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New Ultrasound Therapy Combats Prostate Cancer

New Ultrasound Therapy Combats Prostate Cancer
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By    |   Monday, 04 December 2017 03:13 PM

For some guys, surviving prostate cancer can require invasive treatment, which often means the end of their sex lives, not to mention a chronic incontinence problem.

But a revolutionary new procedure called high intensity focused ultrasound (HIFU) offers hope that men can get their tumors zapped without all of the nasty side effects that can follow standard treatments such as surgery, radiation, and chemotherapy.

High-tech HIFU uses concentrated sound waves to destroy cancerous tissue. Delivered through a rectal probe, the outpatient procedure is targeted to avoid the healthy tissue and nerve bundles that are responsible for erections and bladder control.

“It’s a very sophisticated technology,” says Dr. Stephen Scionti, a Sarasota, Fla., urologist and American pioneer of the technique. “We can design precise, personalized treatments to preserve more healthy tissue, and that, in turn, preserves more function.”

But HIFU is only a viable option for about half of all prostate cancer patients, he adds.

“It’s for men with contained prostate cancer that is found early, not for men with advanced cancers or cancers that have metastasized,” Scionti tells Health Radar. “The size of the prostate gland is also an important factor. This is one case where bigger is not better because the more tissue the sound wave has to penetrate, the less energy there is available to ablate the cancer.”

The procedure was first used in Europe 30 years ago and has been an accepted treatment for prostate cancer there for decades. But it wasn’t approved by the U.S. Food and Drug Administration (FDA) until October 2015. Before that, Scionti had to perform HIFU overseas.

“For 10 years I had to bring patients to Bermuda, the Bahamas and Cayman Islands,” he recalls. “I made 90 trips to (the Bahamas resort) Atlantis and went down a water slide once. That’s because I was always working when I was there. It was what we had to do.”

Since the FDA’s approval of HIFU, Scionti can perform the procedure in his Sarasota office. He says he’s one of just five physicians in the U.S. who have done at least 100 HIFU procedures – and he’s racked up more than 1,000.

“It’s a little slow to catch on [in the U.S.] because, like anything new, it is disruptive to the old way of doing things,” says Scionti, “It will take a generation of urologists to change the paradigm of just taking out the prostrate when it has cancer.”

HIFU has also been slow to catch on with insurance companies, which typically don’t cover its $25,000 cost.

“That will change as the procedure becomes more common,” predicts Scionti. “Right now, it’s a matter of priorities. For a lot of men, it’s worth the price of a new car for a chance to keep their sexual function.”

Word of the procedure is spreading. Dr. Richard M. Lieberman, a prominent Allentown, Pa., urologist, doesn’t perform HIFU himself but knows about it and says he mentions it as a potential option to some patients.

“HIFU is not very widely used, but the protocol for treating prostate cancer is changing rapidly,” Lieberman tells Health Radar. “Where we once treated it aggressively with radical surgery or radiation, now we’re trying to match a patient’s prostate cancer with the appropriate degree of therapy. For someone with a minimally aggressive cancer, HIFU may be a good fit.”

Still, there are some risks as procedure catches on with the mainstream.

“One real challenge is making sure physicians understand there is a learning curve to mastering the technique,” says Scionti. “Patients need to do their homework and ask their doctors the right questions to make sure they’ve had the proper amount of training and experience.”

And despite its promise, HIFU is no miracle cure.

“No procedure has a zero recurrent rate,” notes Scionti. “In general, levels of recurrence range from 10 to 40 percent. A 10-year study looking at PSA numbers, survival rate and other parameters of various treatments found that HIFU patients don’t do any differently than the others.”

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Many men with prostate cancer undergo surgery, which can lead to impotence or chronic incontinence. But a revolutionary new procedure called high intensity focused ultrasound (HIFU) zaps tumors without all of the nasty side effects.
prostate, cancer, ultrasound, therapy
Monday, 04 December 2017 03:13 PM
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