Michael H. Schlesinger, MD
High intensity focused ultrasound treatment of prostate cancer is the newest and least invasive treatment for localized prostate cancer. HIFU offers treatment success rates similar to more invasive treatments such as radiation and surgery with less pain, and one of the lowest risks of erectile dysfunction (less than 20%) and incontinence (<1%)H
Dr. Michael Schlesinger of Piedmont HealthCare Urology in Statesville North Carolina has been treating prostate cancer with HIFU since 2008. Please call our office today for a consultation regarding minimally invasive options for the treatment of prostate cancer at (704)873-1777
For more information about prostate cancer and treatment options read on.
Do you or your loved one have prostate cancer. What do you do now?
The first thing to realize is that you are not alone. The American Cancer Society has estimated that there will be more than 239,000 new cases of prostate cancer diagnosed this year. This makes prostate cancer the most common cancer other than skin cancer diagnosed in American Men. Prostate cancer is the second leading cause of cancer deaths in American men after lung cancer. Almost 34,000 men will die from this disease this year.
Despite recent media publicity, people do die from prostate cancer. When caught early however, this is a highly treatable disease. In it's advanced stages, prostate cancer has no real cures.
For early stage prostate cancer there are many different treatment options. These include:
Radical Prostatectomy either open or robot assisted
External beam radiation therapy
Prostate brachytherapy (radioactive seed implant)
Proton beam therapy
High Intensity focused ultrasound (HIFU)
Treatment choice can be difficult, and you must take into account many variables. Ultimately you must make a decision that is best for you.
Because of the relatively slow grow of the tumor and early detection, you do have time to make an educated decision
When I talk with patients about treatment options, I refer to the three goals in prostate cancer treatment.
1. Treat the cancer. This is most important!
2. Maintain urinary function.
3. Maintain erectile function.
The good news is that each of these treatments carries about a 90% chance of a cure for patients with a PSA of less than 10 and a Gleason score of 6 or less.
Urinary function is a very important issue that affects you on a day to day basis. Incontinence or the inability to control your urine can be devastating. Many of the treatments can affect this since the prostate sits right between the bladder and urethra. Radical prostatectomy in particular has the highest rate of incontinence with as much as 40% of patients experiencing mild leakage when they cough or sneeze to 2% risk of complete loss of control. Many of the radiation options can cause another type of incontinence called urge incontinence which involves a sudden urge to urinate that you cannot control.
With all prostate cancer treatments, if you have problems with your erections prior to your diagnosis, none of the treatments will make it better. That being said, each treatment carries of risk of erectile dysfunction. Cryosurgery has the highest risk of essentially 100%. HIFU carries the lowest risk at about 10-20%.
There are many other factors to consider as well. These include.
Time away from work
Radiation exposure and secondary malignancies
All these factors must go into your decision for the type of treatment that is best for you. If you are the kind of person that is very anxious about your cancer and cannot live with anything but cutting it out despite the risks of prostate surgery, then a radical prostatectomy is for you.
I suspect however that since you found my website, that you value a safe and effective treatment that has a very low risk of incontinence or erectile dysfunction. This would be high intensity focused ultrasound of the prostate or HIFU.
High Intensity Focused Ultrasound (HIFU) uses similar sound waves to the ultrasound that your doctor used to look at your prostate. These sound waves are more powerful than those used in diagnostic ultrasound and are then focused much the same way you can focus the sun with a magnifying glass. This results in a small precise area about ½ inch long by 1/8 inch wide of powerful heating of the prostate tissue. This small area of prostate reaches near boiling in a matter of seconds leaving the surrounding tissue unharmed. The treated prostate tissue is later reabsorbed by body and disposed of. The precision of the device allows the nerves and urinary sphincter to remain intact preserving erectile and urinary function.
Amazing as it sounds; this technology was first discovered in the 1950’s and was originally being used to treat brain lesions. These first machines were crude and did not have the technology of a modern day HIFU generator. By the 1990’s HIFU was first used on prostate. In 2004 the Sonoblate 500 was introduced. This machine combined the HIFU technology with the accuracy of a 3D sonogram machine, and impressive computer controls. The most recent advance is TCM or tissue control monitoring. This new feature can show if the area was treated completely, or if it needs retreatment.
For more on HIFU go to the HIFU page
HIFU with Sonablate® 500 is not approved for use in the U.S. The Sonablate® 500 remains investigational in the U.S. and is being studied for the treatment of prostate cancer in clinical trials in the U.S.
The FDA has made no decision as to the safety or efficacy of the Sonablate® 500 for the treatment of prostate cancer. Currently the device is available for use in Canada, the Dominican Republic, Argentina, the Bahamas, Bermuda and Mexico