A prostate cancer diagnosis brings many questions and weighing treatments that involve surgery or radiation can feel overwhelming. But if your cancer is diagnosed early and is determined to be contained within the prostate, you may have another option.
Robotic HIFU (high-intensity focused ultrasound) is a non-surgical treatment for localized prostate cancer. It uses the energy of focused sound waves to target and destroy cancer within the prostate while sparing the healthy tissue around it. This speeds recovery and lowers the risk of common side effects like incontinence and erectile dysfunction. Loma Linda University Health delivers robotic HIFU using the Focal One system, the latest generation of this technology. For men with localized prostate cancer, HIFU offers a way to effectively treat the cancer while preserving quality of life.
Robotic HIFU uses high-intensity focused ultrasound (HIFU) to treat prostate cancer that has not spread beyond the prostate. It is a non-surgical, minimally invasive approach that targets cancer inside the prostate without an incision.
During treatment, focused sound wave energy is aimed at the cancer within the prostate. These waves create heat at one precise point, which destroys the targeted cells. The approach works like sunlight passing through a magnifying glass, concentrating energy on a single spot. Because the energy is so focused, the treatment can spare the healthy tissue surrounding the cancer and help preserve quality of life by causing fewer side effects.
HIFU is done in the operating room because the patient must remain completely still during the treatment, but there is no surgery, no incision, no bleeding, and no radiation. Most men go home the same day.
HIFU has been used to treat prostate cancer for more than 30 years, and tens of thousands of men around the world have been treated with it. It was recently cleared by the U.S. Food and Drug Administration to for prostate tissue ablation and decades of clinical research continue to support its use today.
A recent study of more than 3,300 men found that robotic HIFU offers cancer control similar to surgery, with a lower risk of side effects such as incontinence and erectile dysfunction.
Your urologist can talk you through what the research means for your situation and whether HIFU fits your diagnosis.
Though HIFU is an excellent treatment in the proper clinical situation, it is not right for everyone. It works best when your prostate cancer is localized, meaning it has not spread beyond the prostate. These are often early-stage and less aggressive variants of prostate cancer. It may also be an option if your cancer has returned after radiation therapy. The treatment can be repeated if necessary.
A few things can make HIFU a poor fit. Patients who have larger prostates, urination difficulties, and scarring from past rectal surgeries or radiation may not be good candidates for HIFU.
If HIFU is a good fit for you, your urologist may treat just the area of cancer or the whole prostate, based on your specific tumor parameters, size, and location within the prostate. Your prostate’s size and shape will also affect the HIFU treatment plan. Your doctor will review your biopsy results, imaging, and health history with you to decide whether HIFU is safe and right for you.
Your care team will guide you before, during, and after your procedure. Here's the typical process:
You'll need to complete a bowel prep at home the night before. On the day of treatment, you'll receive general anesthesia, so you are completely still, stay comfortable, and feel no pain during the procedure.
The procedure is outpatient (not overnight) and will take about one to two hours.
Your urologist will scan the prostate using an ultrasound probe, and using special software, merge the ultrasound image with MRI images to create a three-dimensional picture of the prostate and area to be treated. Using those images, your urologist will plan the treatment and target the cancer. The Focal One system then uses surgeon-controlled robotic guidance to deliver the focused ultrasound to the targeted tissue. Your urologist directs and monitors the process in real time.
You'll go home the same day with a temporary urethral catheter to help with urination while the swelling in the prostate goes down. The catheter is usually removed at your first follow-up visit within a week. Any discomfort is usually mild and tends to ease within several days.
Your urologist will monitor your recovery over the following year. Follow-up care typically includes a symptom check and PSA blood tests at three months, six months, and one year. These tests measure a protein made by the prostate, and tracking the level over time helps your urologist assess and monitor how well the treatment worked. You'll also have periodic MRIs, and possibly a follow-up biopsy, to confirm treatment success. If you traveled from out of the area, some of this follow-up can be handled by video visit with our urologists or by your local urologist.
If you have been diagnosed with prostate cancer and want to learn whether HIFU is right for you, we are here to help. Make an appointment or call us at 800-782-2623, and our team will help you find the right next step.
Coverage varies by plan and by your specific diagnosis. Some insurers cover HIFU for prostate cancer and some do not. Our team can help you understand insurances accepted and understand any out-of-pocket costs before you decide.
Surgery removes the prostate, and radiation uses high-energy ionizing rays to kill cancer cells over several visits. HIFU instead uses focused sound waves to destroy (ablate the tissue) in the targeted area. The treated tissue turns into a scar without live prostate tissue. The treatment is usually in one outpatient session, with no skin incision and no radiation. Each option has its own benefits and risks, and your urologist can help you compare them for your specific situation.
You'll receive general anesthesia to keep you still during the procedure and you shouldn't feel pain during the procedure. Most patients feel only mild discomfort in the pelvic area afterward, which usually goes away within a few days.
Like any prostate cancer treatment, HIFU can have side effects, though they tend to be less severe and less common than with surgery or radiation. Some men have temporary urinary symptoms, such as trouble urinating or the need to use a catheter for a short time after the procedure. Your urologist will talk with you about the risks based on your diagnosis and what to expect in your recovery.
Recovery is usually quick. Most patients go home the same day and return to everyday activities within a week after, once the temporary catheter is removed at a follow-up visit a few days later.
In some cases, yes. HIFU can sometimes be repeated, and other treatments may still be options afterward. Your urologist will talk through what makes sense based on your results.
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