Niagara HIFU- Your Prostate Cancer Solution

Prostate cancer has many treatments, including highly invasive and non-invasive options. Each treatment has its own unique benefits as well as potential side effects and problems. As part of the overall treatment for prostate cancer, the patient and his doctor will consider the benefits and potential drawbacks of each treatment option, and then decide on the best course of action. Patient factors such as Gleason score, lifestyle, and age will all be considered when deciding on a course of treatment.

The prostate treatments currently available include:

• High Intensity Focused Ultrasound (HIFU)
• Hormone therapy
• Cryotherapy
• Radical prostatectomy
• Radiation therapy

One option, which some patients choose due to the potential side effects of treating their prostate cancer, is to do nothing at all. This is called watchful waiting.

Here is a discussion of each of the treatment options.

High Intensity Focused Ultrasound

HIFU using the Sonablate 500 is a minimally invasive treatment option for prostate cancer patients. HIFU uses a transrectal probe that focuses high intensity ultrasound waves directly into the prostate gland. In the area where the waves are directed, called the focal zone, the temperature rises to levels that kill the tissues. In order to reduce the risk of recurrence of the prostate cancer, HIFU destroys the entire prostate gland.

HIFU with the Sonablate 500 takes from one to three hours. This outpatient procedure requires an epidural anesthesia to numb the area while the procedure is taking place. There is a very short recovery time, and most patients are walking within hours of the procedure. The patient will use a catheter during the first two or three weeks after the procedure to aid in emptying the bladder while the body heals. It takes only a couple of days, however, before patients treated with HIFU can be enjoying the normal activities of their lives. There is a low risk of side effects with HIFU with the Sonablate 500, including impotence and incontinence. See the Treatment Comparison chart to compare HIFU with other treatment options.

Hormone Therapy

The goal of hormone therapy is to reduce the amount of testosterone in the body. Testosterone is the stimulant that feeds cancerous tumors of the prostate. While hormone therapy does not cure prostate cancer, clinical trials seem to indicate that hormone therapy temporarily stops the disease from progressing. This extends the life of the patient, but it is a short-term option because prostate cancer does become resistant to hormone therapy with time. Those undergoing hormone therapy may experience breast pain, growth of breast tissue, decreased mental capacity, weight gain, hot flashes, tiredness, anemia, osteoporosis, depression, and a decrease in HDL cholesterol, the “good” cholesterol.

Cryotherapy

Cryotherapy is sometimes called cryoablation or cryosurgery. This is a minimally invasive prostate cancer treatment option that freezes the prostate cells to destroy the gland and the cancer inside. The procedure begins by infusing the gland with toxic argon gas, which destroys the prostate. Immediately after this the cells are infused with helium to “thaw” them. This must be done twice in order to destroy all of the cancer cells. This procedure requires an overnight hospital stay, which makes it a major operation even though it is classified as a minimally invasive procedure. Patients will wear a catheter for two or three weeks after having cryotherapy. More than 90% or prostate cancer patients who are treated in this way become impotent, and 10% to 30% will develop incontinence.

Radical Prostatectomy

One of the most invasive prostate cancer treatment options is a radical prostatectomy, which involves surgically removing the prostate gland and surrounding tissues. This can be done through laparoscopic surgery or open surgery. A laparoscopic prostatectomy lasts up to eight hours, and an open prostatectomy usually takes two to four hours. This requires general anesthesia, and a patient undergoing a prostatectomy will stay in the hospital for up to a week. Once the procedure is complete, the patient will wear a catheter for up to three weeks. It can take two months for the patient to fully recover from a prostatectomy. After the procedure as many as 80% of patients are impotent, and 50% to 80% are incontinent.

Radiation Therapy

There are two main types of radiation therapies: brachytherapy or seed implants, and External Beam Radiation Therapy, otherwise known as EBRT. Brachytherapy uses tiny radioactive pellets placed deep inside the prostate to deliver the correct dose of radiation. EBRT involves directing radiation into the prostate from outside the body, and is only recommended for men with prostate volumes less than 60 grams. This treatment lasts six to eight weeks.

While radiation therapy has seen tremendous improvement in recent years, there are still concerns about this treatment, particularly because the radiation cannot always be confined precisely to the area of the cancer. When the radioactivity extends outside of the prostate, the urinary sphincter and neurovascular bundles can be damaged. This leads to problems with impotence and incontinence that cannot be reversed. As many as 33% of men who are treated with radiation have difficulty achieving an erection. This change may happen gradually over the first year after the therapy takes place. One-fifth of all men who undergo radiation for prostate cancer have problems with incontinence.

Radiation therapy can also damage the rectum and intestines because of ionizing radiation passing through the tissues of this area. Potential problems include a rectal fistula or proctisis. These conditions could require a colonoscopy, and treating prostate cancer with radiation therapy has recently been shown to cause a higher risk for rectal or colon cancers. If the field of radiation treatment extends into the bladder, a condition called radiation cystitis, which is an irritation of the bladder from the radiation, can occur.