High Intensity Focused Ultrasound for Prostate Cancer

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High-intensity focused ultrasound (HIFU) is a noninvasive way to destroy tissue or stop it from working. It was approved by the U.S. Food and Drug Administration for prostate ablation in 2015, but the technology has been used to treat cancer and other diseases for decades.

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How HIFU Can Treat Prostate Cancer

HIFU uses a highly focused, high-intensity beam of sound energy. The focus of the beam is about the size of a grain of rice. In this spot, the energy is 1,000 times more intense than from a diagnostic ultrasound.

The beam quickly heats the target area, destroying the cancer cells. Each second-long pulse of HIFU energy kills the cells in a specific zone. There’s no incision and no radiation.

George Schade
Dr. George Schade, Fred Hutch urologic oncologist and HIFU expert

Why Choose Fred Hutch for HIFU for Prostate Cancer 

Fred Hutch Cancer Center was the first cancer center in the Puget Sound region to offer HIFU. It’s available at UW Medical Center – Montlake as part of our comprehensive approach to prostate cancer care. We offer a wide range of treatment options so you and your care team can design a treatment plan that’s right for you.

Our physicians use the most advanced HIFU technology available — the Focal One. This device has several features, including:

  • A greater range of depth compared to other HIFU technologies — The Focal One has a shorter minimum depth and greater maximum depth. This larger range has benefits for men with larger prostates. It means they don’t need hormone therapy or surgery to shrink their prostate before having HIFU treatment. A shorter minimum depth also means we can use HIFU to treat tumors close to the wall of the rectum.
  • Magnetic resonance imaging (MRI) fusion — We upload an MRI image of your tumor to the HIFU device. During your procedure, the device does a 3D ultrasound scan of your prostate. It combines this scan with the MRI image. Your physician uses the combined picture to precisely target your tumor and the area around it. Fred Hutch’s radiology team uses the latest MRI equipment and protocols. They have extensive expertise in interpreting images to make your treatment accurate.
  • Post-treatment contrast-enhanced ultrasound —  After HIFU, an ultrasound with contrast highlights blood flow through your prostate. The ablated section shows up as a black hole. If there are any bright spots in the targeted area, your physician can do another HIFU treatment to get those too, destroying the entire tumor.
Read More About HIFU at Fred Hutch

High-Intensity Focused Ultrasound for Prostate Cancer FAQ

During treatment, you are under general anesthesia. A surgeon inserts a special HIFU probe into your rectum. The probe emits ultrasound waves that travel the short distance through your tissues to your prostate. HIFU is done in a single outpatient visit that takes about two hours.

Good candidates are those who have cancer in only a small part of their prostate. At the same time, your cancer needs to be aggressive enough to benefit from treatment but not so aggressive that there is a risk of undertreatment.

Your Fred Hutch care team may recommend HIFU if:

  • You have a Gleason score of 6 or 7 and prostate cancer that can be seen on MRI, with a single focus for treatment
  • You have localized prostate cancer that came back after radiation therapy

If you need treatment to a larger area of your prostate, surgery or radiation therapy may be a better option for you.

HIFU heats the target area with little heat to nearby tissues. So, it causes minimal side effects.

“Recovery is usually quick,” said urologic oncologist and HIFU expert George Schade, MD. “The most common short-term side effect is swelling of the prostate. Patients go home with a catheter to help them urinate until the swelling subsides, which takes about a week.”

For men with normal sexual function, there’s a lower risk of decreased function after HIFU than after surgery or radiation therapy for prostate cancer. HIFU also carries a lower risk of problems with urine leakage.

Prostate cancer grows slowly, and technologies for treating the disease are changing rapidly. So, it’s been difficult to measure HIFU outcomes, said Schade. More time is needed to see the long-term results.

“We don’t currently have any randomized trials comparing outcomes between HIFU, surgery and radiation therapy. But based on what we know, we think that cancer control with HIFU is similar to what we would expect for surgery and radiation,” he said.