High intensity focused ultrasound (HIFU) is a treatment that aims to kill cancer cells with high frequency sound waves. HIFU doesn't pass through solid bone or air, so it's not suitable for every cancer.
What it is
You have this treatment from a machine that gives off high frequency sound waves. These waves deliver a strong beam to a specific part of a cancer. Some cells die when this high intensity ultrasound beam is focused directly onto them.
When HIFU is used
HIFU is only useful to treat a single tumour or part of a large tumour. It can't be used to treat tumours that are more widespread. This means that HIFU is not suitable for people with cancer that has spread to more than one place in their body.
Why you might have it
HIFU is sometimes used to treat the following cancers:
Because the prostate is positioned deep within the pelvis, you have HIFU for prostate cancer by putting an ultrasound probe (transrectal probe) into your back passage. This is done under a general anaesthetic or spinal anaesthetic. From that position, the ultrasound can direct beams more accurately at the prostate.
Research shows that HIFU has fewer side effects such as incontinence and erection problems. It also shows that HIFU may be as successful in treating prostate cancer as treatment with removal of the prostate (radical prostatectomy) or radiotherapy.
However, we also have to be sure that the long term results will be as good as surgery or radiotherapy. The treatment hasn't been around long enough for us to know that yet.
The National Institute for Health and Care Excellence (NICE) has issued guidelines for the treatment of prostate cancer.
Generally HIFU for prostate cancer is given as part of a clinical trial, however sometimes it could be given outside of a trial.
You might be offered HIFU instead of surgery or radiotherapy for localised prostate cancer.
Doctors have used it for cancer that has just been diagnosed, or for cancer that has come back in the prostate after earlier treatment. This is known as salvage treatment.
Your doctors should make sure that you know:
- what is involved in having the treatment
- that we don't know everything about side effects yet
- that we don't fully understand how long term effects of HIFU compare to other treatments
- what other treatment options there are
Doctors must monitor everyone who has HIFU. This is so that we can learn more about side effects and long term benefits.
You sign a consent form to say that all these things have been explained to you before you have treatment.
Reseachers are interested in looking at HIFU for early and advanced kidney cancer.
Researchers have looked HIFU for primary liver cancer (hepatocellular cancer, HCC) and cancer that has spread to the liver (secondary liver cancer).
More research is needed to see if using HIFU for primary liver cancer is better than standard treatments.
Researchers also want to find out if HIFU is helpful in combination with other treatments for primary liver cancer. And to see if HIFU helps control symptoms for advanced disease.
Doctors outside the UK have used HIFU to help pain and other symptoms in people with advanced pancreatic cancer. It is not being used to cure pancreatic cancer.
Surgery is still the first choice of treatment for people with pancreatic cancer that has not spread to other parts of the body.
Outside the UK doctors are interested in treating people with bladder cancer with HIFU. At the moment, if the cancer comes back these doctors use surgery as standard treatment.
Side effects of HIFU
People who have been treated with HIFU so far have had very few side effects.
It may cause some discomfort or pain for 3 to 4 days afterwards. It may also cause soreness in the skin or back passage depending on the area being treated, but this is mild and doesn't last long. It's unusual for the soreness to be ongoing or severe.
Doctors are interested in researching HIFU for people with different cancer types.