Two thermal techniques compared for localized prostate cancer

This study compared the safety and effectiveness of two alternative treatment options for localized prostate cancer. Researchers reported comparable treatment effectivity for high-intensity focused ultrasound (HIFU) and cryoablation. However, HIFU was overall associated with fewer side effects.

Localized prostate cancer is cancer that is confined to the prostate gland. Treatment typically involves surgery or radiation. High-intensity focused ultrasound (HIFU) has recently emerged as a less invasive alternative to standard-of-care treatments. HIFU targets and removes damaged or diseased tissue using heat energy. Cryoablation is another alternative treatment that uses thermal energy to treat localized prostate cancer. It involves administering an extremely cold fluid to the tumor site to kill cancer cells. Both thermal techniques have been associated with good effectiveness. However, more studies are needed directly comparing both treatments for localized prostate cancer. 

This study aimed to compare HIFU and cryoablation directly. 234 men with localized prostate cancer were included. 114 men underwent cryoabalation (of the whole prostate gland). 120 men underwent HIFU (either with or after TURP, a minimally invasive prostate surgery technique).

During a follow-up of 2 years, the rates of cancer recurrence (based on blood tests) were similar between HIFU (18.3%) and cryoablation (25.4%). The risk of cancer recurrence before treatment did not significantly affect this outcome. Quality of life was also similarly improved in both groups. However, HIFU was associated with greater short- and long-term improvements in urinary symptoms.

Damage to the scrotum during the procedure was greatly reduced with HIFU (reported in 0% of men) relative to cryoablation (reported in 74.7% of men). The average duration of catheterization (emptying the bladder using a tube) was also lower following HIFU, while urethral stricture (temporary narrowing of urine tract) was more common with HIFU. The rates of erectile dysfunction at 1 year were lower for HIFU (65.5%) than for cryoablation (88%).

Researchers concluded that HIFU and cryoablation are safe and effective primary treatment options for localized prostate cancer. However, HIFU was associated with better urinary and erectile function compared to cryoablation.