HIFU: Local Treatment of Prostate Cancer

ObjectiveTreatment of carcinoma of the prostate (CaP) begs some complex questions. Different disease stages call for different treatment modalities and no universally ‘gold standard’ treatment has yet been agreed upon. In the present work we will present the results, indications and limitations of HIFU in the treatment of CaP.MethodsRelevant information on HIFU treatment was identified through a literature search of published studies and review articles.ResultsHIFU can be considered for patients with (recurrent) localized CaP and a prostate volume of 40 cc or failure after radiotherapy. Treatment outcome is evaluated with PSA measurements and prostate biopsies. Mid-term follow up (2–5 years) reveals a PSA of 0.15 ng/ml and in 85% of cases the PSA level remains at the post HIFU nadir. The negative control biopsies are found in 90% of patients. A combination with a TURP reduces the treatment related morbidity.ConclusionsHIFU has proven mid-term high local and biochemical efficacy in patients with local confined prostate cancer. A HIFU also shows promising results in local recurrence of prostate cancer after external beam radiation.