HIFU is an FDA approved precise and targeted therapy that reduces the risk of complications caused by surgery and radiation.
HIFU uses ultrasound energy, or sound waves, to heat and destroy specifically targeted areas of tissue. During HIFU, the sound waves pass through healthy tissue without causing damage. However, at the focal point of the sound waves (like a magnifying glass focusing the rays of the sun to burn a leaf), the tissue temperature is raised to 90 degrees Celsius, destroying the targeted tissue.
Men treated with HIFU wake up and go home without pain or bleeding. They are able to travel the same day, drive the next day, and resume normal activities within a few days. Those with office based jobs can go back to work the next day. A catheter is left in for 5 days to 3 weeks, depending on how much of the gland is treated and/or the degree of swelling.
Focal Therapy is not associated with incontinence, and erectile dysfunction is just under 10%. Sparing of the urethra avoids scar tissue formation which, when present, may diminish the urinary stream. The eventual need for additional therapy is now under 10%.
Total Gland Therapy is necessary for men with significant cancer on both sides of the gland. Incontinence of a few drops of urine (soaking pads is not seen) is limited to 2-3%. Erectile dysfunction is only 10-20% as opposed to the much higher rates seen with surgery or radiation. Scar tissue formation occurs in 10-20% of men who have the whole gland treated due to the involvement of the urethra. We are developing techniques to treat the whole gland while sparing the urethra. Cancer cure rates are comparable to surgery and radiation.
Insurance coverage is coming slowly. A big help is the issuance of a facility billing code by Medicare which will save Medicare patients about $7,000, and help to mainstream HIFU. Hopefully conventional insurance companies will follow suit in the near future. This therapy should not be available only to those who can afford it.