High intensity focused ultrasound (HIFU)
This page has information about a type of cancer treatment called High Intensity Focused Ultrasound (HIFU). There is information about
What high intensity focused ultrasound is
High frequency intensity focused ultrasound (HIFU) uses high frequency sound waves. Focusing these waves on a cancer can kill some of the cells. HIFU is currently used as a treatment for some types of cancer in certain situations. Research is looking into how well it works, how best to use it as a treatment, and which other cancers it can treat.
Which cancers it can treat
Researchers have been looking at using HIFU for prostate cancer, kidney cancer, primary and secondary liver cancer, pancreatic cancer and bladder cancer. It is only used to treat single tumours or part of a large tumour. It can't be used to treat tumours that are more widespread. Early results have been promising but we need long term results to see how well HIFU works compared to other treatments. We also need to find out more about the side effects.
How you have HIFU
How you have treatment depends on where the cancer is in the body. The doctor puts the probe that gives off the high frequency sound waves through the skin and next to the tumour. They turn the machine on to deliver the high frequency sound waves to the cancer.
Possible side effects
People who have had HIFU treatment have had very few side effects. It may cause some pain for 3 to 4 days afterwards. And it may cause sore skin in the area treated, but this is not common. Your treatment team will discuss the possible side effects with you.
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High intensity focused ultrasound or HIFU is a type of cancer treatment. Doctors give the treatment using 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.
One advantage of this type of treatment is that because it only uses sound waves to kill the cancer cells, it doesn’t have as many side effects as other types of cancer treatments already in use.
HIFU is currently used as a treatment for some types of cancer in certain situations.
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.
HIFU doesn’t pass through either solid bone or air. This means that it is not suitable to treat every type of cancer.
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 (rectum). This can be done under a general anaesthetic or spinal anaesthetic. From that position, the ultrasound can direct beams more accurately at the prostate.
Results from trials so far show that HIFU has fewer side effects such as incontinence and erection problems. These studies have also shown that HIFU may be as successful in treating prostate cancer as treatment with 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) have issued guidelines for the treatment of prostate cancer. Generally HIFU for prostate cancer is given as part of a clinical trial, however in some circumstances it may be given outside of a trial. NICE have guidelines about this.
You could 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 (salvage treatment).
If you have HIFU for prostate cancer, your doctors need to make sure 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 also monitor all the patients who have HIFU so that we can learn more about side effects and long term benefits or drawbacks. You will sign a consent form to say that all these things have been explained to you before you have the treatment.
There is a trial called INDEX-LITE which is looking at using HIFU for prostate cancer in men whose cancer hasn't spread. Another trial is looking at comparing HIFU with surgery for men with prostate cancer. These trials and others can be found on our clinical trials database.
There have been trials in the UK using HIFU for renal cell (kidney) cancer. In one trial patients had HIFU and a week or two later they had an operation to remove their cancer. The doctors looked at the cancer cells they removed to see what effect the HIFU had. The other trial was for patients with more advanced cancer that could not be removed with an operation. The aim of these trials was to find out how well HIFU works for kidney cancer, and what the side effects are. The results have not yet been made available.
Primary and secondary liver cancer
HIFU has been looked at in trials for both primary liver cancer (hepatocellular cancer, HCC) and cancer that has spread to the liver (secondary liver cancer).
Studies, mainly in China, have looked at treating small HCC's with promising results. But more research is needed, particularly randomised trials 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.
HIFU also appears to be helpful for some secondary liver cancers. But researchers in the UK and other countries continue to look into this.
Doctors in China have used HIFU to help relieve pain and other symptoms in people with advanced pancreatic cancer. It is not being used to cure pancreatic cancer. Both in the UK and China, surgery is still the first choice of treatment for people with pancreatic cancer that has not spread to other parts of the body. If you are not fit enough to have surgery to cure your cancer, then HIFU treatment would not cure your cancer either.
Doctors in China have used HIFU to treat people with bladder cancer. But if the cancer comes back in the bladder then doctors in China use surgery as the standard treatment with regular follow up.
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. And it may cause soreness in the skin or back passage depending on the area being treated, but this is mild and doesn't last long. It is unusual for the soreness to be ongoing or severe.
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