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What role do you see for high-intensity focused ultrasound as a treatment for prostate cancer in the U.S.?

Article

Urologists find HIFU promising, but remain cautious

Men should really look for treatments that treat the whole gland rather than part of the gland because of the volatility of prostate cancer.

Another concern I have is with the safety of HIFU. Although I've seen images of it used for BPH and periurethral ablation in Japan, I'm always concerned when the treatment is coming from the rectal side of the gland. The potential is there for the rare but disastrous radical prostatic fistula."
Joseph Grocela, MD, MPH
Boston

We have such good radiation techniques now compared to 20 years ago that we can target the prostate better. Even at Kaiser, we're doing high-density radiation that's more specific and still not for everybody.

We have so many good options now that are proven in a way HIFU is not that I would be reluctant to recommend it to anyone as a primary treatment. The data isn't out there."
Kelly Morgan, MD
Fremont, CA

"HIFU is a promising technology, but its role in the focal treatment of prostate cancer does not fit with the model I know of prostate cancer as a multifocal, multiclonal tumor. I will wait for further studies before employing this technology on my patients.

It seems right now, we all need to concentrate on selecting which patients will benefit from treatment of any kind rather than pursuing new technology in which long-term results are lacking. That being said, HIFU does seem to have a future role as a minimally invasive therapy that can be effective in selected patients with short-term follow-up."
Jeffrey Simerville, MD
Anchorage, AK

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