HIFU in Canada

High-intensity focused ultrasound (HIFU) uses precision ultrasound waves to destroy tissue, and is now approved to treat prostate cancer in Canada. According to the early findings reported in this Canadian study, HIFU appears to be effective and safe compared to standard therapies, with low rates of complications.

The study included 95 patients ranging from 46 to 91 years of age who were treated between March 2006 and December 2007 by five urologists. Over half of the men (53) had Gleason scores of 6. Of the rest: 35 had Gleason 7, five had Gleason 8 and two had Gleason 9. Ten of the men were given hormones to reduce their prostate volume or to treat their cancer before HIFU. Salvage HIFU after radiation failure was done in seven men.

Follow-ups every three months included serial PSA measurements and assessments of erectile function and incontinence. Twenty-seven patients experienced early complications, including catheter-related issues, urinary retention and urinary tract infection. Late complications occurred in 41 men and included the need for cystoscopy, transurethral resection of the prostate, urethral dilatation and self-catheterization. Only six patients had serious complications (fistula, bladder neck contractures). At a minimum of six months’ follow-up after HIFU, 17% of the men had moderate to severe erectile dysfunction, and 36.6% had any degree of incontinence. Seven men were diagnosed with a cancer recurrence following HIFU; subsequent salvage treatments included surgery, radiation therapy, repeat HIFU and hormone treatment.

According to the authors of the report, early Canadian experience with HIFU indicates that it is an effective and safe treatment compared to other standard therapies, but further studies are needed to examine its long-term outcomes.