How does HIFU compare with other treatments?

Prostate cancer is a disease that progresses very slowly, therefore it is important to consider the outcome over a long period of time and, importantly, how much of a difference the treatment makes to survival. Patients are also concerned about the side effects of treatment, both in the short and long term.

There are various ways to quantify whether a treatment has been successful. Studies generally consider biochemical progression and some also carry out a prostate biopsy after treatment. ‘Biochemical progression’ simply means ‘has the PSA gone up since treatment?’. A rise in PSA after treatment may indicate that disease is still present. It is also important to consider short and long term side effects: in the short term, the time that a patient stays in hospital and the risk of complications and in the long term, the major issues are incontinence and impotence.

Results available so far show that HIFU is effective at treating prostate cancer; one large study reports 92% of patients had a PSA of less than 1ng/ml (i.e. no biochemical progression) and 93% had negative prostate biopsies over the course of follow up (an average of 22 months). This is comparable with results for radical prostatectomy. Data so far suggest that approximately 20% of men will have erectile dysfunction. However, the equipment and techniques have advanced since these figures were reported and it is expected that the current figure will be lower. Incontinence is seen in less than 1% of men.