High- Intensity Focused Ultrasound as a Salvage Therapy for Patients with Recurrent Prostate Cancer
Men who have tried External Beam Radiation Therapy (EBRT) or Interstitial Brachytherapy for clinically localized prostate cancer possess a 20-30% greater probability of having prostate-specific antigen (PSA) failure. Salvage therapy is indicated when men are treated with radiotherapy, brachytherapy, or a combination of these for presumed localized prostate cancer and have a recurrence. The success rates after salvage procedures are considerably less than those that have been reported after more fundamental treatments. The results of the use of HIFU as a salvage therapy for patients with recurrent prostate cancer have been good, with negative biopsy rates as elevated as 80% and 61% achieving a PSA nadir of <0.5 µg/L (n = 71); 44% were reported as freed from biochemical relapse at the follow up exam, at an average follow-up of 14.8 (6-86) months.
To analyze the usage of high-intensity focused ultrasound (HIFU) as a salvage therapy in patients with a recurrence of localized prostate cancer after external beam radiation (EBRT), brachytherapy, or proton therapy, the charts of all patients who had undergone salvage HIFU for biopsy-proven prostate cancer after primary radiation therapy, were reviewed retrospectively. Patient characteristics and oncological effects were assessed
Records of 22 patients with a median (range) follow-up of 24 (5-80) months were reviewed. Patients were men with presumed organ-confined disease who were treated with salvage HIFU following recurrent disease after EBRT (fourteen patients), brachytherapy (five patients: four with high-dose brachytherapy using In (192); and one with low-dose brachytherapy applying Au (98)) or proton therapy (three patients). The median (range) age at salvage HIFU was 65 (52-80) years, with a median (range) prostate-specific antigen (PSA) level before radiation therapy of 14.3 (5.7-118) ng/mL and an average (range) PSA level of 4.0 (1.2-30.1) ng/mL before HIFU. The median (range) period to HIFU after radiation therapy was 36 (4-96) months. The biochemical disease-free survival (bDFS) rate in all patients at 5 years was 52%. Rates of bDFS in low-, intermediate- and high-risk groups were 100%, 86%, and 14%, respectively. One among the twelve patients who received post-HIFU prostate biopsy showed malignancy. Side effects included urethral stricture in four patients, grade I urinary incontinence in four patients, rectourethral fistula and epididymitis in one of each patient.
This preliminary data recommend that high intensity focused ultrasound represents a legitimate alternative treatment strategy for patients with localized prostate cancer. Salvage HIFU is often a promising treatment option for local recurrence after radiation therapy, with morbidity comparable with other types of salvage treatment. A careful choice by the patient is imperative depending upon the aforementioned prognostic factors.
Questions and Answers
HIFU (high-intensity focused ultrasound) uses high-energy sound waves to destroy prostate cancer cells without radiation. Intersecting, precision-focused ultrasound waves raise the temperature in the targeted cancerous tissue to more than 80–90 degrees Celsius in seconds, effectively destroying the tissue.
Prostate cancer is cancer that starts in the prostate gland. The prostate is a small, walnut-sized structure which wraps around the urethra making up the part of a man's reproductive system which produces a fluid that makes up part of semen. Generally, a tumor grows slowly and remains confined to the gland for many years. During this time, the tumor produces little to no symptoms or outward signs. Some aggressive types of prostate cancer grow and spread more rapidly than others and can cause a s
HIFU is an acoustic ablation technology that harnesses the power of ultrasound waves to destroy deep-seated tissue in areas of the body that are hard to reach with traditional treatments. When used to treat prostate cancer, it is a highly effective treatment option that is able to target and destroy the prostate gland's cancerous tissue with pinpoint accuracy. HIFU can be used as a prostate cancer salvage technique when other non-repeatable treatments fail.
Cancer translational research brings together scientists' and clinicians' suggestions to develop solutions to biomedical complications. This kind of applied research strives to offer strategies to questions surrounding the etiology, pathology, diagnosis, prevention and treating cancer.
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Through the evolution of modern medicine, medical physicians have now come up with a new prostate cancer treatment known in many circles as HIFU, which stands for high intensity focused ultrasound. This new technology assists men suffering from prostate cancer by getting rid of all cancer infected tissue in the prostate region using an advanced acoustic ablation method that utilizes the powers of an ultrasound.
The Sonblate 500 is a minimal invasive treatment technique using a transrectal probe to ensure focus of ultrasound waves on the prostate, to a targeted and precise location. It raises the temperature, causes the tissue to break down, treating the entire prostate. HIFU using the Sonablate 500 takes at most four hours a
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