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High-Intensity Focused Ultrasound Safe as First-Line Treatment for Prostate Cancer

By Aude Lecrubier

PARIS APR 10, 2006 (Reuters Health) - The first long-term tolerance study of high-intensity focused ultrasound (HIFU) as treatment for localized prostate cancer shows it has a low morbidity profile; most side effects, when they arise, occur in patients who have had prior treatment with other modalities.

The 10-year safety study was presented at the 21st meeting of the European Association of Urology. "What we found is simply that the side effects of HIFU depend more on the pre-treatment than from HIFU itself," Dr. Stefan Thueroff of Krankenhaus Muenchen Harlaching in Munich, Germany, reported.

Although there is a wide choice of treatment for organ-confined prostate cancer, HIFU is an attractive choice for men willing to choose less invasive options. However, up to now, data on complication rates were sparse since few teams had reported long-term experience.

The analysis of the data compiled over a 10-year period showed that the side-effect profile of the 1078 patients who underwent HIFU as a first treatment option was very similar to that seen with classic transurethral resection of the prostate (TURP).

Regarding the need for TURP after HIFU treatment, Dr. Thueroff and his colleagues noted that 50% of patients who underwent HIFU salvage after radiation had a TURP afterward compared to only 5% of the patients who only had HIFU.

Regarding the occurrence of recto-urethral fistula, the team reported only two instances among the 1078 patients in the primary HIFU group. In contrast, among the 40 patients who underwent multiple treatments before HIFU, there were 5 cases of fistula.

Also, cancer recurrences, which are often reported after external beam radiation and hormonal ablation, were not observed after HIFU.

In conclusion, Dr. Thueroff told the audience not to hesitate to use HIFU as a therapeutic alternative in some prostate cancer populations. "It is an additional option for some patients who can't undergo surgery for several reasons. We now know that HIFU has a high efficacy and a low side effects long-term profile," he said.

© 2006 by Reuters