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| Using ultrasound wand inserted in the rectum, the doctor directs HIFU energy to the prostate tumor to ablate or kill it. Image credit – SonaCare Sonablate |
CANCER DIGEST – June 19, 2022 – High Intensity Focused Ultrasound (HIFU) guided by MRI can effectively control intermediate risk prostate cancer without surgery, chemotherapy, or radiation, and few adverse side effects, according to results of a new phase 2 clinical trial. The trial results were published in the June 14, 2022 Lancet Oncology.
Led by Dr. Behfar Ehdaie, a urologic surgeon at Memorial Sloan Kettering Cancer Center in New York, the trial treated 101 patients with MRI-guided HIFU between May 2017 and December 2018. The men were between 58 and 67 years old with grade group 2 or higher prostate cancer. Biopsies at six months and 24 months showed that 78 patients (88 percent) had no evidence of prostate cancer in the treated area, and only one had severe (grade 3) adverse treatment-related side effects.
The HIFU treatment uses ultrasound to ablate or kill the cancer tumor confined to the prostate, the treatment is called partial gland ablation.
“To draw a parallel with how breast cancer treatment changed 30 years ago," Dr. Ehdaie said in a press release, "you could think of focal therapy as a ‘male lumpectomy.’ Instead of removing all the tissue in a breast or prostate, we have learned that it is safe and effective to treat specific areas and greatly reduce the burden on patients.”
When prostate cancer is confined to the prostate, conventional treatment included active surveillance, surgery, and/or radiation. Each of which often results in urinary or sexual dysfunction.
MR-guided focused ultrasound is an outpatient treatment that takes about two hours. Patients are given anesthesia and placed in an MRI machine that covers the lower half of the body. Using the image produced for guidance, the doctor delivers the focused ultrasound waves to the tumor, which heats the cancer cells to more than 158 degrees Fahrenheit, killing them.
After the anesthesia wears off the patient can go home and return to normal activity immediately. In the study, none of the participants reported any urinary incontinence or experienced bowel problems. Most were able to achieve erections.
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