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Why didn't your doctor mention HIFU treatment?

Why didn't your doctor mention HIFU treatment?

When you hear about cancer, regardless of the type, it often results in a wave of fear. Until a few years ago cancer was frequently fatal as there were limited treatment options. Some patients resorted to extreme methods to deal with their disease. The first person in Australia who legally performed euthanasia was Bob Dent; he opted for this route because of his advanced prostate cancer. Medical advancements have made a huge leap since then. New treatment for prostate cancer is very curable if caught early, and side effect profiles for standard treatments have been significantly reduced. 

Prostate cancer can be treated in a variety of ways. HIFU treatment, cryoablation, radiation and surgery are the primary options. Your doctor is likely familiar with all of them, although he may not perform them all. For this reason it is a smart idea to look at all your options before you decide which method is most suitable for you.

A digital rectal exam (DRE) is used find abnormalities. If your urologist feels an area of concern a prostate biopsy should be done in order to determine if cancer really exists and, if so, how advanced it is. This helps determine what your treatment options are. 

If your cancer is less than 1% many patients opt for watchful waiting. HIFU therapy might also be employed as a focal treatment designed to only treat the affected part of the prostate and minimize side effects. Surgery and radiation cannot be performed in a truly focal manner. If a person's cancer is not localized and has spread beyond the margins of the prostate then radiation is usually used to try to halt the spread of the disease. 

HIFU therapy is not yet FDA approved. No license has been given in the US to perform HIFU treatment, but it is approved for use in many other countries including France, Germany, the UK, and Canada. It is also a secondary option for cancers that have been treated through radiation and cryoablation and the cancer has recurred. Its side effects are less than those of other treatments but it is not risk free. The ultrasound raises the temperature of the tumor to 90 degrees Celsius when the soundwaves are concentrated focally on the gland. It is a two hour procedure that requires no hospitalization.

Over 30,000 people have been successfully treated around the world with HIFU therapy. The side effects include urinary retention, mild Type 1 incontinence (which usually self resolves within a few months after treatment), and strictures (in about 12% of cases). Impotence can occur as well, but this side effect is not unexpected given the nature of the disease and the area of the body that is being treated. Erectile issues related to HIFU are less frequent than those related to surgery and radiation. Standard treatments for erectile dysfunction, like Viagra and Cialis, are helpful in cases of impotence, and many patients who initially experience impotence after HIFU end up regaining full functionality in that area. Doctors in the US may not initially mention the HIFU treatment to new treatment for prostate cancer patients given that it is not yet FDA approved, but motivated patients are finding out about it on their own and asking their doctors about it.

This has resulted in more and more doctors learning about HIFU. Even if they can't perform it in the US, they can help their patients find suitable doctors in Canada who are trained in the procedure and can help US patients gain access to this increasingly popular treatment option.

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