HIFU Prostate Cancer Treatment Side Effects

Ablatherm HIFU has fewer significant side effects than other forms of prostate cancer treatment

Ablatherm HIFU is a very safe procedure with no reported mortality and minimal morbidity. Over 30,000 patients have been treated worldwide since the Ablatherm HIFU device received European approval in 2000. HIFU also offers early success determination with nadir PSA after only 3 months.

Better quality of life is maintained with the HIFU procedure and repeat treatments are possible.


WILL I Need Further Tests?

A quarterly measurement of the PSA is recommended for the first two years, and biannual tests are recommended in years three and four.

Thereafter we recommend an annual PSA test. Three to six months after the treatment the PSA should be reduced to 0.5 ug/l.

If the PSA reading does not return to very low levels or rises, a repeat ultrasound and biopsy can be performed. If this biopsy shows residual tumor (approximately 7% of Canadian cases), a second Ablatherm® HIFU session can be conducted. A major advantage of Ablatherm ® HIFU is that it is repeatable and does not preclude future treatment by any other treatment options. A bone scan and CAT scan would also be ordered. If biopsies are negative but the PSA rises, additional therapy may be prescribed.

Urinary System

Narrowing of the urethra where it passes through the prostate can appear in the months following the treatment due to the scar tissue which replaces the treated prostate tissue.

This narrowing can necessitate a simple outpatient treatment called a transurethral urethrotomy to re-establish the normal urethral channel. This is a simple procedure performed by any urologist.


Will I be Incontinent?

In the patients treated with Ablatherm® HIFU approximately 1 in 50 experienced either Type 2 or Type 3 incontinence.

Type 1 incontinence is the leakage of urine with marked straining.

Type 2 is the leakage of urine with mild to moderate straining. Both types of incontinence are manageable with medications and pelvic floor exercises.

Importantly, there are essentially no total, severe incontinence cases (Type 3) reported unless patients have had previous radiation. 


Sexual Activity

When sexual impotence occurs, it is usually responsive to pharmacological treatment (Viagra, Levitra, or Cialis).

There is evidence that the use of these oral medications after treatment will help to enhance healing.

Following a period of 6 to 12 months after treatment, potency will spontaneously be recovered in many cases.

Will I be Impotent?

Forty percent of patients retain normal erectile function after treatment. This compares favorably with patients undergoing radical surgery. In those patients specifically treated with nerve sparing techniques, erectile function is retained in over 80% of cases.

In addition, the majority of patients who suffer erectile dysfunction following treatment by Ablatherm® HIFU will respond to oral medications (Viagra, Levitra, Cialis).

Peer reviewed journal articles now support the use of these oral medications after treatment to enhance healing. Fortunately, many patients regain potency 6 to 12 months after treatment.


Complications

Summary of Ablatherm® HIFU Complications Reported Throughout the World

The chart below describes the complications of using the Ablatherm® HIFU device for treatment as primary care of localized prostate cancer based on experience from around the world:

Death

0%

Digestive complications

0%

Mild to moderate urinary incontinence

8%

Total urinary incontinence

< 1%

Urethral stenosis

8%

Sexual impotence with nerve-sparing procedure

20%

Sexual impotence without nerve-sparing procedure

66%

Digestive System

There have been no digestive system complications reported when Ablatherm® HIFU was used in the initial treatment of T-1 or T-2 cancer of the prostate.

In the cases where Ablatherm® HIFU was used in patients with previous radiation treatment failures, there were some reports of a feeling of mild rectal burning.