelous new leap forward that can supplant all previous therapies? Is it better than surgery and radiation and all the other options? 

Basically, I have reservations about HIFU as of the time of this video. My reservations have to do with the type of skill and precision that the doctors are required to have to give effective therapy. I think HIFU is an attractive option as a sort of a minimalistic treatment to a small section of the gland in people that have fairly low-risk disease. The problem I'm encountering is that the doctors that give these treatments are still in their learning curves. They're still discovering how to correlate their scan findings with their hand-eye coordination, and allow for a certain margin around—a safe margin—around the prostate cancer to ensure that it is all eradicated. So this is not as easy as it sounds and as of yet, even though I'm fully immersed in this field as a full-time expert, I really haven't found a leading expert that I trust has really figured this out and is delivering consistent results. 

So, although HIFU, I think, has hope for the future and I believe that as a treatment it is relatively safe in skilled hands, I'm not convinced that the experts are consistently getting the kind of cure rates that would satisfy me. And when people go through non-invasive treatment, and it can be very expensive, I found it is very disappointing when people have to go back to the well a second time because they didn't get it all. 

So in summary then, HIFU is an up-and-coming treatment. There are a number of centers that are in their learning curves and it's possible that certain mavens will appear who can really do a great job at HIFU. As yet, I don't know who those are, and for that reason, I have reserved my patients for other, more traditional treatments, that I know can consistently get good results.