Originally Posted by daff
... It would be interesting to hear from others on any positive or negative experience, either first-hand or otherwise, with HIFU.
One of the trial HIFU sites was near me in Washington, DC, but I'm not sure whether they are still treating patients. No one coming to our support group has had HIFU.
All indications I'm getting are that HIFU is still in the investigational stage. I just went to [url]www.pubmed.med[/url] and entered this search string to see how much research was being reported: " HIFU AND prostate cancer ". I got 95 hits, with the majority in just the past few years, and with the earliest in 1995. Both the relatively small number of hits and the fact that the first research was reported only thirteen years ago indicates how new this therapy really is.
Here's the conclusion from the abstract of the first hit on the list, a 2008 paper: "...Although a great deal about HIFU physics is understood, its clinical applications are currently limited, and multiple trials are underway worldwide to determine its efficacy."
The third hit (as of today) is from a German study that reviewed results for low and intermediate risk patients treated from 1997. Here's a key sentence from the results: " The actuarial biochemical failure-free [probably means no adverse PSA score] survival rates (SR) at 5 and 7 yr were 77% and 69%, respectively. The actuarial disease-free SR at 5 and 7 yr were 66%
, respectively. CONCLUSIONS: This study demonstrates the effective long-term cancer control achieved with HIFU in patients with low- or intermediate-risk localised prostate cancer." This was actually a fairly low risk group, all stage T1 or T2, but with a Gleason up to 7 allowed in the series. Frankly, the failure free rates do not seem nearly as good as the rates achieved by surgery and radiation, especially considering that the average patient in this HIFU series was low risk or not more than intermediate risk.
On the other hand, results for most therapies improve as they mature, and that may turn out to be the case with HIFU.
Here's another line of evidence. I use the Prostate Cancer Research Institute for its information to survivors on therapies, and PCRI has not yet addressed HIFU in a broadcast manner, though I found information when I dug for it. HIFU has not yet been presented at the series of nearly annual National Conferences on Prostate Cancer, this year with PCRI as the main sponsor, that are aimed primarily at informing survivors. The National Conference on Prostate Cancer series is not shy about introducing promising investigational assessment and treatment technologies, especially when patients are curious about them as they are about HIFU, so I find it unfavorably significant that HIFU has not yet been included.
Personally, with the other options now available, if I were a low risk patient considering my options, I would not want to be part of the HIFU learning curve unless my HIFU doctor had diligently kept records of his patients for at least five years and could convince me that his five year followup patients were doing very well.