High Intensity Focused Ultrasound

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

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