Effectiveness of HIFU
The team lead by professor Guy Vallancien (IMM Paris) recently won an award for the best study1 for its pioneering research in an ablatherm-based "disease control" approach. From 1997 to 2000, 12 patients received "focal treatment" with HIFU. Ten years on, none of the patients have died from prostate cancer. No significant side effects or metastases have been reported. During the follow-up period, five patients received additional treatment but there was no increase in complications. In a more recent multi-centric study independently promoted by the French Association of Urology (AFU) and published in the prestigious European Urology Journal,2 the focal treatment with HIFU (hemiablation) has shown an efficient cancer control at 2 years with no clinically significant cancer in the treated lobe for 95% of the patients, an optimal preservation of the quality of life with 97% continence, and 78% potency preservation.
A multicenter study conducted between 1995 and 2000, involving 402 patients at six European sites, revealed that the cancerous tissue disappeared in 87% of patients who received first-line treatment with HIFU. A recently-published scientific paper,2 which also concerns several European centers, confirmed the long-term effectiveness of HIFU (with some patients having nine-year follow-up histories).
Continence and sexual function preservation
98% of patients did not experience any incontinence issues3 and 87% remained sexually potent when ablathermy was performed in conjunction with a strategy to preserve the erector nerves.4
Effective cancer control
According to an international literature review by Association Française d’Urologie5 concerning the effectiveness of and tolerance to HIFU in patients with localized prostate cancer who received first-line treatment with the HIFU device, up to 93% (64-93%) of patients met the criteria for being declared cured.
Another leading European HIFU center, the Saint Joseph Caritas hospital in Germany has published a paper entitled Eight Years’ Experience With High-Intensity Focused Ultrasonography for Treatment of Localized Prostate Cancer,6 covering a cohort of 163 patients. After an average follow-up of almost five years, 92.7% of patients had negative check-up biopsies. More than 98% of patients reported no severe incontinence. The ability to have erections depended on the treatment strategy chosen by the patient and his urologist.
Robotic HIFU prostate tissue ablation is efficient for recurrence after radiation therapy
Doctors Albert Gelet and F.J. Murat from the urology department at Edouard Herriot Hospital in Lyons pioneered the treatment of cases of localized recurrence following radiotherapy.7 A paper by Doctors Murat and Poissonnier published in European Urology 2008) describes a cohort of 167 patients treated for the aforementioned indication. The results after a 10-year follow-up are highly satisfactory: 73% of check-up biopsies were negative and the morbidity rate remained acceptable among a high-risk population offered a new chance of a cure.
Based on the experience gained and published in the literature since 2000 and as with any treatment of prostate cancer, HIFU treatment may have some undesirable effects. Beyond the risks of incontinence and erectile dysfunction mentioned above, a narrowing of the urethra and the bladder neck can occur following a focused ultrasound treatment.
BladderOrgan in which urine accumulates before being expelled from the body.
Erector nerveThese nerves, situated along the perimeter of the prostate, initiate penile erections.
High Intensity Focused Ultrasound (HIFU)Medical technique that treats tumors by using focused ultrasound pulses to generate heat.
IncontinenceInability to refrain from urinating or defecating.
ProstateGland in the male genital system that plays a role in semen production.
Radical prostatectomySurgical procedure that completely removes the prostate.
RecurrenceReappearance of signs indicating the presence of cancer following a period of remission.
Side effectGenerally adverse secondary consequence of a treatment.
UltrasoundPainless medical imaging examination performed using an ultrasound scanner.
UrethraTube leading from the bladder through which urine leaves the body. The urethra also carries semen during an ejaculation.
UrologistPhysician who specializes in urinary and genital conditions.