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High Intensity Focused Ultrasound

What is high-intensity focused ultrasound?

Focused ultrasound works in the same way as rays of sunlight that pass through a magnifying glass and are concentrated at a single point, causing a significant temperature rise around the focal point.
Thermal ablation is a non-invasive (incisionless and radiation-free) treatment that has been used in humans since 1993.

Focused ultrasound treatments can be performed on an outpatient basis, require no incisions, and can result in minimal discomfort and few complications, allowing for rapid recovery.
Source: Focused Ultrasound Foundation

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HIFU Focal Therapy is an effective, non-invasive set of treatments for men with early-stage localised prostate cancer. It has been pioneered and advanced in the UK by clinicians committed to offering men precision treatment options that effectively controls their cancer and preserves their quality of life.
Source: The Focal Therapy Clinic

Scientific evidence

This study says:
In clinics, HIFU has been applied to treat a variety of solid malignant tumors in a well-defined volume, including the pancreas, liver, prostate, breast, uterine fibroids, and soft-tissue sarcomas. In comparison to conventional tumor/cancer treatment modalities, such as open surgery, radio- and chemo-therapy, HIFU has the advantages of non-invasion, non-ionization, and fewer complications after treatment. Over 100,000 cases have been treated throughout the world with great success.

This study says:
A variety of solid tumors have been tried on thousands of patients in the last fifteen years with great success.

More studies below.

HIFU Treatment for other types of cancer

Pancreatic cancer
This 2018 Review includes the following:
HIFU has also been clinically evaluated for advanced-stage pancreatic cancer. The tumors appear to shrink in size due to the absence of blood supply, but the median survival time of patients was 11.25 months. Later studies on advanced pancreatic cancer (stage III or IV) treatment demonstrated good survival rates i.e., 52% for 6 months, 30% for 12 months, and 22% for 18 months. Further increase in survival rates (up to 82%) with significant pain relief (79%) has also been reported by Gao et al…

This study says:
Pain relief was achieved in 79.5% of patients…preliminary results demonstrate the safetyof clinical application of HIFU for pancreatic cancer and reveal it to be a promising mode of treatment for local advanced pancreatic cancers.

Breast cancer
In many reports HIFU has been successively used for breast cancer treatment. 
Source: Focused Ultrasound Foundation

Brain Tumors
Brain tumor patients are those who have the potential to gain the most from Focused Ultrasound technology. As this modality is non-invasive and accurate, it has the potential to thermally ablate only targeted tissue while sparing healthy adjacent brain tissue, reducing the risk for infection and bleeding, lowering procedural morbidity by avoiding the need to open the skull and avoiding ionized radiation related toxicity.

In addition Focused Ultrasound allows a non-invasive, localized transient opening of the blood brain barrier, thereby enabling an increased drug delivery to targeted areas in the brain. This modality has the potential to augment effects of the currently used chemotherapies as well as enable the usage on new types of drugs.
Source: Focused Ultrasound Foundation

Uterine Fibroids
Focused ultrasound is a completely noninvasive way to treat uterine fibroids. Using this treatment modality in conjunction with image guidance, the physician directs a focused beam of acoustic energy through the patient’s skin, superficial fat layer, and abdominal muscles to thermally coagulate the fibroid tissue, thereby destroying it without damaging nearby tissue or the tissues that the beam passes through on its way to the target. Uterine fibroids can be visualized using ultrasound or magnetic resonance imaging (MRI).

Source: Focused Ultrasound Foundation

Metastatic Bone Cancer
Physicians at the University Medical Center – Utrecht, the Royal Marsden Hospital in Sutton, U.K., and elsewhere are effectively treating painful bone metastases with the MR-guided high intensity focused ultrasound system (MR-HIFU) called Philips Sonalleve MR-HIFU. Palliative bone metastases pain therapy with MR-HIFU can lead to fast pain relief, has fewer side effects than traditional treatments, and helps patients quickly return to normal activities.

Liver Cancer
HIFU is a minimally invasive treatment for patients with
hepatocellular carcinoma; however, there are some systemic and local complications that
should be taken into consideration in evaluating HIFU for therapeutic use.

This 2016 study says:
The reviewed FUS [Focused Ultrasound] – induced immunomodulation effects can be harnessed to current and developing immunotherapy approaches. Together, these may overcome GBM [ glioblastoma multiforme] – induced immune-evasion and generate a clinically relevant anti-tumor immune response.

What professionals say:
“In the later stages of their disease, many cancer patients develop bone metastases, which can cause severe and debilitating pain. UMC Utrecht is using innovative Sonalleve MR-HIFU therapy to treat non-invasive palliative pain treatment of bone metastases.
Dr. Merel Huisman, radiologist. Professor Maurice van den Bosch, Chairman Department of Radiology & Nuclear Medicine

“We started to treat our cancer patients for their pain from bone metastasis with the Sonalleve MR-HIFU system. The results had been exciting from the beginning; most of our patients experience a very significant pain relief within a week of having the procedure”.
Professor Nandita deSouza, co-director of The Institute of Cancer Research, Sutton, Surrey, UK
Source:
Philips

What are the side effects of HIFU?

Like all treatments, HIFU can cause side effects. These will affect each man differently, and you might not get all of them.

Short-term side effects
The following side effects can develop soon after your treatment.

Blood or tissue in your urine
You might see some blood in your urine while the catheter is in place. You might also see some small pieces of prostate tissue in your urine for six to eight weeks after HIFU. This is normal.

Erection problems
Some men have problems getting or keeping an erection (erectile dysfunction) after HIFU. This is because it can damage the blood vessels and nerves that control erections. For some men this will improve, but for others this will be a longer-term side effect of HIFU.

Urine infections
Some men get a urine infection after HIFU. Signs of a possible urine infection include:

  • a fever (high temperature)
  • a burning sensation when you urinate
  • dark or cloudy urine with a strong smell
  • needing to urinate more often than usual.

Urinary problems
Some men find it hard to empty their bladder properly after their catheter is removed – this is called urine retention. This is because HIFU can cause the prostate to swell and block the urethra, which is the tube you urinate through.

Testicle infections
Some men get an infection in the testicles or the tubes that carry sperm from the testicles. Signs of a possible infection include pain, swelling and tenderness in one or both testicles.

Longer-term side effects
Most side effects will settle down after HIFU, but some men have longer-term side effects or problems that develop later.

Sexual problems
Some men get erection problems that improve over time, but other men find that their erection problems don’t improve.

Urinary problems
HIFU can cause longer-term urinary problems. You may have some of the following symptoms straight after treatment, or they might develop some time later.

  • Some men leak urine (urinary incontinence) after HIFU. This is more likely if you’ve already had external beam radiotherapy.
  • You may leak urine when you cough, sneeze or exercise (stress incontinence).
  • If your urethra, which is the tube you urinate through, or the opening of your bladder becomes narrow (a stricture), you may find it difficult to empty your bladder.
  • Some men need to urinate more often than usual (frequency).
  • You may have a sudden urge to urinate (urgency)..

A hole between the back passage and the urethra (rectal fistula)
Very rarely, HIFU can cause a hole between the back passage (rectum) and the urethra, which is the tube you urinate through. This is called a rectal fistula. It affects fewer than 1 in 100 men who have whole-prostate HIFU (1 per cent). It is slightly more likely if you’ve already had radiotherapy.

Signs of a possible rectal fistula include:

  • urine coming out of your back passage
  • pain in your pelvis or back passage
  • bowel contents in your urine
  • air bubbles in your urine
  • urine infections, although these can be caused by other things.

Source: Prostate Cancer UK

More studies

This study says:
This study demonstrates the effective long-term cancer control achieved with HIFU in patients with low or intermediate-risk localised prostate cancer.

This study says:
HIFU for localized prostate cancer offered high control of local disease with low morbidity.

This study says:
Image-guided FUS is both safe and effective in the treatment of primary and secondary tumours.

This study concludes:
In this, the largest prospective series to date, we demonstrate that salvage HIFU for locally recurrent prostate cancer after failed primary brachytherapy has encouraging disease control results, albeit with a relatively high complication rate.

This study concludes:
We suggest that HIFU therapy is safe and has the potential to be a new method of combination therapy for PC.

This study says:
Salvage HIFU is a curative treatment option for local relapse after EBRT [external beam radiation] with acceptable morbidity.

This Review says:
FT offers a promising treatment option in the field of low to moderate risk localized PCa. FT might eventually become a ‘middle ground’ between active surveillance and radical treat­ment, combining minimal morbidity with can­cer control and the potential for retreatment.

This study (patients with painful bone metastasis) says:
All patients showed significant pain relief within 2 weeks. Two patients experienced complete pain reduction that lasted for 1 year.

From a 2010 study published in World Journal of Clinical Oncology:
In clinics, HIFU has been applied to treat a variety of solid malignant tumors in a well-defined volume, including the pancreas, liver, prostate, breast, uterine fibroids, and soft-tissue sarcomas. In comparison to conventional tumor/cancer treatment modalities, such as open surgery, radio- and chemo-therapy, HIFU has the advantages of non-invasion, non-ionization, and fewer complications after treatment. Over 100,000 cases have been treated throughout the world with great success.

This study says:
In clinics, HIFU has been applied to treat a variety of solid malignant tumors in a well-defined volume, including the pancreas, liver, prostate, breast, uterine fibroids, and soft-tissue sarcomas. In comparison to conventional tumor/cancer treatment modalities, such as open surgery, radio- and chemo-therapy, HIFU has the advantages of non-invasion, non-ionization, and fewer complications after treatment. Over 100,000 cases have been treated throughout the world with great success.

This study says:

A variety of solid tumors have been tried on thousands of patients in the last fifteen years with great success.

This study says:
It can effectively alleviate cancer-related abdominal pain, and may confer an additional survival benefit with few significant complications.

This study says:
Image-guided FUS is both safe and effective in the treatment of primary and secondary tumours.

This 2017 study concluded:
We believe that the proposed combinational blue light emitting diode-high frequency focused ultrasound treatment could have therapeutic benefits to alleviate cancer cell proliferation.

This study says:
The findings suggest that this novel technology can be used to induce SMMC-7721 apoptosis via the Ca(2+)/mitochondrial pathway and could potentially be of clinical use for the treatment of hepatocellular carcinoma (SMMC-7721 cell line) and other cancers.

Patient testimonials

Meet David

“It is 12 years since I was treated and have moved from a 58 year old to a 70 year old. For the last 6 years I have been mayor of my local city and I attach a photograph in regalia with my five grandchildren, all born since my treatment. You may use this also if you like to reassure potential patients that there is normal and interesting life after HIFU.”
-David Parkin

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Patient Stories: Bill W.
A week after my HIFU I went to see Dr. Jackson, and everything looked fine. About two weeks later he removed the catheter, and things were pretty much back to normal. My most recent PSA was 0.45, and the one before that was 0.39.

See more patient testimonials

Even more patient testimonials

Lots more testimonials at International HIFU

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Clinics offering HIFU treatment:

The Focal Therapy Clinic (UK)

Focused Ultrasound Foundation

Main pic: James Ross McLaughlan, CC BY-SA 4.0 https://creativecommons.org/licenses/by-sa/4.0, via Wikimedia Commons


Page updated September 2024

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