High intensity focused ultrasound (HIFU)

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.

Doctors have been interested in this type of treatment for nearly 50 years. But it is only in recent years that they have been seriously investigating its use in treating different types of cancer. 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.

Doctors hope to use HIFU to kill cancer cells without damaging healthy cells. Chinese researchers were the first to lead the way using this treatment. They have done trials treating nearly 5,000 people with many different types of cancers. Researchers in Europe are now doing trials to find out if HIFU could be used for people unable to have surgery to remove their cancer. But they are not sure yet how well this will work.

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 not currently considered a standard treatment. It is available in the UK as part of clinical trials for some types of cancer.

HIFU is used to treat

• Prostate cancer
• Kidney cancer
• Primary and secondary liver cancer
• Pancreatic cancer
• Bladder cancer

HIFU is not a suitable treatment for

• Brain tumours
• Lung cancer
• Cancers in the pelvic area
• Cancer that has spread to the lymph nodes
• Skin cancers
• Head and neck cancers

Prostate cancer

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). From that position, the ultrasound can direct beams more accurately at the prostate. Results from trials so far show that HIFU may be as successful in treating prostate cancer as treatment with radical prostatectomy or radiotherapy. But 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 Clinical Excellence (NICE) have issued guidelines for the treatment of prostate cancer. The guidelines say that HIFU should only be used as part of a clinical trial. 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). You can download the guidelines from the NICE website (opens PDF in new window).  

If you are invited to go on a trial of 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 information about UK prostate cancer trials on our clinical trials database. Select 'prostate' from the dropdown menu of cancer types.

Kidney cancer

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

There have also been trials in the UK using HIFU to see how it affects liver cancer cells. One trial was for cancer that started in the liver (primary liver cancer). Another was for cancer that had spread to the liver from a cancer in another part of the body (secondary liver cancer).

In the first trial, patients had HIFU and a week or two later had an operation to remove their cancer. The researchers will be looking at the cancer to see what effect the HIFU had. In the other trial, patients with cancer that spread to the liver and couldn't be removed with an operation had HIFU treatment. This trial is to see how well HIFU works for secondary liver cancer, and to find out more about the side effects. The results of these trials have not yet been made available.

Pancreatic cancer

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.

Bladder cancer

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 pain for 3 to 4 days afterwards. And it may cause sore skin in the area treated, but this is unusual.

To find out if there are HIFU trials currently recruiting in the UK, you can visit our clinical trials database. Type 'HIFU' into the free text search box on the clinical trials page.