HIFU Preserves Quality of Life for Prostate Cancer Patients

Faced with a diagnosis of prostate cancer, patients must often choose between three basic healthcare options: engage in active surveillance (“watchful waiting”) to monitor the typically slow-growing disease, or sign up for radical surgery to remove the whole prostate or undergo multiple rounds of radiation, both of which potentially cause life-changing side effects like urinary incontinence and erectile dysfunction.

But as National Prostate Cancer Awareness Month gets underway in September, David Silver, MD, Chief, Division of Urology and Director, Prostate Center at Maimonides Medical Center, is urging men to get screened, especially African American men who are at increased risk for developing prostate cancer over white men and other men of color.

Also during September, men can learn about a different treatment option: High Intensity Focused Ultrasound (HIFU). For men with localized prostate cancer, HIFU significantly decreases the side effects of incontinence and impotence that have become synonymous with prostate cancer treatment.

“Because HIFU uses imaging technology that allows us to pinpoint the exact location of the tumor, we can direct the sound waves to destroy the diseased tissue and spare the rest of the organ," said Dr. Silver. “We like to say, ‘kill the cancer, keep the prostate.”

The HIFU device being used at Maimonides Medical Center, called Focal One, fuses MRI and biopsy data with real-time ultrasound imaging, which allows urologists to view integrated, detailed 3D images of the prostate on a large monitor and direct high intensity ultrasound waves to destroy the targeted area.

With Focal One, the urologist can establish precise contours around the diseased tissue and ablate an even smaller portion of the prostate. This lessens the damage to healthy surrounding tissue, and thereby minimizes potential side effects of incontinence and impotence for patients. Today, more than 65,000 men around the world have had the HIFU procedure, with positive results in terms of both survival rates and quality of life.

Today, urologists like Dr. Silver and others in major medical centers around the country now actively using HIFU to treat localized prostate cancer, that is, cancer that has spread in but not beyond the capsule of the prostate gland and which has not reached other parts of the body. According to The Urology Care Foundation, more than 90 percent of men who are told they have prostate cancer have localized disease.

As of January 1, 2021, a new Category 1 CPT code for HIFU went into effect and this increases the probability of insurance reimbursement. The CPT code was approved by the American Medical Association for the “ablation of malignant prostate tissue, transrectal, with HIFU, including ultrasound guidance.” In addition to Medicare coverage, the new CPT code allows HIFU patients to submit a claim to their private insurer which reviews each case for reimbursement.

If patients experience a recurrence of prostate cancer after HIFU treatment they can still undergo surgery, radiation, or repeat the HIFU treatment. HIFU enables patients to keep this and other options open in the future while maintaining an optimal quality of life.

For more information about HIFU visit Maimonides Medical Center.