Prostate Cancer Treatment

HIFU, short for high intensity focused ultrasound, as a new, updated technology offering an acoustic ablation technique utilizing the unique power of an ultrasound to eliminate prostate cancer tissue using pinpoint accuracy. Through focused sound waves toward a targeted area, HIFU rapidly elevated the temperature in that area causing the complete breakdown of tissue.

Due to the precision and control of HIFU, the risk of common side effects associated with other prostate cancer treatments is reduced. These risks include incontinence and erectile dysfunction. The HIFU process often takes around two to three hours and can be done in one procedure. It is often considered an out-patient procedure that uses epidural or spinal anesthesia. HIFU is marked off as non-ionizing, there is no radiation meaning that the HIFU treatment can be utilized a number of times if necessary and there will be no damage done to healthy tissue. Because of this, in some cases, HIFU is used as an alternative technique if various other treatments for prostate cancer fail to work.

Possibly the most well known HIFU system to treat prostate cancer is the Sonablate 500. The Sonablate 500 is a device that is computer controlled and designed to transrectally deliver HIFU energy directed toward the prostate to remove all diseased tissue in the area. The Sonablate 500 technology utilizes what is known as integrated biplanar ultrasound imaging to provide real-time planning, monitoring, and before and after therapy imaging of the area where the prostate is located.

HIFU works similarly to what occurs when an individual focuses sunlight through the magnifying lens. The precise focusing of this ultrasound energy throughout the duration of an HIFU therapy session increases the temperature of tissue located within the focal zone at a very rapid pace, while enabling it so that the intervening tissue located between the focal zone and transducer remain safe with no increase in temperature. The final result is a precise lesion located at the target area and monitored by the physician. All zones that are affected with the cancerous tissue or checked by the physician and a plan is created prior to commencing HIFU therapy. The technology’s imaging capabilities allows for easy identification of all vital structures, including the rectal wall, seminal vesicles and neurovascular bundles, to ensure that only affected areas are targeted and no unnecessary damage is caused.

When undergoing HIFU, patients need to take two enemas approximately two hours before the commencement of the procedure. Because the patient cannot move during the procedure, a light sedation is given intravenously. During the HIFU treatment, the physician inserts a small probe into the rectum. The probe emits ultrasound waves sent to the tissue. Throughout the course of the procedure, the Sonablate 500 provides real-time images of the entire area, like the prostate and surrounding tissue, providing detailed, immediate feedback. When the treatment is over, patients often need about one or two hours to recover and then are discharged. There is minimal recovery and men find they can return to their daily life within a few days.

At Palm Beach Urology Associates, we offer more than just state-of-the-art urology treatments — we offer world class medical services by specialists who care. Our practice services a wide number of patients who come from all over South Florida and abroad seeking state of the art care in urology with a personal touch

High intensity focused ultrasound, also known as HIFU for short, is an updated technology to assist men diagnosed with prostate cancer. It provides an acoustic ablation technique that utilizes the power of ultrasound waves to get rid of cancerous tissue on and around the prostate with fine accuracy. The targeted area is focused on using sound waves, allowing HIFU to increase the temperature of the tissue, causing it to completely break down.

Because of HIFU’s control and precision, the overall risk of negative side effects connected with other prostate cancer treatments are greatly reduced, including erectile dysfunction and incontinence. Men only have to set aside up to three hours for the HIFU process and it is listed as an out-patient procedure. The HIFU process is often done in one sitting and minimal spinal or epidural anesthesia is used just to limit discomfort of the rectal probe. There is no actual radiation associated with HIFU – it is non-ionizing, which means that this treatment can be used more than one without damaging healthy tissue. Because it can be used when necessary, many physicians look at HIFU as an alternative method if other prostate cancer treatment options do not work.

Sonablate 500 is the most popular HIFU system used in the treatment of prostate cancer. This device is controlled by a computer and it delivers HIFU energy at the prostate through a rectal probe that removes all the cancer-infected tissue in the region. The technology found in the Sonablate 500 uses integrated biplanar ultrasound imaging which provides planning and monitoring in real-time as well as images of the location of the prostate both before as well as after the treatment.

The action of the HIFU is comparable to the action of focusing sunlight through a magnifying lens. HIFU provides precise focusing of ultrasound energy during the therapy session which increases the core temperature of the tissue that is located in the focal zone. This is done at a quick pace and all intervening tissue located around the focal zone remain safe and do not undergo an increase in temperature. In the end, there is a precise lesion within the target area that can be easily monitored by the cancer physician. Before undergoing HIFU therapy, a plan is created to determine all the areas that harbor cancerous tissue. Many physicians like the HIFU system because its high imaging resolution allows physicians to easily identify all vital structures, including neurovascular bundles, rectal wall, and seminal vesicles, and guarantee that only the affected areas will be targeted without causing unnecessary damage.

Prior to the HIFU therapy, patients are required to undergo two enemas two hours prior to the procedure. Because the patients need to remain still all through the duration of the treatment, a light anesthetic is given. A small rectal probe is inserted into the patient that emits ultrasound waves that bounce off the tissue. During the procedure, real-time images are provided by the Sonablate 500 of all the areas in and around the prostate. This offers the physician with immediate, detailed feedback. When the procedure is done, individuals often need roughly two hours to fully recover from the anesthesia before being sent home. After a few days, they can go back to their regular life.

Central Maryland Urology Associates is a state-of-the-art urology practice, comprised of 8 urologists located in Columbia, Maryland, half-way between Washington, DC and Baltimore, Maryland. CMUA is the only urology practice exclusively serving Howard County for over 30 years.The CMUA mission is to provide the highest quality of urologic care for our entire community through innovation, service excellence, compassion, and patient safety.

All men have the organ known as the prostate gland. This muscular organ is compared, size-wise to that of the average walnut. The prostate is located right in front of the rectum, just below the man’s bladder. A normal prostate gland measures at less than two inches long and they tend to weight approximately one ounce. The prostate gland is located around the urethra, the organ that is known for the transportation of urine and sexual fluids through the penis to exit the body.

The prostate is made up of a large number of very small glands. These glands are protected by the prostatic capsule, a very fibrous tissue. Around the prostatic capsule is a thick layer of fat offering more protection. The prostate gland is made of two lobes – one on the right and one on the left. The apex of the prostate gland is located further away from the bladder while the base is located just under the bladder. The back of the prostate gland is called the posterior and the front of the prostate gland is the anterior.

There are five zones associated with the prostate. The peripheral zone is deemed the largest zone. It contains an estimated 75 percent of all prostate glands. It is also the location most likely to be affected by prostate cancer, where chronic prostatitis will most likely occur, and where a large number of needle biopsies take place. The transition zone is the most likely scene of benign prostatic hyperplasia. The anterior zone is one-third of the entire prostate and made up of smooth muscle. Lastly, the central zone is where the remaining 25 percent of the prostate glands are. To prevent the semen from heading backwards into the bladder, there is the preprostatic tissue.

One of the most common cancers that men face all over the world is prostate cancer. There is no one cause of prostate cancer but there are factors that elevate a man’s risk of contracting it. Men who are older than 65 and men that come from a family with a history of prostate cancer are more susceptible. Common signs of prostate cancer include the need to urinate often, inability to urinate, difficulty in either stopping and/or starting urine flow, a feeling of not emptying the bladder, burning sensation while urinating and painful ejaculation. This is because the prostate becomes enlarged. There are numerous types of prostate cancer treatments available, some more invasive than others.

The prostate’s main function is the production of a large portion of the fluid known as semen. The semen is what carries sperm when it exits the penis. When the sperm is produced inside the testicles, it travels up to the prostate via the vas deferens. The sperm is added into the semen in the prostate. Once orgasm is reached, the semen is pushed from the prostate to the urethra by the ejaculatory ducts. The urethra leads all the way to the tip of the penis when the semen then exits.

Urination may also be affected by the prostate. Many individuals are aware of the fact that the kidneys are the responsible organ in terms of creating urine. When the urine exits from the kidneys and into the ureters, it empties into the bladder. When the bladder reaches capacity, the urine is sent through the urethra and out of the penis. Because the prostate rests right at the bottom of the bladder, it encircles around the urethra at the precise location where the urethra connects to the man’s bladder. When the prostate expands, either because of prostate growth or prostate cancer, the prostate becomes a tight ring around the urethra. It then restricts the ability of the urine to leave the bladder and enter into the urethra.

Dr. Anshu Guleria and his staff at the Virginia Prostate Cancer Center have considerable experience in minimally invasive treatments for prostate cancer.  They will take the time to sit down with you to see if HIFU is the right prostate cancer treatment for you.  When HIFU became available in North America, Dr. Guleria studied the reports of its use in Europe and decided that HIFU is going to be the next evolution in localized prostate cancer therapy. Dr. Guleria is the most experienced doctor practicing HIFU for Prostate Cancer in Virginia and he looks forward to helping you decide what is the best prostate cancer treatment option for you.