High intensity focused ultrasound (HIFU)

High intensity focused ultrasound (HIFU) is a treatment that uses high frequency sound waves. The sound waves create heat that destroys the cancer cells.

You might have HIFU as treatment for prostate cancer or part of a clinical trial Open a glossary item for prostate cancer. Researchers are also looking at HIFU for some other types of cancer.

Doctors also use HIFU to treat some non cancerous conditions such as fibroids Open a glossary item . These are benign growths in the womb .

It is only available in specific centres in the UK or as part of a clinical trial.

What is high intensity focused ultrasound (HIFU)?

HIFU is a cancer treatment that uses high frequency sound waves. You have HIFU from a machine. The machine gives off the sound waves which deliver a strong beam to a specific part of a cancer. This heats and destroys the cancer cells.

Who can have HIFU?

HIFU can treat a single tumour or part of a large tumour.

Researchers are looking at HIFU as a treatment for different cancer types. Most of the research so far has been for prostate cancer. But you might also have it as part of a clinical trial for:

rectal cancer
cervical cancer
vaginal cancer
womb cancer
soft tissue sarcoma
pancreatic cancer
breast cancer

Researchers around the world have also looked at HIFU as a treatment for other cancers including kidney cancer and liver cancer.

There are also clinical trials to find out if HIFU helps people with advanced cancer. Researchers want to find out if it helps with symptoms such as pain.

You can have HIFU again if your cancer grows back. Or your doctor might suggest another treatment.

HIFU for prostate cancer

The National Institute for Health and Care Excellence (NICE) is an independent organisation. It provides guidance to the NHS and develops recommendations about treatment. NICE recommends HIFU for prostate cancer only in specific centres or as part of clinical trials.

You might have HIFU treatment to either:

the whole prostate gland - this is whole prostate HIFU
specific areas of the prostate gland - this is focal HIFU

Your doctor might recommend HIFU if your cancer:

is contained inside the prostate gland - this is localised prostate cancer
is just breaking through the covering of the prostate - this is locally advanced prostate cancer
has come back after earlier treatment - this is salvage treatment

You can’t have HIFU if your cancer has spread to other parts of your body. This is metastatic or advanced prostate cancer.

HIFU for non cancerous conditions

Doctors can also use HIFU to treat:

non cancerous growths in the womb (uterine fibroids)
non cancerous growths on the breast (fibroadenomas)

How you have HIFU

There are different ways to have HIFU. How you have it depends on where the cancer is in your body.

You might have HIFU through your:

back passage (rectum) to treat cancers in your pelvis
skin to treat cancers in your tummy (abdomen)

Your doctor or specialist nurse will talk to you beforehand. They will explain what it involves and any side effects you might have. This depends on the area of your body that you're having treatment to.

Before you have HIFU

Check your appointment letter for any specific ways to prepare for HIFU.

You have HIFU treatment at the hospital as an outpatient. This means you can usually leave on the same day that you have HIFU. Your doctor asks you to sign a consent form to say that you agree to have the treatment. This is a good time to ask all the questions that you have.

For prostate cancer, you have HIFU in the operating theatre. For other types of cancer, you usually have the treatment in the radiology department.

You might have an MRI scan Open a glossary item before treatment. This is to find the exact position of the cancer.

If you have HIFU through the rectum, on the morning of the treatment, you usually have an enema Open a glossary item to empty your bowels. Or you take a laxative drink.

You usually have a general anaesthetic Open a glossary item , which means you are asleep during the treatment. Or for some cancers or conditions you might have a spinal anaesthetic (epidural) or sedation which makes you sleepy.

Having HIFU through your back passage (rectum)

You have HIFU through your back passage (rectum) to treat cancers in your pelvis. These include prostate cancer, rectal cancer, vaginal cancer, cervical cancer or womb cancer.

The doctor puts the ultrasound probe into your rectum. This probe gives out high intensity ultrasound that can destroy the cancer cells. The high intensity ultrasound travels through the back passage to the cancer.

Your surgeon usually puts a thin tube into your bladder through your urethra Open a glossary item . The tube drains your urine. It is called a urinary catheter. You might have a catheter for up to a week to drain urine. If you go home with a catheter your nurse will teach you how to care for it. They will arrange for someone to remove it.

Having HIFU through your skin (extracorporeal HIFU)

You might have HIFU through your skin. Doctors also call this extracorporeal HIFU. The doctor doesn’t need to cut your skin. The HIFU machine remains outside your body and the high intensity ultrasound travels through your skin to the cancer.

You have this type of HIFU to treat cancers in your tummy (abdomen). These include kidney cancers, liver cancers, pancreatic cancers or sarcomas. You can also have this to treat non cancerous growths (fibroids) in your womb.

You have treatment on a special HIFU table. There is usually a water bath within the table. There is a disc at the bottom of the water bath. This disc sends out the focused ultrasound waves. Ultrasound waves don't travel well through air so doctors use water. This also helps reduce side effects to the skin.

You lie on the table. The position you lie in depends on which part of your body is being treated. You might lie on your back, your front or your side. The body part being treated goes into the water in the bath. For example, to treat fibroids in your womb, you lie on your front. Your pelvis and lower abdomen go into the water bath.

The disc sends out the focused ultrasound waves. These travel through the water and go through your skin to treat the cancer or fibroids.

Side effects of HIFU

The possible side effects depend on the area of your body that you're having treatment to.

Before you agree to treatment your doctor will talk to you about the possible risks.

If you are having HIFU as part of a clinical trial, the doctors might not know about all the side effects.

Side effects of HIFU treatment through your back passage (rectum)

The most serious side effect might be a hole in your rectum. This is because the HIFU treatment could damage the wall of your rectum.

Side effects of HIFU for prostate cancer include:

blood in your pee
pain or discomfort
erection problems
urine infection
problems passing urine, you may want to go to the toilet urgently, have some discomfort and wake up at night to have a pee
pain - you might have pain between your testicles and rectum

Side effects of HIFU through your skin

HIFU through the skin can cause a burn to the skin in the treatment area. You might also have some mild pain or discomfort in the treatment area. There is also a risk of damage to nearby organs, such as the bowel or bladder, if they are close to the treatment area.