HIFU treatment for prostate cancer

Welcome Len, sorry you need to join our club. There is a lot of treatment experience on this forum, hopefully you will find it useful.

My understanding is that HIFU has not been used much in the US as it had not been approved by the FDA, thus men would usually go to the Bahamas or Canada. My understanding is that it hasn't been shown to be any better than the more traditional treatments of surgery and radiation.

As you look at treatment options it is imprtant to get multiple opinions from all the main treatment protocals including Active Surveilance, if you are low risk.

Welcome and sorry you are here.

You will find a fair bit on the web on HIFU. The very short of it is that that with HIFU you get much lower incidence of serious SE's than with other treatments. The rates are 15% or so against 30% or so for Brachy and as much as 50% + for surgery. Recovery time is also much quicker than surgery.

The trade off is that recurrence rates are higher.

Cost is about $25k

So if you want to trade 5-10 years of much less serious SE's for the the potential that you will need retreatment in 5-10 years, and consider that trade worth $25k, then go for it.

Good Luck

HIFU may get it's release in 2013 for the US. This month at our UsTOO meeting we have a HIFU discussion planned, but sorry you're probably not into a Las Vegas PCa meeting.

Right now the difficulty with HIFU is that it must be performed outside the US. The cost is $25k and is the patients burden. Insurance is not accepted but you may be able to get reimbursement. I know quite a few guys that have had this procedure done and for the most part they are happy with the results...Some of the doctors I know set a limit on Gleason scores of 7 or less. You seem to fit the profile.

What is your age?
Do you have any other health issues?

Tony

I looked into it a bit before I had my surgery so my information is limited and old. But, for what it is worth, here it is.

HIFU for prostate cancer is not currently approved in the US but there are clinical trials going on and getting good results and it is hoped that it will be available in the near future (but that is not guaranteed). There are two primary manufacturers of the machines. One is American (Sonablate) and one is French (Ablatherm). One of the clinical trials is being done at Duke hospital in NC (local for me) and I have heard third hand that they had initially started their study using the Ablatherm and ran into problems but switched to the Sonablate and are getting better results. Both machines are being used internationally and have thousands of men treated with decent results.

There are several medical-tourist facilities where US residents can go for HIFU treatment. They are outside the US and your insurance probably won't pay for it. But it's not crushingly expensive (about the cost of a high-end car) and if you want it you can finance it with about the same payments as a Cadillac. I think it is available in Canada if you happen to be Canadian.

HIFU is less invasive than surgery (although it doesn't sound like much fun) and it may have fewer side effects (although how it compared with brachytherapy, I don't know).

If you are a good candidate for Active Surveillance you could potentially read up on it while you follow the AS regimen, that way if it is approved in the US before you decide to seek treatment (if you ever do) then it would be an option.

Bottom line: it's a promising new technology but it's not approved in the US. It's not clear that it offers any real benefits vs other treatment options although it looks particularly promising for salvage procedures with localized failures, especially after primary radiation treatment. That may be the area where it is first approved in the US.

Update: I am told that "Hifu is available in Canada- approved by Health Canada - but not covered by OHIP or other provincial plans - so it is all out of your pocket $11-25K- regardless of being Canadian or USA".

fightson,
This is the latest data on HIFU which is summarized. I think this is the most unbiased review of HIFU I have seen as it deals with only published data and is without the hype or common criticisms of the treatment. It also includes all of the studies on the treatment.

http://prostate-cancer.org/PDFs/Is14-1_p14-20.pdf

Here is the link that John T posted, made clickable:

prostate-cancer.org/PDFs/Is14-1_p14-20.pdf

These results are pretty disappointing--the complication rate (e.g. erectile dysfunction) is similar to what would be expected with surgery, and there is reason for concern that risk of recurrence may be higher.