High-intensity focused ultrasound (HIFU) and focal therapy are two terms used for a few methods that kill small ranges of the prostate with varied types of heating, radiating or freezing tissue. These methods can kill small tumors inside the prostate. It may be used to treat cancer while saving the whole gland and healthy tissue nearby. The goal is to limit side effects, such as changes in urinary problems (incontinence or uncontrolled urination). There are a few types of HIFU and focal therapy in clinical studies. At this time, the FDA has approved HIFU and focal therapy to kill prostate tissue, but not clearly to treat prostate cancer.

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The types of therapies in studies are:

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• High-intensity focused ultrasound (HIFU) uses sound waves to superheat the tumor and kill cells. It is led by MRI scans and can be used for the whole gland.

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• Focal cryoablation uses a needle-thin probe to surround the tumor with a special mixture. This freezes the tumor to kill it.

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• Irreversible electroporation uses a “NanoKnife” to pass an electrical current through the tumor. The electricity makes very tiny holes (called pores) in the tumor’s cells, leading to cell death.

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Who is a Good Candidate?

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HIFU and focal therapy may be good choices for men with small, localized prostate tumors. Still, many of these treatments are so new that insurance coverage is not often available.

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Should I Choose HIFU or Focal Therapy?

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Choosing the right care for prostate cancer is a personal choice. Patients should make this choice with their doctor and family. Before moving on, it is of great value to grasp side effects, costs, and your quality of life goals.

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What are the Benefits and Side Effects of HIFU and Focal Therapy?

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The main benefit of HIFU and focal therapy is the removal of cancerous prostate tissue with small or no side effects. The risks and long-term help of focal therapy are not yet known. Research is being done to study this further. We are not sure if it is a cure or even needed.

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Other Considerations

After HIFU and focal therapy, follow-up care will involve routine visits with your doctor and may involve routine PSA tests and biopsies. Talk to your doctor about which treatment is right for you.

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