For some patients with prostate cancer, surgery and/or radiation are considered standard treatments. However, these procedures may cause side effects, including urinary incontinence or impotency. A recent study published by Abreu et al in the Journal of Urology demonstrated that high-intensity focused ultrasound (HIFU) ablation of the prostate may be an effective alternative to surgery or radiation, with encouraging outcomes and shortened recovery time.

HIFU ablation is an outpatient procedure that uses a focused ultrasound beam to raise the temperature inside the prostate to approximately 90°C (194°F) to destroy targeted areas of prostate tissue. The procedure takes about 2 hours, and patients who undergo it are often discharged home the same day.

Study Results

The study followed 100 men in the United States who underwent a HIFU procedure for prostate cancer between 2015 and 2019. This is the first and largest study examining the outcomes of focal HIFU ablation as a primary treatment for prostate cancer in the United States.

During follow-up, 91% of patients treated with HIFU successfully avoided radical treatment. Also, 73% of patients did not experience treatment failure, which the researchers defined as clinically significant cancer recurrence, metastases, or mortality, or the need for additional hormone therapy, chemotherapy, surgery, or radiation.

The results demonstrated that focal HIFU carries a low risk of complications and can help preserve quality of life. In fact, all patients remained continent, and there was no significant decrease in sexual function. There also were no serious adverse events or major complications. Minor complications, including difficulties with urination and urinary tract infection, occurred in a small proportion of the patients and were addressed without major interventions. Patients were typically discharged the same day as their procedure and resumed regular activities shortly thereafter.

“These positive data empower urologists to use focal HIFU ablation to effectively address prostate cancer without the intrinsic side effects of radical treatments,” said first study author Andre Abreu, MD, a urologic surgeon at Keck Medicine of the University of Southern California. “We hope this study encourages [patients with] prostate cancer to talk to their doctor about all potential treatment options to ensure that they receive a personalized care plan that addresses their individual needs.”

Disclosure: For full disclosures of the study authors, visit auajournals.org.