Due to the precision and flexibility of Sonablate HIFU, patients with their physician can decide on a customized treatment plan tailored to their prostate cancer diagnosis. Below is a summary of the different levels of customization and their clinical results.
In all approaches to the treatment of Prostate Cancer one is hoping to achieve the TRIFECTA of Results:
Standard HIFU Procedure
The standard Sonablate HIFU procedure destroys the entire prostate gland. This procedure is the most appropriate choice for patients that have organ-confined prostate cancer, which is not limited to one discrete area of the prostate.
The clinical results of a standard HIFU procedure:
- 92% of patients are successfully treated1
- Over 99% of men remain continent1
- 70% of men retain erectile function1
Focal HIFU Therapy
Focal HIFU at Can-Am HIFU is becoming quite a common technique for the treatment of prostate cancer, in which only the foci of tumor are treated instead of the whole prostate gland. This is ideal for patients that have fewer than 4 cores positive on their biopsies, particularly if all of the positive cores are in the same area or zone. We usually recommend an MRI (Magnetic Resonance Imaging) to confirm that location of the positive biopsies are the only suspicious areas that are seen on the MRI. If there are other areas, then the suggestion is to do an MRI guided biopsy of those suspicious areas. By approaching the Focal HIFU Therapy in this manner, the chances of leaving prostate cancer behind are greatly reduced. Focal HIFU is intended to increase the likelihood of avoiding important structures located around the prostate thereby reducing the risk of side-effects such as erectile dysfunction. It may be suitable for men with low- or intermediate-risk cancer who have a small tumor volume inside the prostate or a few tumor sites all on the same side of the gland. Focal HIFU allows for a shorter procedure, usually 20-90 minutes, and a quicker return to normal life. Often after Focal Therapy, there is no need for the Supra-pubic catheter
The clinical results of a focal HIFU procedure:
- 95% maintained potency (defined as return of erections sufficient for penetrative sex)2
- 89% of men achieved the trifecta status (defined as pad-free, leak-free continence, erections sufficient for intercourse and cancer control at 12 months)2
The clinician can determine if a patient is a candidate for the standard or focal Sonablate HIFU procedure. A Clinical Trial for focal therapy is underway in London, UK. The details of the INDEX trial can be found here.
Salvage Treatment with HIFU
Sonablate HIFU may be performed on patients who have previously been treated for prostate cancer and their cancer has returned, this form of treatment is often referred to as a salvage treatment. A salvage HIFU treatment can be performed on patients who have been treated with a radical prostatectomy, radiation, cryotherapy or previous HIFU procedure, where there is biopsy proof of recurrence and tissue that can be visualized with the ultrasound.. A clinician will have to determine if the patient is a candidate for salvage Sonablate HIFU.
Clinical outcomes of salvage Sonablate HIFU following external beam radiation therapy (EBRT):
- 71% biochemical disease free rate3
- 93% of men remain continent3
Sonablate HIFU may be repeated if your prostate cancer should return after a HIFU procedure. All potential side effects and complications should be discussed with a physician prior to undergoing any procedure. If Salvage HIFU is being performed the risk of side effects are slightly higher than if it was a Primary (First Time) HIFU treatment.
Please see the "Comparison of Treatment Results and Side Effect" section of the website for a list of possible complications from all prostate cancer treatments.
1 Ahmed, HU. (2009). BJC. High-intensity-focused ultrasound in the treatment of primary prostate cancer: the first UK series, 101, 19-26.
2 Ahmed, HU. (2011). Journal of Urology. Focal Therapy for Localized Prostate Cancer: A Phase I/II Trial, 185(4), 1254-5.
3 Zacharakis, E. (2008). BJUI. The feasibility and safety of high-intensity focused ultrasound as salvage therapy for recurrent prostate cancer following external beam radiotherapy,102, 786-792