HIFU - Prostate Treatment in India

HIFU Procedure (High-Intensity Focused Ultrasound Therapy)

The HIFU procedure (High-Intensity Focused Ultrasound Therapy) is the most modern technology for prostate carcinoma treatment. Using focused ultrasound energy only cancerous tissue is destroyed with no incident of injury to the surrounding tissue.

The ultrasound is focused (focal point), the sudden and intense absorption of the ultrasound beam quickly raises the temperature up to 70-100° for less than a second. The area destroyed by each beam is very small and precise.

HIFU – technique allows physicians to treat and monitor treatment at the same time. They aim the prostate tumor and destroy it with a beam of High-Intensity Ultra sound energy without damaging the surrounding tissue. HIFU energy targets tissue in the prostate in the same way that sunlight focuses by a magnifying glass. When a magnifying glass is held above a leaf, the sun’s rays intersect beyond the lens and cause the leaf to burn at the point of intersection.


The recovery time after a HIFU treatment is considerably shorter than in other types of treatment as radical prostatectomy. Most often patient are back to their normal daily activities immediately after the procedure that lasts 2-3 hours.

For the first time HIFU allows only the affected area to be treated without damaging the surrounding tissue, nerves, vessels and organs. In cases of a more complex condition of the patient the bloodless and minimum invasive therapy can be combined successfully with the GreenLight technology.

Advantages of HIFU Treatment :-

 • No blood loss

 • Quick recovery

 • Non surgical

 • Radiation free

 • An outpatient procedure

This is most modern technique ideal for treatment of low grade prostate cancer. It involves no surgery, no radiation , good cancer control, minimal morbidity. HIFU helps to improve the quality of life after Treatment and there are some more advantages like early return of erections and good urinary control.

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HIFU is a great advancement over other prostate cancer treatment options

HIFU treatment uses high frequency ultrasound energy to heat and destroy cancer cells in your prostate gland. When high frequency sound waves are concentrated on body tissues, those tissues heat up and die. To use this as a cancer treatment, the specialist targets the area containing the cancer.

HIFU is a great advancement over other prostate cancer treatment options as this technique involves heating only the tumours with a highly focused ultrasound, will mean men can be treated without an overnight stay in hospital and avoiding the distressing side effects associated with current therapies.

If you have an enlarged prostate and your urologist (a doctor who specialises in identifying and treating conditions that affect the urinary system) recommends you for HIFU, you may be offered another type of treatment beforehand to shrink the gland. For example, you may be given hormone therapy, or a procedure called transurethral resection of the prostate.

What are the Alternatives to HIFU ?
The type of treatment you have for prostate cancer depends on whether the cancer has spread, and if so, how much. If you’re invited to take part in a clinical trial for HIFU, your surgeon will make sure you’re aware of the other treatment options that are available.

Alternative treatments for prostate cancer include the following : - 
• Watchful waiting – This involves monitoring the cancer, but not treating it unless it grows.
• Surgery – Your prostate may be removed using either open or keyhole surgery.
• Radiotherapy – This is where radiation is used to destroy cancer cells.
• Brachytherapy – This involves having small, radioactive seeds put into your prostate. There is also high-dose rate brachytherapy, in which radiation is put into your prostate for a few minutes at a time.
• Cryotherapy – Liquid gas is used to freeze and kill the cancer cells (but is only offered as part of a clinical trial).
Chemotherapy, which uses medicines to destroy cancer cells, and hormone therapy can be used to treat more advanced forms of prostate cancer.

Preparing for HIFU

Your surgeon will explain how to prepare for the procedure.
HIFU is usually done as a day-case procedure under general anaesthesia. This means you will be asleep during the procedure. If you’re having a general anaesthetic, you will be asked to follow fasting instructions. This means not eating or drinking, typically for about six hours beforehand. However, it’s important to follow your surgeon’s advice.

Your surgeon will discuss with you what will happen before, during and after your procedure, and any pain you might have. This is your opportunity to understand what will happen, and you can help yourself by preparing questions to ask about the risks, benefits and any alternatives to the procedure. This will help you to be informed, so you can give your consent for the procedure to go ahead, which you may be asked to do by signing a consent form.

What Happens During HIFU?
HIFU takes up to three hours, but this depends on the size of your prostate and how much of it is being treated. Your surgeon will pass a lubricated probe into your rectum. The probe gives out a beam of ultrasound, which your surgeon will focus so that it heats and destroys the area of prostate tissue where there is cancer. The probe will have a cooling balloon around it to protect nearby areas from the high temperature
.
Recovering from HIFU: -
If you’ve been prescribed antibiotics, it’s important to complete the full course. If you need pain relief, you can take over-the-counter painkillers such as paracetamol or ibuprofen.

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There is No Evidence of side effects of HIFU – Fibroid and Prostate Treatment

HIFU is a new type of cancer treatment using a machine that gives off high frequency sound waves, which 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, without harming surrounding structures.

It is commercially available only for a few applications, namely uterine fibroid treatment (the sole FDA approved device) and prostate treatment. A lot of work is currently done for developing this technique to treat other organs, especially the liver.

Small tumours can generally be destroyed in one session, but large tumours may require more than one session. There are advantages in some cases to combine HIFU with other medical treatments. It is normal to follow up the HIFU treatment with one or more MRI scans to confirm the destruction of the tumour.There is no evidence of side effects of diagnostic ultrasound. With HIFU there have been occasions when the skin has been affected by the equivalent of a mild sunburn, which clears up in a matter of days.

HIFU treatment can stimulate the immune system. In some treated patients, tumours that were not directly targeted have become smaller, and even disappeared. There is also evidence from Europe, where HIFU is being used to treat prostate cancer, of a similar immune response.
To be treatable with HIFU a tumour must be "lumpy" and in a position where it is visible using imaging ultrasound. There must be a clear path for the HIFU through to the tumour. Cancers near the surface of the skin are not treated, owing to the danger of skin damage. A decision on whether or not a tumour is treatable will be made before treatment commences.

HIFU, which is short for High Intensity Focused Ultrasound, is a state-of-the-art technology acoustic ablation technique that utilizes the power of ultrasound to destroy deep-seated tissue with pinpoint accuracy for treatment of prostate cancer. HIFU focuses sound waves in a targeted area which rapidly increases the temperature in the focal zone causing tissue destruction.

 In most cases, HIFU is a 1-4 hour, one-time procedure performed on an out-patient basis under spinal anesthesia. Unlike radiation, HIFU is non-ionizing; this means that HIFU may also be used as a salvage technique if other prostate cancer treatments fail.

 HIFU is an outpatient procedure general performed under local or general anesthesia that is completely radiation free. Because HIFU is non surgical, there is no incisions or blood loss and recovery is quick. HIFU therapy can be repeated, if necessary. It can also be used as a salvage therapy if other prostate cancer treatment options fail. Because it uses clean, ultrasound energy it doesn't cause harm to any tissue surrounding the targeted focal point.

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HIFU Ultrasound Hope for Prostate Cancer Patients without affecting sex life

Soundwaves could help 95% of prostate cancer patients … without affecting sex life,”  Its story comes from a small study that looked at an experimental treatment using high-intensity focusedultrasound (HIFU) to target areas of prostate cancer in men where the disease had not spread.

Standard treatments for prostate cancer often lead to undesirable side effects, in particular erectile dysfunction and urinary incontinence. Researchers found that a year after this experimental treatment, 89% of men still had erectile function and all were still continent. Ninety-five per cent of the men showed no evidence of disease on an MRI scan.

The results of this small study look promising. Men with early (localised) prostate cancer that has not spread can often live for years without developing life-threatening symptoms, and are often faced with a difficult decision about whether or not to have conventional treatment, which can have side effects. A treatment that can target areas of cancer without damaging healthy tissue might enable more men to have treatment for prostate cancer at an early stage.

However, it’s important to point out that this is an early “proof of concept” study and that a far larger trial is required to assess both its effectiveness and safety.This was an early (prospective development) study looking at a new treatment for localised prostate cancer called high-intensity focused ultrasound (HIFU).

HIFU Ultrasound

Prostate cancer is the most common cancer in men, yet, as the authors point out, treating localised prostate cancer is difficult since the disease often progresses slowly and may not cause any symptoms for many years. There are several standard treatments for localised prostate cancer. Some involve treating the whole prostate with radiotherapy or removing it with surgery, and these can damage surrounding healthy tissue. The more destructive treatments of the whole prostate gland lead to undesirable side effects, in particular, erection problems (affecting 30-70% of men treated) and urinary incontinence (affecting 5-20%). One alternative for men at present is to have no active treatment but to undergo regular checks. This is known as active surveillance.

The new treatment, say the authors, is less aggressive and able to target the cancer site rather than the whole organ. In this respect, it is similar to treatment for other malignancies, such as localised breast cancer (where a lumpectomy is now an alternative to mastectomy). They say that in a previous study they had used HIFU to destroy one half of the prostate where the cancer was situated. But they point out that only one in five men have disease in one half of the prostate only. Their new study looked at whether HIFU could be used for treating cancer at specific sites within the prostate.

Advantages of HIFU Treatment :-

 • No blood loss

 • Quick recovery

 • Non surgical

 • Radiation free

 • An outpatient procedure

This is most modern technique ideal for treatment of low grade prostate cancer. It involves no surgery, no radiation , good cancer control, minimal morbidity. HIFU helps to improve the quality of life after Treatment and there are some more advantages like early return of erections and good urinary control.

For more information visit:          http://www.medworldindia.com        
                    https://www.facebook.com/medworld.india

Please scan and email your medical reports  to us at care@medworldindia.com and we shall get you a Free Medical Opinion from India’s Best Doctors.

Call Us : +91-9811058159

Mail Us : care@medworldindia.com

HIFU - Non-Surgical treatment of Uterine Fibroids

What are fibroids?

Uterine fibroids or myomas are the most common tumours to affect women, and are present in up to 40% of women in the reproductive age group. Not all of these women are symptomatic, and they usually do not require any treatment for these fibroids. Occasionally, the fibroids can cause pain, heavy menstrual as well as inter-menstrual bleeding, and pressure effects such as frequency of urination due to the size of the fibroid. In a small number of cases, fibroids can be a cause of infertility.

Fibroids are traditionally known to grow very slowly throughout the reproductive life of a woman, and they exhibit a growth spurt during pregnancy. After menopause, a fibroid typically begins regressing in size, and at this stage, fibroids rarely need to be treated.

Attempts at symptomatic relief through medications have largely been unsuccessful, leaving the patient suffering from fibroids no option other than surgery.

The mainstay of treatment of symptomatic fibroids has been surgery, which could be either myomectomy (removal of the fibroid), or hysterectomy (removal of the uterus). Of these, only hysterectomy ensures that the patient will never suffer from fibroids again, but is a rather radical option for a benign tumour that only requires symptomatic relief. Also, a hysterectomy is followed by a lengthy recovery period before the patient returns to normal activities. Both hysterectomy as well as myomectomy can also be done laparoscopically (key-hole surgery), dramatically reducing the post- operative morbidity. However, even these are invasive techniques, and the risks and possible complications of surgery and anesthesia remain a constant threat.

The search for non-invasive techniques to provide the patient with relief from this otherwise non- threatening illness led to other minimally invasive options like Uterine Artery Embolisation, and Radio- Frequency Ablation which however had limited efficacy, and considerable adverse effects like excruciating post-treatment pain.

How can Fibroids be treated in a non invasivemanner? [without surgery]

MRI guided HIFU or Magnetic Resonance Imaging- guided High Intensity Focused Ultrasound is an innovative mode for genuinely non-invasive treatment of fibroids. Under MRI guidance, sound waves are passed into the body and focused into the fibroid to heat and coagulate the tissues.

As fibroids are almost always benign, with a neglible percentage (0.07% of operated patients - Parker W, Berek J, Fu YS., Obstetrics and Gynecology 1994; 83:414-8) showing the presence of a sarcoma (malignancy),fibroids only require treatment for the alleviation of symptoms due to the fibroid.

How MRI does guided HIFU work?

The MRI acquires high resolution 3-D images of the fibroid and surrounding structures. These images are used for accurate planning and mapping of the treatment. During treatment, the HIFU transducer focuses the ultrasound beam into the fibroid as per the planned areas (cells) and heats the tissue up to 65 degree Celsius, coagulating it. This is called sonication.

Sonalleve MRI guided HIFU ensures patient safety by having a number of safety mechanisms built into the system. All of these ensure that apart from the tissue being targeted, no other organ or tissue is affected by the treatment.

During treatment, the MRI plays an important role by monitoring temperatures within the treatment areas as well as in the surrounding tissues. The recorded temperatures are then superimposed in the form of colour coded maps on the 3-D images that are being used for the treatment monitoring.

The real-time feedback loop ensures that adequate heating takes place, treating every bit of tissue that has been targeted and volumetric ablation (a Philips proprietary technology) helps treat larger volumes efficiently and quickly.

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