At the 2007 meeting of the American Urological Association (AUA), physicians from Germany presented a video on “Pulsed high intensity focused ultrasound (HIFU) at 3 MHZ for prostate cancer treatment.”[1] It was also announced that US studies of the device called Ablatherm® HIFU (EDAP corporation) would be carried out at Duke University. 

European physicians have accepted HIFU as a standard method of treating localized prostate cancer for some time. However, this technique has not been extensively studied in the US and apparently that is about to change. In this treatment, focused energy is delivered from an endorectal probe containing ultrasound treatment and imaging transducers. HIFU causes thermal destruction of prostate tissue. Treatment is carried out under general or spinal anesthesia for a single two hour treatment. 

A study from Germany was published in Urology in 2004. This study included 146 men with stage 1-2 prostate cancer who were not deemed suitable for prostatectomy were treated with the Ablatherm device.[2] At two years of follow-up, 87% had PSA control and 93.4% had negative repeat biopsies. Complications in this study included transurethral resection in 12% for obstruction. Erectile function was preserved in 12%. These authors concluded that HIFU was a valid therapy for men not suitable for radical prostatectomy. 

Current studies are focusing on primary treatment of localized prostate cancer as an alternative to surgery and radiotherapy. One of the strategies outlined is to treat patients primarily with HIFU and reserve radiation therapy for failures of this approach. A study presented at the AUA meeting showed that radiation therapy following failure of HIFU resulted in a 78% PSA control rate with little toxicity.[3] 

Comments: Apparently some US patients have gone to Europe to receive this therapy rather than get more conventional treatment in the US. EDAP intends to conduct US trials leading to FDA approval.