The Bower Hill Road hospital is now offering robotic focal high-intensity focused ultrasound (HIFU) for patients living with prostate cancer. Dr. Kevin Bordeau, a urologic surgeon with St. Clair Medical Group, performed the first HIFU procedure in January using the Focal One platform technology. It has given physicians yet another tool in their toolbox to fight prostate cancer, according to Dr. Bordeau.
As imaging and medical technology have improved drastically over the years, it has become easier in many cases to detect prostate cancer earlier. Early detection allows doctors to start treating the cancer sooner, which lends itself to improved outcomes for patients. That is why the HIFU procedure is so exciting to Dr. Bordeau and others in the urology group.
“We have been increasingly finding a lot of these people who were kind of in this ‘gray’ zone between those who needed their prostate either removed or radiated, and those who could be watched and treated with active surveillance,” Dr. Bordeau said. “That was the exciting part of HIFU, because it allows us to be able to offer something to people who were in that ‘in-between’ area. I sensed that in those patients there was a desire to do something about the cancer, especially those who were maybe just starting to have more aggressive disease, but you still didn’t really want to put them through a major operation or radiation. We now have this HIFU procedure we can use in those cases.”
The HIFU procedure is an outpatient surgery in which there are no cuts, incisions or radiation. A patient is placed under general anesthesia, and a probe is inserted that allows surgeons to precisely image and map out where in the prostate to treat. HIFU uses high-intensity ultrasound waves precisely focused on cancerous prostate tissue, creating localized heat that destroys targeted cells while preserving surrounding healthy tissue.
Focused ultrasound works similarly to sunlight passing through a magnifying glass, where rays are concentrated at a single point, causing a significant temperature rise around the focal point. The process takes about 1 hour and 30 minutes, Dr. Bordeau said.
Another aspect that makes HIFU potentially appealing to patients is that it may produce fewer side effects — such as incontinence and erectile dysfunction — compared with other treatment options. If the procedure is performed, it also does not eliminate the possibility of surgery or radiation in the future if needed. Studies so far have shown comparable oncologic outcomes compared with other prostate cancer treatment methods, with low residual cancer following the HIFU procedure,
Dr. Bordeau noted.
“I think HIFU is the future of prostate cancer treatment, because the imaging is only going to get better,” Dr. Bordeau said. “And as we get better and know where the cancer is, we’re going to be able to more accurately treat it within the prostate. What I’m seeing so far is that it’s expanding the options for people with prostate cancer and not necessarily replacing something else. If you have cancer on both sides of the prostate where you can’t go in and treat just a certain area and you’d have to treat the whole prostate, then surgery or radiation is still going to be the best option. But I would say our ability to know that is only going to get better as imaging continues to improve.”
Dr. Bordeau also underscored the importance of people being screened for prostate cancer, as early detection can make treatments like HIFU extremely effective options.
“I think there’s debate sometimes about whether people should be screened for prostate cancer,” he said. “The earlier you find it, the more options you have. For people who are fearful about side effects like urinary control and erection problems, sometimes they will not get screened because they’re apprehensive about the possibility of needing treatment and potentially losing those functions. It’s important for people to know that we’re working on treatments to try to make things less difficult for them and help them maintain their quality of life. But the cornerstone of that is making sure people get checked so we can find things early.”
Visit stclair.org to learn more about the HIFU innovative prostate cancer treatment option at St. Clair Health.
