HIFU Treatment for Prostate Cancer, Non-Surgical

HIFU, which is short for high intensity focused ultrasound, is the focusing of high intensity sound waves to create heat at a specific point, called the focal point. With state-of-the-art technology, HIFU can be used to destroy targeted tissue during a procedure that is individually customized for each patient's prostate cancer treatment. When HIFU energy is delivered to a specific location within the body, the tissue temperature at the focal point is elevated to nearly 195 degrees Fahrenheit in a matter of seconds, resulting in tissue destruction, while the tissue outside the focal point remains unharmed.

HIFU is a revolutionary form of treatment for organ-confined disease that allows treatment of prostate cancer without radiation and without having to make a surgical incision in the body.

The technology, High Intensity Focused Ultrasound (HIFU), helped over 40,000 patients in 22 years.

HIFU Treatment does not involve surgery but instead uses a High Intensity Focused Ultrasound (HIFU) beam which safely and effectively destroys the prostate tissue with minimal side effects.

After reviewing the information on this website, you and your family will have a better understanding of prostate cancer treatment options and whether Ablatherm HIFU may be the right prostate cancer treatment for you.

We are still waiting for the final rates from CMS for 2021. The latest rumors are announcing the final rules for early December. On the physician side, CMS has proposed a total of 29.15 RVUs (this is 30% more than Cryo) and we hope they will go even higher in the final rule. We know AUA and AMA have advocated for this.

We know what the code will be: CPT 55880 - Ablation of malignant prostate tissue, transrectal, with high intensity-focused ultrasound (HIFU), including ultrasound guidance. The good news is that the descriptor includes the word “malignant” which should help make a case for payers to pay this for prostate cancer patients. With regards to private insurances, this will for sure be a case-by-case discussion at the beginning. We know that Aetna and Cigna have already released a policy where they pay automatically the HIFU procedure in case of recurrence post radiation.

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How is a HIFU treatment performed?

HIFU treatment is performed under general or spinal anesthesia. A probe is introduced in the rectum and the imaging transducer starts the gland scanning to plan the treatment. The treatment transducer then emits high intensity focused ultrasound in the prostate gland. At the point where the ultrasound waves are focused, the absorption of the ultrasound beam creates a sudden temperature increase (around 185°F) which destroys the tissue in the targeted zone.

Is HIFU procedure painful?

The treatment itself is not painful as it is carried out under spinal or general anesthesia. Pain at the end of the treatment is rare, although most patients feel a slight discomfort which resolves after a few days. The procedure is non-invasive so there are no incision or scar and patients do not experience the burning sensation often associated with radiotherapy.

Who should have this type of treatment?

HIFU is recommended for:

First-line treatment of T1-T2 patients who are not suitable or do not want surgery
Salvage treatment for local recurrence after Radiotherapy or radical prostatectomy
Focal treatment of a well localized/well defined tumor in both first-line and salvage strategy

What is the standard follow-up after treatment?

Usually PSA levels are checked every three months and a biopsy is undertaken six to twelve months after treatment. If cancer cells remain (10 to 15% of cases), a second HIFU treatment is likely to be given a minimum of six months after the first treatment.

What is the efficiency and Quality of Life after HIFU?

Non-invasive medical technologies are intended to deliver at least the same level of clinical efficiency as traditional invasive techniques without some of the downfalls in terms of quality of life for the patient. The clinical experience gathered for more than 15 years, shows that HIFU fits perfectly in this category with an excellent risk/benefit ratio:

Efficiency : the literature published since 2000 – year of Ablatherm® HIFU CE marking – shows reproducible and consistent results with long term survival results comparable to the standard treatment of Prostate Cancer
Salvage HIFU shows promising local control with 80% negative biopsies combined with good specific survival rate at 5 years: 78% and 49.5% for low and intermediate-risk patients, respectively.
Quality of life: a literature analysis since 2000 demonstrates that HIFU is an excellent tool for preserving quality of life with low morbidity and few side effects.

What are the side effects?

Trials of HIFU treatment have found few side effects. The healthy surrounding cells are not destroyed along with the cancerous cells and the procedure is non-invasive (does not involve any incision through the skin). This means only a short hospital stay is required and you will be able to return to normal activity after only a few days. The reported side effects are: Incontinence, Urinary retention, Urinary tract infections and Erectile Dysfunction. HIFU side effects compare favorably with more invasive therapies.