Effectiveness of HIFU
The team headed by professor Guy Vallancien (IMM Paris) recently won an award for the best study(1) for its pioneering research into a ablathermy-based "disease control" approach. From 1997 to 2000, 12 patients received "focal treatment" with HIFU. Ten years on, none of the patients have died from prostate cancer. No significant side effects or metastases have been reported. During the follow-up period, five patients received additional treatment but there was no increase in complications.
(1) Focal therapy with HIFU for prostate cancer in the elderly: A feasibility study with 10 years follow-up, Department of urology, Institut Montsouris, Université Paris Descartes, France ; FTW, Amsterdam 2009
A multicenter study conducted between 1995 and 2000, involving 402 patients at six European sites, revealed that the cancerous tissue disappeared in 87% of patients who received first-line treatment with HIFU. A recently-published scientific paper (2), which also concerns several European centers, confirmed the long-term effectiveness of HIFU (with some patients having nine-year follow-up histories).
(2) First Analysis of the Long-Term Results with Transrectal HIFU in Patients with Localised Prostate Cancer, Andreas Blana et al, European Urology 53 (2008) 1194-1203
Continence and sexual function preservation
98% of patients did not experience any incontinence issues (3) and 87% remained sexually potent when ablathermy was performed in conjunction with a strategy to preserve the erector nerves (4).
(3) The Status of High-Intensity Focused Ultrasound in the Treatment of Localized Prostate Cancer and the Impact of a Combined Resection, C. Chaussy, S. Thüroff, Munich-Harlaching University, Germany, Current Urology Reports, Volume 4, Issue 3, 2003: 248
(4) High-Intensity Focused Ultrasound and Localized Prostate Cancer: Efficacy Results from the European Multicentric Study, S. Thüroff et al, Journal of Endourology, Volume 17, Number 8, October 2003
Effective cancer control
According to an international literature review by Association Française d’Urologie (5) concerning the effectiveness of and tolerance to ablathermy in patients with localized prostate cancer who received first-line treatment with the HIFU device up to 93% (64-93%) of patients satisfied the criteria for being declared cured.
(5) High-intensity focused ultrasound in prostate cancer; a systematic literature review of the French Association of Urology, Xavier Rebillard et al, BJU International 2008 1464-410X.2008.07504.x
Another leading European ablathermy center, the Saint Joseph Caritas hospital in Germany has published a paper entitled Eight Years’ Experience With High-Intensity Focused Ultrasonography for Treatment of Localized Prostate Cancer (6), covering a cohort of 163 patients. After an average follow-up of almost five years, 92.7% of patients had negative check-up biopsies. More than 98% of patients reported no severe incontinence. The ability to have erections depended on the treatment strategy chosen by the patient and his urologist.
(6) Eight Years’ Experience With High-Intensity Focused Ultrasonography for Treatment of Localized Prostate Cancer, Andreas Blana et al, Journal of Urology 2008.06.062
HIFU prostate cancer treatment is efficient for recurrence after radiation therapy
Doctors Albert Gelet and F.J. Murat from the urology department at Edouard Herriot hospital in Lyons pioneered the treatment of cases of localized recurrence following radiotherapy (7). A paper by Doctors Murat and Poissonnier published in European Urology 2008) describes a cohort of 167 patients treated for the aforementioned indication. The results, with 10 years' follow-up, are highly satisfactory: 73% of check-up biopsies were negative and the morbidity rate remained acceptable among a high-risk population offered a new chance of a cure.
(7) Mid-term Results Demonstrate Salvage High-Intensity Focused Ultrasound (HIFU) as an Effective and Acceptably Morbid Salvage Treatment Option for Locally Radiorecurrent Prostate Cancer, François-Joseph Murat et al, 2008 European Urology, doi:10.1016/j.eururo.2008.04.091