Focused ultrasound ablation (HIFU) in Germany

High Intensity Focused Ultrasound Ablation (HIFU) in Germany — treatment of prostate cancer without surgery through exposure to ultrasound.

How is HIFU ablation performed?

Prostate cancer — is not only a medical problem, but also a social problem, as most men worry about a possible dramatic decrease in their quality of life after treatment (incontinence, urinary retention, impotence, blood in the urine). Therefore, before treatment, physicians should discuss all options with the patient and pay attention to improving the patient’s quality of life after treatment. 

One of the most innovative treatments for prostate cancer is ultrasound-guided HIFU-ablation. It is a high-intensity focused ultrasound that is among the minimally invasive procedures as it does not require large incisions.

With HIFU, using an ultrasound transducer placed in the intestine, high-energy sound waves are focused on the prostate gland, causing vibration in the tissue and releasing heat from 75-90 grams, which kills cancer cells.

The main benefit of HIFU is survivability!

If you’re comparing HIFU with other treatments, HIFU has a higher survival rate and fewer side effects because the doctors only treat the tumor.

The high effectiveness of HIFU-ablation is confirmed by the data of the largest study published in the specialized journal European Urology, conducted by British scientists under the leadership of Imperial College in London.

The study involved 625 men with an average age of 65 years. The study was conducted for 56 months, during which the men underwent HIFU ablation. After the treatment, the patients were followed for 5 years.

Positive results were obtained from the method:

1. The survival rate for men with prostate cancer five years after treatment was 100%.
2. At 1 year after HIFU, 99% of patients were alive without metastasis formation or need for further treatment.
3. At 3 years after therapy, the number of men without additional anticancer therapy was 92%, and at 5 years, 88%.
4. To date, none of the patients have died.
5. The number of complications after treatment was minimal compared to other treatment methods. Only 2 patients had incontinence and 15% had erectile dysfunction, whereas after radiation therapy such complications occur in 5-30% of cases, and the % of impotence reaches 60. 

By combining several individual applications, it is possible to treat large areas of the prostate gland with ultrasound.

Focused ultrasound ablation (HIFU) in Germany — how is the ablation performed?

The procedure is performed under regional or general anesthesia. 

The whole process looks something like this:

1. During the procedure, the patient lies on his or her side.
2. The doctor inserts the ultrasound transducer into the rectum and presses it against the prostate gland.
3. The doctor sees the prostate in 3D on the monitor. The doctor plans and controls all the steps thanks to the image on the screen.
4. Pointing ultrasound waves at the cancerous tissue with an ultrasound sensor, the doctor directs the ultrasound waves at the cancerous tissue.
5. High-intensity ultrasound generates a lot of energy and heat. In the places where the ultrasound hits, the temperature reaches 90 degrees. To prevent overheating and damage to the intestinal walls, doctors cool the ultrasound tube. Under the influence of energy and heat, cancer cells, as if «boiled», and die. The action of ultrasound, in this case, can be compared to the impact on the paper of sunlight through a magnifying glass. The body itself breaks down tissue remnants, and some of the dead cells are excreted through urine.
6. Sometimes doctors have to target multiple points on the prostate, which can increase the length of surgery (1 to 3 hours).
7. After the procedure, the patient is under medical supervision for one to several days.

Focused ultrasound ablation (HIFU) in Germany — who can have it?

HIFU ablation is the primary treatment for men over the age of 75 who have other serious medical conditions in addition to cancer.

Despite its good reputation, the HIFU ablation method is not suitable for all men. Doctors use it only in cases of locally limited cancer, when the process is within the prostate and has not ruptured the capsule.

For this reason, it is not recommended for patients with locally advanced or metastatic cancer when the cancer has «spread» far beyond the gland and has metastasized to other organs, such as bone. Currently, there is no reliable data on the benefits and side effects of HIFU in locally advanced cancer. In this case, additional and alternative therapies are recommended (традиционная китайская медицина (ТКМ) с иглоукалыванием, натуропатия или гомеопатия).

HIFU ultrasound is used when surgery is not indicated or when the cancer has recurred.

The method should not be used in patients who have undergone rectal surgery because there is a high risk of rupture of the colon and fistula formation.

HIFU is effective when the gland is small. If it is larger than 30 cc, transurethral resection (TUR) or laser enucleation is performed first.

Focused ultrasound ablation (HIFU) in Germany — ultrasound against cancer. 

Prostate cancer in men is one of the leading diseases. The insidiousness is that prostate cancer does not manifest itself for a long time, but quickly metastasizes and, if delayed, is poorly amenable to treatment.

The most common gland problems are found in older men whose age is over 60. As a rule, most of them have concomitant diseases that not only aggravate the course of cancer, but also seriously limit the choice of treatment methods. Also, hereditary predisposition and risk factors play a major role in the development of cancer:

• smoking;
• vitamin D deficiency;
• infections;
• obesity;
• hormonal disorders;
• low physical activity.

In the early stages, complaints similar to those of prostate adenoma (ineffective urination, delayed, frequent urges or urinary incontinence) may be bothersome.

For diagnosis, they’re prescribing: 

• ULTRASOUND; 
• MR;
• Prostate-specific antigen (normal PSA 4 ng/mL). 
• If cancer is suspected, a prostate biopsy is taken for histologic examination.

HIFUprostate cancerprostate cancer treatment