High-intensity focused ultrasound, or HIFU, is a treatment that uses concentrated ultrasound energy to heat and destroy targeted prostate tissue. Unlike prostate surgery, HIFU does not involve removing the prostate.

HIFU may be an option for some men with localized prostate cancer, but it is not appropriate for every diagnosis. If you are researching HIFU treatment in Chicago, it is important to understand how it works and how it compares with other prostate cancer treatments.

How Does HIFU Treat Prostate Cancer?

HIFU uses focused ultrasound energy to heat a defined area of prostate tissue. The heat destroys the targeted tissue without requiring a surgical incision.

During treatment, a probe is placed in the rectum. Imaging helps the physician identify the area of the prostate being treated and direct the ultrasound energy to the intended tissue.

HIFU may be used to treat a specific portion of the prostate or a larger area. Focal HIFU, also called focal ablation, targets the area where clinically significant cancer has been identified rather than treating the entire prostate.

This makes accurate imaging and biopsy results especially important. Your doctor needs to understand where the cancer is located and how much of the prostate may be involved before deciding whether focal therapy may be appropriate.

Who May Be a Candidate for HIFU?

Patient selection is an important part of considering HIFU. A prostate cancer specialist will look at your individual diagnosis rather than relying on any single test result.

Factors may include:

• Your PSA level
• Your Gleason score and grade Group
• Where the cancer is located
• How much cancer was found on biopsy
• MRI findings
• The size and anatomy of your prostate
• Previous prostate cancer treatments
• Your age and overall health

Current AUA/ASTRO guidance notes that for patients with intermediate-risk prostate cancer considering whole-gland or focal ablation, there is a lack of high-quality data comparing ablation outcomes with radiation therapy, surgery, and active surveillance. Patients considering HIFU should understand that uncertainty before making a decision.

The same guidance advises against focal or whole-gland ablation for men with high-risk prostate cancer outside a clinical trial.

What Happens During HIFU Treatment?

HIFU is commonly performed as an outpatient procedure under anesthesia.

During the treatment session, the physician uses a probe to deliver focused ultrasound energy to the prostate. Imaging helps guide treatment and allows the physician to target the planned area.

The length of a HIFU session can vary. It depends on factors such as the technology being used and how much prostate tissue needs to be treated. Some patients are able to return home the same day.

HIFU should not be thought of as a guaranteed one-time treatment. Some men may eventually need additional HIFU or another prostate cancer treatment if cancer remains or returns.

Recovery and Follow-Up After HIFU

Finishing HIFU treatment is not the end of prostate cancer care. Continued monitoring is an important part of follow-up.

Your healthcare team may use several methods to look for signs of remaining or recurring cancer.

Ask your doctor what your individual follow-up schedule will include and how treatment success will be evaluated. If testing finds persistent or recurrent prostate cancer, your healthcare team can discuss whether additional treatment is needed.

Benefits and Possible Side Effects of HIFU

One reason some patients consider focal HIFU is its ability to treat selected prostate tissue while limiting treatment of surrounding areas.

For appropriately selected men, that may offer an alternative to removing or treating the entire prostate. However, HIFU still carries potential risks and side effects.

These can include:

• Urinary symptoms or difficulty urinating
• Urinary retention
• Urinary incontinence
• Erectile dysfunction
• Infection
• Narrowing of the urethra or bladder neck
• Rare complications involving the rectum

Your experience may depend on where the cancer is located, how much tissue is treated, your overall health, and your urinary and sexual function before treatment.

Ask your physician about both short-term recovery and longer-term outcomes based on your individual diagnosis.

HIFU Compared with Other Prostate Cancer Treatments

HIFU is one of several approaches you may hear about after a prostate cancer diagnosis. Depending on your diagnosis, your options may include:

• active surveillance: Closely monitors certain prostate cancers without beginning treatment right away.
• Surgery: Removes the prostate and surrounding tissue as needed.
• external beam radiation: Uses radiation delivered from outside the body to target prostate cancer cells.
• brachytherapy: Places a radiation source inside or near the prostate to treat the cancer.

If you are unsure which approach is right for you, consider getting a second opinion before making your decision.

Does Insurance Cover HIFU for Prostate Cancer?

Insurance coverage for HIFU can vary based on your health plan, provider, procedure, and individual circumstances.

Before scheduling treatment, contact your insurance company and treatment center. Ask whether prior authorization is required and what portion of the treatment may be your responsibility.

Your provider may also be able to give you an estimate of expected out-of-pocket costs before your treatment session.

Questions to Ask Before Choosing HIFU

You may want to bring these questions to your next appointment:

• Is HIFU appropriate for my prostate cancer risk level?
• Would you recommend focal or whole-gland treatment?
• Why are you recommending HIFU rather than active surveillance, surgery, or radiation?
• What side effects are most likely for me?
• How could treatment affect urinary and sexual function?
• How will we know whether treatment worked?
• Will I need another MRI or biopsy?
• What options would I have if my cancer returns?

PCFC Can Help You Understand Your Options

Choosing a prostate cancer treatment can feel like a lot to take in, especially when you have only recently been diagnosed. You do not have to sort through every question by yourself.

PCFC provides education, local resources, and support for prostate cancer patients and their families throughout the Chicago area.

Our free monthly support group meets at Wellness House in Hinsdale. Patients, survivors, spouses, partners, and family members are welcome. PCFC also supports prostate cancer programs at Wellness House and sponsors a Wellness House staff member who leads prostate cancer outreach activities.

If you have questions about treatment options or simply want to talk with people who understand what you are going through, contact PCFC or join us at an upcoming meeting.

Frequently Asked Questions About HIFU

Is HIFU FDA approved for prostate cancer?

There is an important distinction. The FDA has authorized HIFU systems for prostate tissue ablation in the United States since 2015. This authorization allows the devices to destroy targeted prostate tissue. It is not a disease-specific FDA indication for the treatment of prostate cancer.

Can HIFU cure prostate cancer?

Cancer-control outcomes depend on the individual cancer and patient. Long-term comparative evidence for HIFU and other prostate ablation techniques is less established than the evidence available for treatments such as surgery and radiation. Ask your physician what is known about outcomes for patients with a diagnosis similar to yours.

Can prostate cancer return after HIFU?

Yes. Cancer may remain after treatment or develop again later. This is why continued PSA testing, imaging, and sometimes repeat biopsy are important after HIFU.

Can HIFU be repeated?

Repeat HIFU may be possible for some patients. In other situations, a doctor may recommend a different treatment if cancer remains or returns. Your options will depend on your individual circumstances.

How long does HIFU treatment take?

Treatment time varies based on the HIFU system being used and the amount of prostate tissue being treated. Your treatment center can tell you what to expect before your procedure.