Medical Breakthroughs: Ultrasound for Prostate Cancer

DISEASE BACKGROUND: The American Cancer Society estimates about 189,000 men in the United States are diagnosed each year with some form of prostate cancer. It is second only to lung cancer as deadly diseases among men.

Prostate cancer is most common among men between ages 60 and 80. The risk factors for this disease include age, race and family history. Prostate cancer is twice as common in blacks as it is in white males.

There are a variety of treatment options for men who are diagnosed with prostate cancer. Some men opt for a radical prostatectomy, which is the removal of the prostate gland by surgery. Another treatment option is hormone therapies or radiation. These options can have some severe side effects. Complete removal of the prostate can cause incontinence or impotence and radiation therapy can cause rectal and bladder damage, impotence and difficult urination.

NEW TREATMENT OPTION: The FDA has approved the beginning of a trial to look at high intensity focused ultrasound (HIFU) to treat prostate cancer. HIFU is a minimally invasive procedure that combines 3-D technology and ultra-focused sound waves. HIFU is 10,000 times stronger than ultrasound. A probe is inserted transrectally and an ultrasound image is displayed. Ultrasound energy is emitted to elevate tissue temperatures 70 degrees to 90 degrees Centigrade (158 degrees to 194 degrees Fahrenheit) in durations of up to four seconds. The heat kills the cancer without damaging tissue surrounding the prostate.

If the cancer returns, HIFU can be done again, unlike radiation treatment. HIFU is an outpatient procedure and can usually be done within three hours. Doctors say the biggest problem with recovery from HIFU is the prostate gland swells right after the treatment is done. This can cause urinating problems for a week or two. However, in terms of pain, patients say they have very little discomfort from this treatment.

Currently, a Phase l clinical trial is being done to investigate the efficiency and safety of using HIFU for prostate cancer. Doctors plan to treat 40 patients including those newly diagnosed with the disease and those who have failed other treatments. The two trial sites are Indiana University and Case Western Reserve University in Cleveland, Ohio.

EUROPEAN STUDIES: While there is not a lot of research yet on HIFU in the United States, results from a large European study look promising. Researchers there have treated about 2,000 patients. So far, they have found HIFU is as effective as radiation therapy, but it's not clear how it compares to surgery.

Also, the side effects have decreased over time because doctors say the devices have continued to improve for this treatment. Another study is now being conducted in Japan. However, like the U.S. study, it is still in a very early stage.

FUTURE STUDIES: Similar technology is in development to treat small kidney tumors. Also, the military is looking at the technology as a way to treat injuries like ruptured spleens directly through the skin.


Mary Hardin
Indiana University School of Medicine
1110 W. Michigan, LO 401
Indianapolis, IN 46202
(317) 274-7722

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