A new paradigm in prostate cancer treatment

Fewer side effects with high-intensity focused ultrasound (HIFU)

A new paradigm emerges in prostate cancer treatment.

This article was written and paid for by UHealth, the University of Miami Health System.

Dr. Dipen Parekh is urologic oncologist and Director of Robotic Surgery at Sylvester Comprehensive Cancer Center, part of the University of Miami Health System. To learn more about innovative treatments for prostate cancer or to make an appointment, call 305-243-1000 or visit the University of Miami's health news blog.

Bill's story

Bill Grafe had been "waiting and watching" the levels of prostate-specific antigen (PSA) in his blood for more than a year when his doctor told him he had prostate cancer. When Bill began to explore treatment options, he discovered a non-invasive treatment called High-intensity Focused Ultrasound (HIFU) offered at Sylvester Comprehensive Cancer Center.

PSA levels, detected using a blood test, can be an indicator of prostate cancer. Once diagnosed, surgical removal of the prostate is the standard of care for most men, but it can result in side effects including urinary incontinence and erectile dysfunction.

"HIFU technology uses sound waves at a very high frequency to create thermal energy to destroy cancer," says Dr. Dipen Parekh, a urologic oncologist and head of robotic surgery at Sylvester Comprehensive Cancer Center.

Ever since the FDA approved HIFU for the treatment of prostate cancer in December 2015, Dr. Parekh has been using HIFU to treat prostate cancers. He says Sylvester's team performs the highest volume of focal treatments using HIFU technology. 

"Experience matters," says Bill. "There's almost no one else doing HIFU in the state of Florida."

Rather than treating the entire prostate, a focal treatment targets a selective area. "This is a paradigm shift in the way we are treating men with prostate cancer," says Dr. Parekh. "In the past, we treated the entire prostate gland with radiation or surgery. We are now shifting focus and only treating a small selected area of cancer."

Dr. Parekh continues to research the outcomes of patients who have been treated with HIFU compared with those who undergo surgery. His findings show promise for HIFU as an alternative to other treatment methods for a specific subset of men with prostate cancer.

For men concerned about the side effects of surgery, HIFU could be the answer. "The side effects are significantly less in terms of urinary incontinence and erectile dysfunction compared to total removal of the prostate or total radiation of the prostate," says Dr. Parekh.

Even though the procedure is done in an operating room, it is non-surgical and patients are able to go home within just a few hours. Among other benefits, HIFU can be used repeatedly, should the prostate cancer return. This was an additional selling point for Bill.

"The nice thing with HIFU is if it did come back, you can redo it," says Bill. "It's not a one time only shot."

Dr. Parekh says the availability of HIFU opens up a greater number of options for patients. "If the cancer either comes back in the treated area or a different portion of the prostate that was previously not treated, you would still be eligible for a repeat HIFU or surgery or radiation," he says. "This is exciting for a lot of men."

Focusing on you

Focusing on You: Innovations in Modern Medicine is a series of healthcare-related stories airing regularly on WPLG Local 10. For more stories like this one, visit YouTube channels for UHealth, the University of Miami Health System.

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