What Is HIFU?
A high-intensity focused ultrasound (HIFU) procedure is one of the newest ways to treat prostate cancer. You may hear your doctor call it "noninvasive," which means a surgeon doesn't have to cut you open.
HIFU targets the cancer cells and leaves healthy cells alone.
Men with cancer that hasn't spread beyond the prostate may be good candidates for the surgery. Your doctor may suggest it either before you've tried other treatments or after radiation therapy that didn't help. It can also be done if the cancer comes back to your prostate. It's not used when your cancer has spread to other parts of your body.
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 or other focused area, 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. He'll direct the waves at your cancer cells.
The sound waves heat up to temperatures as high as 90 F and can kill cancer cells in just a few seconds. Doctors use magnetic resonance imaging (MRI) and ultrasound imaging to tell them exactly where the tumor is and where to point the sound waves.
What Happens During the Procedure?
It usually takes 1 to 4 hours. Before it starts, you'll get an enema to make sure your bowels are empty. You won't be able to eat or drink anything for 6 hours before the operation.
You won't feel any pain during the procedure because you will get anesthesia while it's going on. The doctor will thread a small tube called a catheter through the head of your penis into your bladder to catch urine during the procedure.
Your doctor will put an ultrasound probe into your rectum. It's a small instrument like the ones used for prostate biopsies. The probe may have one or two crystals inside. Sound waves from a crystal bounce back to a computer to make a picture of the prostate gland. This will show where to send the sound waves. A crystal sends focused sound waves through the rectal wall into the gland.
After the procedure is done and the anesthesia wears off, you can usually go home. The doctor may leave the catheter in for a week, and you will make an appointment to take it out
What Are the Side Effects?
Although HIFU has fewer side effects than many other treatments for prostate cancer, that doesn't mean it doesn't have any.
After HIFU, you may have trouble getting an erection, but this usually goes away in time and there are drugs that can help you while you regain your ability. Some men also have trouble peeing or may leak urine between trips to the bathroom.
Other side effects may include pain between your testicles and your rectum, which can often be handled with medication. There's also a risk for blood in your urine, a urinary infection, and an infection in your testicles. Always call your doctor right away if you have signs of any of these.
WebMD Medical Reference
Reviewed by Laura J. Martin, MD on December 11, 2016