Prostate cancer is a disease that affects men, and cases of its diagnosis are most often found after the age of 50. Traditionally, many patients undergo surgery to remove the entire prostate. However, there is now hope for a significant change in the methods of treating this disease.
Thanks to the application of HIFU and cryotherapy technologies, the treatment was conducted in such a way that the removal of the entire prostate was not required, and the impact was directed exclusively at the affected areas. This data was presented in a study published in the journal European Urology.
The study covered 3477 patients from 14 medical centers in the UK who underwent focal HIFU therapy before the cancer spread to other parts of the body. Of these, 2897 patients received HIFU treatment, and 580 received cryotherapy. After ten years of follow-up, the mortality rate from prostate cancer among these patients was only 0.13%, and the probability of metastasis to other organs was 3.3%. These results demonstrated the high effectiveness of HIFU treatment.
Previously, surgical methods and radiotherapy were widely used in the treatment of prostate cancer. If surgery is necessary, the entire prostate is removed—the gland located under the bladder and surrounding the urethra. In contrast, the HIFU method aims to preserve healthy prostate tissue by treating only the affected focus. This is done to avoid future problems with urination or other complications in men.
Despite the complex name, the principle of how HIFU works can be explained simply: if only weeds appear in one part of a large field, the machine should be set up to eliminate the weed without disturbing the rest of the vegetation. This is the approach characteristic of focal treatment.
In the HIFU procedure, high-intensity ultrasound focuses on the area of the prostate where cancer has been detected. This causes localized heating, which is intended to destroy cancerous tissues, thereby treating only the affected area, not the entire gland. Therefore, this method is called 'focal'—meaning focused on a specific zone.
It is important to understand that HIFU is not a completely new technology; it has been in use for many years. This study merely confirmed its potential benefit by providing data from a 10-year follow-up. It was found that the mortality directly from prostate cancer was extremely low among more than three thousand patients with long-term follow-up. According to scientists, this conclusion strengthens hopes for the use of focal therapy provided there is careful patient selection.
Nevertheless, it cannot be claimed that the results apply exclusively to HIFU, as the study included both HIFU and cryotherapy.
If the cancer is limited to a specific part of the prostate and the patient is suitable for this treatment, doctors may consider treating only the affected area instead of completely removing the gland. The goal of this approach is to preserve healthy prostate tissue and adjacent vital structures during treatment. This is especially important for minimizing the impact on functions such as urinary control and sexual activity. However, it should be noted that not every patient who undergoes HIFU will avoid such problems; this depends on the state of the disease and the circumstances of the treatment.
In India, the use of HIFU is growing due to increased awareness of prostate cancer, the availability of tests such as PSA, multiparametric MRI, and targeted biopsy, which increases the chances of early detection of the disease. In such cases, focal therapy can be considered for individual patients.
Some major medical institutions in the country have included HIFU in their multidisciplinary prostate cancer treatment programs. Among them are the Rajiv Gandhi Cancer Institute and Research Centre in New Delhi, Tata Memorial Hospital in Mumbai, and Kokilaben Dhirubhai Ambani Hospital in Mumbai.
Dr. Sudhir Rawal, Medical Director and Head of Urological Oncology at the Rajiv Gandhi Cancer Institute and Research Centre, noted that the transition from HIFU to organ-sparing focal therapy represents a significant advance in prostate cancer treatment. He emphasized that while long-term data is encouraging, careful patient selection and an experienced medical team are necessary to achieve the best results.
It is important to remember that this treatment is not suitable for everyone. First and foremost, the doctor must determine the localization, extent of spread, and aggressiveness of the tumor using examinations such as PSA, MRI, and biopsy. Only then is the decision made regarding the patient's suitability for focal HIFU.
