HIFU vs Prostatectomy for Prostate Cancer

September 6, 2021

Prostate cancer is a significant health problem in the United States with about one in nine men diagnosed with prostate cancer in his lifetime. Prostate cancer is the most common cancer in men, excluding skin cancer. It is also one of the leading causes of cancer death among men. About six in ten cases are diagnosed in men ages 65 or older.

Prostate cancer is a cancer that occurs in the prostate and begins when cells in the prostate gland start to grow uncontrollably. Prostate cancer often does not cause symptoms in the early stages. This type of cancer can be small and slow-growing or it can be fast-growing. Early detection of prostate cancer means that treatment is more likely to be successful. 

Prostate cancer often goes undetected as there are typically no real indicative symptoms.

Surgical options are determined by the pathology obtained from a biopsy, including the amount of cancer detected throughout the prostate and the aggressiveness of the cancer. Factors such as age and general health of the patient also play a role in determining the best option.

In addition to surgery, treatments might also include a combination of hormone therapy or radiation.

Surgical options include:

1. HIFU (High-intensity focused ultrasound): High-intensity focused ultrasound (HIFU) is a medical procedure that uses ultrasound waves to treat prostate cancer. In HIFU,  harmless ultrasound waves are produced at a higher intensity and in a highly focused form. Multiple beams of ultrasound focus on the exact tissue area within the prostate that requires treatment. The energy from the ultrasound causes the temperature of the tissue to rise and the heat destroys the targeted tissue area or cancer. The ultrasound beams are able to pass through layers of tissue, leaving them unharmed, until they reach their target.

The procedure is approved by the FDA. HIFU can be considered as an alternative option to monitoring (no treatment) for patients who have early stage prostate cancer. It’s also an alternative to and/or follow-up option for radiation, surgery or other failed treatment for tumors that are small and localized. 

An advantage of high-intensity focused ultrasound is that it’s non-invasive, meaning no surgical incisions are made. It also doesn’t use radiation and can target cancerous tissue, leaving healthy tissue unharmed.

2. Prostatectomy: Oftentimes, a radical prostatectomy (surgery) is the most effective treatment method. A radical prostatectomy is a surgical treatment option for localized prostate cancer. The surgery involves removing the entire prostate gland and seminal vesicles, as well as the surrounding tissue which often includes lymph nodes. This is often the best surgical option for men who have prostate cancer that is not limited to a small area of the prostate.

There are three different surgical techniques commonly used to perform a radical prostatectomy:

Robot-assisted surgery or robotics (da Vinci System): A surgeon makes five incisions, less than the size of a dime, in the lower abdomen. These incisions allow for instruments attached to a “robot” to precisely target the prostate and surrounding tissue with minimal invasion. The surgeon is ten feet away and controls the movements of the robot using a 3D, HD system that  allows for more exact precision and greater dexterity.

Open surgery: Typically, the surgeon makes an incision in the lower abdomen to remove the prostate (retropubic surgery) and any surrounding tissues.

Laparoscopic surgery: The surgeon makes several small incisions in the lower abdomen and inserts special tools to assist the removal of the prostate and surrounding tissues.

If you’re interested in learning more about surgical treatment options for prostate cancer or want to schedule a screening, contact Austin Urology Institute at 512.694.888 to schedule an appointment with Dr. Shaw or Dr. Tsai.