Is Hifu Treatment Using Focal One Safe And Effective
HIFU therapy is a newer treatment option that received market clearance in June, 2018. More than 45,000 men around the world with localized prostate cancer have received the HIFU procedure, which has demonstrated its effectiveness to reduce the need for further treatments. In Europe, where the first generation HIFU system originated and was used for whole prostate treatment, researchers published many peer-reviewed studies of the use of HIFU for whole gland ablation with positive results. Prostate Cancer treatment is considered focal when a part of the gland is spared from treatment.
Although focal HIFU treatment is available for localized prostate cancer, studies in Europe have demonstrated its safety and efficacy. In 2013, the Journal of Urology published a German study of 704 patients treated with HIFU, in which co-investigators concluded that long-term follow-up with HIFU therapy demonstrated a high overall rate of cancer specific survival and 10-year salvage treatment-free, meaning these patients did not require additional treatment for cancer after 10 years. Urologic surgeons in the US typically seek at least 10 years of data to establish focal HIFU therapy as a standard treatment.
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List Of The Pros Of The Hifu Treatment For Prostate Cancer
1. HIFU is approved by the FDA for treatment of prostate cancer.Although the high-intensity focused ultrasound procedure was hanging in limbo for several years waiting for regulatory approval, it is now available to men in the United States when they receive a diagnosis of prostate cancer. There are two systems currently available that can treat tumors or destroy diseased tissue, making it a useful option for many men. Medicare has already agreed to cover the treatment with their coverage protocol as well, which should impact its level of availability in the near future.
2. It doesnt take long to produce the results that you want.The HIFU treatment option takes four hours or less to successfully deal with the prostate cancer. Some patients can have their procedure completed in 60 minutes because of how effective it is. Before you can have it done, your doctor will want you to have an enema to ensure that your bowels are empty. There is also a restriction in place that you cannot eat or drink anything for at least six hours before having the operation.
Some men report that they have trouble urinating after having the HIFU procedure. They might also leak urine between trips to the toilet. There can also be pain between your rectum and testicles that medication can treat. Rare side effects include a UTI, blood in the urine, and a testicular infection.
Albissini Study On Hifu Procedure For Prostate Cancer
Albissini, et al, in the January, 2017 issue of Journal of Endourology, published a study of 55 men who had undergone hemi-ablation for localized prostate cancer. The follow up was an average of 3 years, including PSA and repeat biopsy. Their results were matched to 55 men who had undergone Robotic Assisted Laparoscopic Prostatectomy . Failure of cancer cure was defined in terms of biochemical recurrence and repeat biopsy leading to salvage therapy with radiation or hormone deprivation. The results were statistically identical, with 6/55 in the RALP and 7/55 in the HIFU group. Both urinary continence and preservation of erectile function were superior in the HIFU group. The HIFU procedure group, despite being significantly older than the surgery group, had 82% zero pad use at 1 month vs. the surgery group, with 40% zero pad use. Preservation of erections was 80% for HIFU, and 15% for RALP at 1 month. At one year, zero pad use was 94.5% in the HIFU group, compared to 87% in the surgery group. Compared to HIFU, more than twice as many men were still incontinent one year after surgery for their prostate cancer. At one year, the return of erections was still 80% in the HIFU procedure group and just 38% in the surgery group . Not surprisingly, compared to HIFU, the rate of complications was significantly higher after Robotic Prostatectomy.
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Caution Urged With High Intensity Focused Ultrasound Therapy In Prostate Cancer
The U.S. Food and Drug Administration has approved 2 types of minimally invasive, high intensity focused ultrasound therapy for treating prostate cancer. However, this advanced revolutionary technology requires significant urologic training as the technology is complex and caution is being urged.
Well-selected prostate cancer patients can benefit by maintaining their quality of life and still treating their prostate cancer. However, due to training requirements, I believe that the technology should roll out slowly over 12 to 24 months. Patients should be cautioned that excellent outcomes are only consistently obtained by highly trained users of the technology, said Stephen Scionti, MD, who is medical director of Vituro Health and founder of the Scionti Prostate Center in Sarasota, FL.
Dr Scionti has been involved in the treatment of approximately 1000 patients over the last decade at the International HIFU Prostate Cancer Centers in the Caribbean and Mexico and as lead proctor for the FDA trials in the United States. He said patients should carefully inquire about the skill level and the experience of the HIFU surgeon and should seek out only highly experienced physicians as this technology rolls out into the US market.
When Do You Need Hifu Therapy
It is important to know that targeted focal therapy for prostate cancer is not suitable for all patients, the overall state of health and other certain criteria should be judiciously examined.
The doctor can recommend HIFU if:
- The patient is diagnosed with an initial stage of prostate cancer
- The cancer is localized i.e. confined to the prostate gland only
- There is recurrent localized prostate cancer
- Prostate cancer is limited to one or very few foci in the prostate
- The Gleason score which is an estimator of the level and grade of tissue change should not be greater than 3+3 or 3+4
- The PSA value which is an indicator of the existence of prostate cancer is under 15 ng/ml
- The operation is not an option due to health problems or a personal choice
More than 80% of patients have a multifocal tumor necessitating treatment of the whole prostate therefore HIFU is not possible as well as if prostate cancer has expanded to other parts of the body the treatment is not performed.
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Faqs About Prostate Cancer Treatment Costs
- How much does open and robotic prostate surgery cost differ?
- There are 2 main types of prostatectomy : open and robotic one. The second one is less traumatic, the recovery period is faster, the urinating and erectile functions are preserved in most of the cases. But the cost of robotic prostate removal is about 25-30% higher than the open one. The treatment effectiveness is about the same level.
- Can a low cost of prostate oncology treatment be a sign of a poor quality or unprofessionalism?
- Yes, it can, but not in all cases. To be sure in quality of treatment, learn the info about a hospital and a doctor who will manage the therapy. If the medical center has international certificates and positive reviews from patients, you do not need to worry. The lower cost of private treatment for prostate cancer is usually explained by the general price policy in a particular country.
- What additional charges can occur during prostate cancer therapy?
- Some hospitals already include such services as a transfer, admission, language assistance in the cost of prostate cancer treating. But some provide a quote without these charges. So you have to specify this before going to treatment. Also, a doctor can prescribe some additional treatment options to increase the effectiveness after the examination in the hospital.
How Does It Work
Our HIFU system captures real-time images of the prostate, allowing the doctor to create a customized treatment plan for each patient. Once the treatment plan is mapped, the doctor delivers the ultrasound energy to targeted sites, or focal points, throughout the prostate gland.
HIFU treatment is focal, meaning that the ultrasound heat only destroys the unhealthy tissue, leaving the healthy part of the prostate intact.
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What Does Hifu For Prostate Cancer Cost Depend On
A focused ultrasound surgery cost is affected by the following facts:
- A country where HIFU therapy is performed. A cost of HIFU for prostate treatment can differ 10-40% depending on the country because of its internal general price policy. For instance, the price for HIFU in Germany is about 15-20% higher than in Poland, but about 5-10% lower than in Switzerland. The HIFU cost in South Korea is about the same level than in Germany. The most expensive HIFU therapy will be in the USA about 2-3 higher than in European or Asian countries.
- A doctor’s experience. If a specialist has been performed a lot of HIFU procedures, has numerous certificates, and is a member of prestigious organizations, they may ask about higher focused ultrasound surgery cost.
- Additional expenses. Some hospitals already provide package HIFU cost for prostate cancer treatment , but others can give price only for HIFU procedure.
You can submit a request on Bookimed, and receive a focal laser ablation cost for prostate cancer from a selected hospital with all required charges.
Can Prostate Cancer Be Managed
Typically, there are 3 ways to manage prostate cancer. Because prostate cancer is slow-growing, it may not have a significant impact the wellbeing of most men for the remainder of their lifetime. For these conditions, active surveillance may be recommended, giving the patient and the doctor more time to assess the progression of the disease and consider options for treatment.
When more significant treatment is recommended, it may include surgery or radiotherapy, or both. These treatments tend to be a final procedure, where the treatment plan is designed to eliminate the progression and spread of cancer cells without the need for additional treatment. Recent innovations, such as with robotic surgery for prostate, reduces recovery time while retaining function, but can still produce some side-effects. Other advancements exist in radiotherapy devices, which has vastly improved treatment delivery methods and clinical outcomes.
HIFU treatment provides an additional treatment option that is designed to bridge the gap between active surveillance and the more significant treatments, such as radical prostatectomy . HIFU Focal One® treatment consists an ultrasonic probe that scans the entire prostate structure then focuses sound waves at only the cancerous portion of the prostate from within the rectum.
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How Does Hifu Work
If you’ve ever used a magnifying glass to reflect the sun’s rays and start a tiny fire or burn a hole into a leaf, you already have an idea of how HIFU works. Instead of light rays, though, HIFU uses sound waves that a doctor points through the wall of your rectum — the bottom part of your large intestine. They’ll direct the waves at your cancer cells.
The sound waves heat up to temperatures as high as 90 C and can kill cancer cells in just a few seconds. Doctors use magnetic resonance imaging and ultrasound imaging to find out exactly where the tumor is and where to point the sound waves.
List Of The Cons Of The Hifu Treatment For Prostate Cancer
1. It still requires pre-treatment options before it can be successful.The reason why HIFU is a successful treatment option for prostate cancer us because it relies on first-hand visualization and real-time data. Guys must go through the entire diagnosis process before this procedure will receive a go-ahead from their treatment physician. Like other treatment options for this cancer, such as CyberKnife, there are CT scans, a prostate biopsy, and imaging requirements necessary that can become costly if your health insurance does not cover the costs effectively.
2. There may not be any availability for this procedure in this region.Because HIFU only recently received FDA approval to treat guys in United States, there are not many providers currently active in this area of prostate cancer treatment. Some guys may need to travel extensively if they receive a referral for this procedure, which is an expense that is not always covered by medical insurance. If youre thinking about the pros and cons of HIFU for your condition, then speak with your treating physician to see if they know of someone in your region that offers it.
Prostate Cancer Ultrasound Treatment As Effective As Surgery Or Radiotherapy
04 July 2018
Ultrasound therapy destroys cancer cells in the prostate
Using high energy ultrasound beams to destroy prostate cancer tumours may be as effective as surgery or radiotherapy, but with fewer side effects.
A new study, carried out at six hospitals across the UK, tracked 625 men with prostate cancer who received a type of treatment called high-intensity focused ultrasound .
The research, published in the journal European Urology, is the largest ever study of HIFU treatment used to target prostate tumours. The treatment is similar to a lumpectomy for other cancers where doctors remove only tumour cells, leaving as much healthy tissue as possible.
The findings, from a number of institutions including Imperial College London, Imperial College Healthcare Trust and University College London, found that after five years the cancer survival rate from HIFU was 100 per cent. Approximately, 1 in 10 men needed further treatment. The cancer survival rate from surgery and radiotherapy is also 100 per cent at five years.
This latest trial of focal HIFU…suggests we may be able to tackle the cancer with fewer side effectsProfessor Hashim AhmedLead author
The research also showed the risk of side effects of HIFU, such as urinary incontinence and erectile dysfunction, were lower than other treatment options, at 2 per cent and 15 per cent respectively.
Prostate cancer is the most common cancer in men in the UK, with around 47,000 cases every year.
Prostate Cancer Outcomes After Hifu Characterized
Research findings presented at the 37th Annual European Association of Urology Congress in Amsterdam, The Netherlands, may give clinicians a better sense of the oncologic outcomes resulting from focal treatment of localized prostate cancer using high-intensity focused ultrasound .
In a retrospective study, investigators propensity-score matched 137 HIFU partial ablation patients with 548 radical prostatectomy patients and 84 HIFU total ablation patients with 336 RP patients. At 30 months after treatment, the HIFU partial ablation group had a significantly lower failure-free survival rate compared with the matched RP group , Changhee Ye, MD, of Seoul National University Bundang Hospital in Seongnam, South Korea, and colleagues reported. The partial ablation group also had a significantly lower salvage-free survival rate compared with the matched RP group . The 30-month FFS and SFS rates did not differ significantly between the HIFU total ablation and RP groups.
With respect to functional outcomes, both HIFU groups had significantly better erectile function compared with the RP groups. Scores on the International Index of Erectile Function -5 instrument at 6 months were 9.15 for the HIFU partial ablation group compared with 5.78 in the matched RP group. The scores were 11.24 for the HIFU total ablation group compared with 9.78 in the matched RP group. Both HIFU groups and the RP patients did not differ significantly with respect to International Prostate Symptom Score.
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Be Careful Of Practices Or Institutions That Tell Your Hifu Procedure Will Be Covered By Your Insurance Plan
This is not true. It is typically stated by doctors or facilities who are just starting to perform HIFU and have little or no experience with patient insurance issues. Dr. Pugach has been performing HIFU for 17 years. He is one of most experienced HIFU practitioner in the world. Based on this experience, you can trust the information we give you. Some practices may lead you to believe your insurance plan will pre-authorize your procedure or definitely pay for it afterward. This is not true so be sure you do not find yourself in an uncomfortable financial situation after or just before your procedure!
Focal Ablation: Unresolved Issues
The HopeMultifocalityHemiablationPompe et al.a studyUS studyIndex Tumor TheoryLiu et al.Mao et al.Johns HopkinsCheng et al.Wei et al.Ibeawuchi et al.Løvf et al.Kneppers et al. Targeting the indextumora studya study at UCLAanother UCLA studyPriester et al.In a study of 461 lesions in 441 men,Pompe et al.Brisbane et al.Hollmann et al.Stabile et alIncomplete ablationin the ablation zonFocal Laser Ablation Feller et al.
- 26% were positive with clinically significant cancer
- 15% were positive with clinically insignificant cancer
- 59% were negative
notHigh IntensityFocused Ultrasound CryoIrreversibleElectroporation/NanoKnife Heat Sink EffectneverBiochemical EffectsOrgan-at-risk damage/toxicitysome
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Hifu For Prostate Cancer
Focal Therapy is the minimally-invasive alternative prostate cancer treatment.
High-Intensity Focused Ultrasound is an outpatient treatment for prostate cancer that doesnt involve surgery or radiation. HIFU cures prostate cancer while allowing the man to maintain the highest possible quality of life, including continence and erectile function.