Treating Prostate Cancer Without The Major Side Effects!

Often associated with obesity, age and family history, it is usually treated by surgery or radiotherapy, both of which are often accompanied by such side effects as incontinence and impotence due to the need to remove the entire gland or kill all cells in the area.

A treatment that’s been used in Europe for more than a decade – robotic assisted High-Intensity Focused Ultrasound (HIFU) – has now been brought to Bangkok by Samitivej Hospital. While US Food and Drug Administration (FDA) approval is still pending, results from trials strongly suggest that HIFU can be a successful treatment for localised prostate cancer. However, it is important for anyone considering the treatment to note that the long-term effects of HIFU are not yet fully understood.

Robotic assisted HIFU is unlike other traditional treatments and the side effects are less drastic. Focal HIFU can be used to target and kill only the cancerous cells.

Robotic-assisted HIFU for prostate cancer is performed by putting an ultrasound probe into the patients' rectum. From that position, the ultrasound can direct beams more accurately at the prostate. As it destroys the diseased tissue non-invasively in less than four hours, the procedure is also known as non-invasive HIFU surgery. 

The entire treatment is done by moving the applicator on its robotic arm in order to put together multiple shots, according to the protocol designed by the doctor. During the progression of the treatment the doctor overlooks the updated real-time images and customises it if required. 

No post-operative morphine is used. The only pain killer the patient might need is paracetamol. There is no extended hospital stay and very little downtime post-procedure. However, pain may be experienced for three to four days following the procedure. 

HIFU is a better option than active surveillance, surgery and radiotherapy, but the choice the doctor makes together with the patient is case sensitive. Many find active surveillance, which is doing nothing until the cancer spreads, mental torture and decide to opt for treatment. Treating it with HIFU is about as effective, definitely less invasive and costs about the same as surgery and radiotherapy.

HIFU waves do not pass through either solid bone or air so the procedure is not suitable to treat all types of cancer. Currently it is used effectively only for men who have early stage, localised prostate cancer that has not spread beyond the prostate. If the cancer has affected only one side of the gland, this procedure is probably the only one that can treat just the affected area without needing to destroy the whole gland. This means the patient can live a normal healthy life post treatment. HIFU does not expose patients to any radiation and HIFU is safe to repeat as well as to treat recurrent cases of cancer.

 

DR ISARES SAISORN is a urological surgeon at Samitivej Sukhumvit Hospital. Call (02) 711 8585.