HIFU – Non surgical prostate cancer treatment

Dr. David Samadi discusses the advantages and risk factors of HIFU, the High-Intensity Focused Ultrasound Procedure for the treatment of early-stage prostate cancer.

HIFU – What is it and who may benefit from it?

Fox News Interviewer – So the FDA approved a new cutting-edge, non-surgical, non-invasive procedure, offering new hope for early-stage prostate cancer patients. But how does it stack up when other proven techniques are in place? So, Dr. Samadi, I would ask you first of all what is it? How does it work and who should get this procedure?

Dr. David Samadi –  Well the news broke out a few months ago about something called HIFU – which is High Intense Focal Ultrasound. Basically, this procedure is and for selected patients with low-risk prostate cancer or Gleason 6 and a small prostate. These factors actually play a role.  There is a transducer in the rectum and with the general anesthesia you basically use a high focus ultrasound energy and you can actually burn the cancer cells.

So if you select your patients this actually could work well. There’s a lot of data that’s coming from Europe, they’ve been doing this for many years. This just came out in the US and has been approved. The discussion with the patient is that it works well if you select your patients well.

Fox News Interviewer – So a low-risk, what does that mean?

Dr. David Samadi –  Well, that’s a very good question. When a patient comes to us they either may have low-risk prostate cancer, moderate or very aggressive. We call that the Gleason score. The next thing that I pay attention to is how many cores or how many areas of the prostate do have cancer. So, the standard of care today is the removal of the cancerous prostatic tissue because it gives a very accurate staging. The week after, I can look at the patient and say this is how much cancer you have, this is how far it’s gone. Six weeks after, the PSA should be undetectable and zero and so that’s what surgery is. But there are other procedures for older patients who do not want to do watchful waiting, don’t want to go for surgery and they still don’t want to walk around with cancer.

Fox News interviewer – But as you know, dr. Samadi, not everybody starts out seeing an expert like you. They go to their general practitioner, like dr. Siegel. So what are you looking for? At what point would you recommend your patients to go see dr. Samadi?

Dr. Marc Siegel – Well, you know, the issue is that the playing field is changing because of robotic prostate surgery in the right hands. I’m able to offer surgery to people that have more of what we call comorbidities than I ever did before. They’re older, they have diabetes, they have heart disease.

Fox News interviewer –  You can offer robotic surgery?

Dr. Marc Siegel – No! There are people I wouldn’t have operated on before and I would have been looking for some other treatment. I can now say that in the right hand, surgery may still be your first option because you can do it minimally invasively, be out the next day and you can operate on sicker people. Now, having said that, there still are people who you wouldn’t operate on. For those people, you might look for other choices. You know, Dr. David Samadi made a really good point here about HIFU, obviously, he’s the expert!

You don’t want to offer this to somebody with advanced cancer because the recurrence rate is 28%. Those are people that probably shouldn’t have had it in the first place. There can be an infection, there can be urinary problems, it’s got side effects. You want to figure out what is the right treatment for each patient and if you can operate. This is because there are 200,000 new cases a year and 25,000 men still die of prostate cancer every year. We don’t have all the genetics figured out yet. I say if it’s going to be a potential to kill you get it out!

Fox News Interviewer – Diagnostically, you can’t always see all the little areas of cancer in the prostate unless you take the prostate out, right?

Dr. David Samadi – That’s right! So, in our Center of Excellence, that we have in New York, and also many other centers, we’re using MRI fusion biopsies. This is much better than the ultrasound, the old-fashioned way of doing the biopsy, but you’re 100% right, you still don’t know how much cancer somebody has. The issue with HIFU is that you can only treat about 10 grams per hour. If you have a large prostate, it would take longer.

Fox News Interviewer – What is the prostate?

Dr. David Samadi – The prostate gland is a gland that we have between the bladder and the urethra and it’s responsible for all the semen that goes through it, a lot of nutrition. It’s basically a male organ. The kind of disease is very similar to breast cancer but it’s for sexual function and all the surrounding nerves around it that are involved. Now, once you have it removed by an expert surgeon who is qualified and does this day in and day out, the sexual function after surgery and continence is good.

For a lot of viewers, if you are newly diagnosed with prostate cancer or have any questions, go to prostatecancer911.com.  You can send your information and we give you a free consultation to help you.

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