ATLANTAHigh-intensity, focused ultrasound (HIFU) delivered
through a rectal probe was highly successful at burning away
localized prostate cancer, Christian Chaussy, MD, reported at the
American Urological Association 2000 Annual Meeting.
Nearly 80% of the 440 men treated had negative follow-up biopsies,
and more than 90% had negative biopsies after repeat HIFU. These
results have been sustained over 4 years of follow-up, said Dr.
Chaussy, of the Department of Urology, Staedt Krankenhaus Harlaching,
Dr. Chaussy suggested that transrectal HIFU might be a better
treatment option than either watchful waiting or hormonal ablation in
patients with localized prostate cancer because it is a minimally
invasive, highly precise treatment method. HIFU delivers heat at a
series of focal points controlled by a computer.
The patients in this study underwent transrectal HIFU under spinal
anesthesia, with a mean treatment time of 96 minutes. The entire
prostate was treated, and results were monitored using
prostate-specific antigen (PSA) assays, sextant biopsies, and
quality-of-life questionnaires. All patients were discharged from the
hospital within 24 hours.
Dr. Chaussy reported that 78% of the 440 men treated had negative
biopsies and that this improved to 96% with a second HIFU treatment.
HIFU resulted in low PSA nadirs in all patients treated. The PSA
nadir was less than 4 ng/mL in 91% of patients and less than 0.5
ng/mL in 66%.
Side effects included a high rate of urinary tract infections, some
incontinence, and a rare fistula. About half the patients were potent