The use of targeted sound waves to destroy tumors can often delay or eliminate the need for more invasive treatments of prostate cancer. HIFU is a newer procedure with fewer side effects and shorter recovery time.

High-intensity focused ultrasound (HIFU) is a minimally invasive treatment for prostate cancer. It uses the energy from targeted sound waves to ablate or destroy cancer cells.

The relatively new procedure is associated with fewer side effects and a shorter recovery time compared with chemotherapy or surgery to remove the prostate.

While HIFU isn’t appropriate for all cases of prostate cancer, it can be an especially helpful option for low- to intermediate-risk individuals with newly diagnosed cancer that hasn’t spread.

CERead on for more detail about HIFU treatment for prostate cancer and what you may want to discuss with your healthcare team.

You may be more familiar with ultrasound as an imaging technique used to view a baby in the uterus, evaluate blood flow, or assess the health of various organs and other tissue.

Instead of creating pictures, HIFU for prostate cancer uses high-energy sound waves to destroy targeted tissue.

HIFU was first tested in clinical trials in the 1990s, and it received Food and Drug Administration (FDA) approval in 2015.

How HIFU works

Prior to an HIFU treatment, you’ll undergo an MRI or traditional ultrasound to pinpoint the location of the cancerous tissue. You may be awake but receive medication to help you relax during the procedure. General anesthesia may be helpful in some cases.

Once you’re ready, a HIFU probe about the size of your index finger is inserted into the rectum and guided to the prostate gland. There, the probe will emit high-energy sound waves focused precisely at the targeted tissue. The beams target areas that are about the size of a grain of rice.

Because the beams reach high temperatures (about 140°F or 60°C), the probe is wrapped in a cooling balloon or casing to avoid damaging any other tissue. Additional imaging is used to determine whether all of the targeted tissue is destroyed.

Like any medical procedure, there are pros and cons associated with HIFU. Among them are:

Pros

  • The procedure is noninvasive, so there’s no blood and a low risk of infection.
  • HIFU is usually done on an outpatient basis, requiring no overnight hospital stays.
  • HIFU does not require radiation.
  • A 2021 study suggested that HIFU leads to lower levels of prostate-specific antigen (PSA), a marker of prostate cancer, and lower prostate health index (PHI) scores, which help doctors distinguish between benign and cancerous prostate conditions.

Cons

  • HIFU can be used only when the cancer is located in one area of the prostate.
  • If the prostate is enlarged or the tumor is located on the front side of the prostate, the sound waves may not be able to effectively reach their target.
  • People with irritable bowel syndrome of the rectum or other related circumstances, such as previous rectal surgery, may not be good candidates for HIFU.
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HIFU is considered a safe and effective alternative to certain other prostate cancer treatments.

A 2020 study found that about 91% of participants who underwent HIFU for prostate cancer were able to avoid radical treatments, such as surgical removal of the prostate, for at least 2 years.

The study also noted that most people who had HIFU did not experience incontinence and had few side effects involving sexual function, which can develop from surgical removal or radiation of the prostate.

HIFU’s most common side effect is a condition known as voiding dysfunction. It can involve greater urination frequency or urgency, as well as urine retention, which is the inability to fully empty your bladder.

Erectile dysfunction (ED) is another potential side effect. However, ED can also happen because of other prostate cancer treatments.

There’s also a possible risk of urinary tract infection. However, antibiotics should be able to treat an infection in a relatively short amount of time.

HIFU can cost around $10,000–$15,000.

However, Medicare and many other health insurance carriers will cover the costs providing that the person meets certain criteria within their insurance policies. It’s always best to work with your insurance company to determine what possible coverage entails and what you might be responsible for paying.

People with early-stage prostate cancer often have several treatment options, including hormone therapy, radiation therapy, or surgery. And for certain individuals, HIFU can be a safer and equally effective treatment in specific situations and reduce the risk of recurrence.

HIFU is a minimally invasive outpatient procedure that’s covered by most insurers. If you’ve been diagnosed with prostate cancer, talk with your doctor about whether you’re a good candidate for HIFU.