Can ultrasound treat prostate cancer?

This study investigated the effectiveness of a single session of high-intensity focused ultrasound (HIFU) in patients with localized (confined) prostate cancer, as a potential curative treatment. 

Radiotherapy or RT (the use of high-energy rays to kill cancer cells) is a widely used, non-invasive therapy for prostate cancer. An alternative treatment called high-intensity focused ultrasound or HIFU is coming to be more popular. This method uses high energy sound waves to heat and destroy cancer cells. Although durable outcomes have been reported for the use of HIFU for the treatment of prostate cancer, its use as primary (first) therapy is still controversial. This study aimed to evaluate the outcomes of a single session of HIFU in patients with localized prostate cancer. 

171 patients diagnosed with localized prostate cancer and with no previous treatment were included in this study. Patients with a prostate cancer size larger than 35 ml, received a neoadjuvant hormonal ablation or NHA therapy, which blocks the effect of testosterone (the male sex hormone that controls the growth of prostate cancer) and aims to reduce the size of the tumor before the HIFU treatment. Also, calcium deposits that might disrupt the beam from reaching its target were removed from the prostate. All patients were treated with a single session of HIFU. After the treatment, patients were followed up for 24 months through digital rectal exams, measurements of prostate specific antigen or PSA (a protein produced by the prostate gland, whose levels rise in prostate cancer and drop after curative treatment) blood level and a biopsy (tissue sample from the prostate which is examined under a microscope to see if there are still cancerous cells present).

Results showed that NHA significantly contributed to the reduction of PSA levels. 25.7% of all patients were diagnosed with disease failure (defined as positive biopsy finding or an increase in PSA levels). However, the 5 year biochemical free survival rate (the percentage of patients who survived without developing increased PSA levels after treatment to show return of the cancer) was 77% after 3 years and 69% after 5 years. Furthermore, the overall survival rate (the percentage of patients who survived for a defined period of time after treatment) was 98.8%.

In conclusion, single-session HIFU treatment had a good curative ability with a high survival rate. Pretreatment with NHA and removal of calcium deposits significantly improved the efficacy of HIFU.

There was no comparison between single session of HIFU treatment and other curative treatment types (such as radiotherapy or surgical removal of the prostate gland) for prostate cancer in order to compare outcomes. Future comparative studies are needed for more accurate results.

Discuss with your physician what is the most appropriate treatment for your situation.