Silicon Valley Urologist – Dr. Jonathan C Hu

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Prostate HIFU

Precision in Every Pulse: Robotic HIFU - Shaping the Future of Prostate Care

Personalized Care, Tailored to Your Life: Your Journey, Your Healing

Welcome to our Prostate High-Intensity Focused Ultrasound (HIFU) resource! If you or someone you care about is dealing with prostate cancer, understanding the available treatments can be both overwhelming and crucial. Prostate HIFU is a cutting-edge approach, and we’re here to guide you through it. We offer both Sonablate and Focal One

-Jonathan Hu. MD

SVU

If you haven’t done so already please read more about prostate cancer

Prostate Cancer

Suggested Reading 23 minutes

What is HIFU?

Prostate HIFU is a non-invasive treatment using focused ultrasound waves to target and destroy prostate cancer cells. Unlike traditional methods, it doesn’t involve surgery or radiation. The ultrasound energy is precisely directed at the cancerous tissue, leaving healthy tissue unharmed.

Similar to concentrating sunlight through a magnifying glass to a specific point, HIFU directs sound waves onto the prostate to precisely target and eliminate cancerous tissue.

The Procedure

While undergoing HIFU, you’ll receive anesthesia, and a foley catheter will be inserted into your urethra for easier urination. Using MRI and live ultrasound images, I’ll plan the treatment area. A specialized probe in the rectum transmits ultrasound energy, concentrating it on the targeted region of the prostate. This outpatient procedure allows you to return home on the same day. Typically lasting a couple of hours, most men can resume regular activities within a few days. You’ll keep the foley catheter temporarily to assist with bladder emptying due to post-treatment swelling.

Risks

HIFU for prostate cancer is generally safe, but like any medical procedure, it carries some risks. Potential risks may include: 

  • urinary incontinence (<1%)
  • rectal fistula (0.1%)
  • erectile dysfunction (5-15%)

Outpatient

Home same day

Non-Invasive

100% No surgery or radiation

Personalized

Targeted Treatment

01.

Is HIFU right for me?

Suitable candidates for HIFU typically have localized prostate cancer that hasn’t spread to other areas of the body, ideally presenting low-to-intermediate risk. Evaluation involves imaging such as MRI, ultrasound, and targeted prostate biopsy to determine eligibility.
  • Confirmed Prostate Cancer Diagnosis
  • Ensure localized prostate cancer
  • Ideally region of interest (ROI) is focal
  • ROI is not more than 4 cm from the ultrasound probe
  • There are no calcifications seen on rectal ultrasound that may block the ultrasound
  • Rectum that is accessible
  • Willing to continue 1-2 yearly MRI and biopsies
  • Cannot have Brachytherapy Seeds

02.

Pre Operative

Your safety is our top priority. We collaborate closely with your primary care physician and/or cardiologist to ensure a safe and smooth procedure for you.
  • Trans Rectal Ultrasound (TRUS) to ensure rectal opening and no calcifications
  • Surgical Clearance from your primary care or cardiologist (Bloodwork and EKG/Chest X-Ray)
  • Informed Consent
  • Fleet enema of the rectum (2x) 2 hour before to ensure empty rectum
  • Nothing to eat or drink per facility anesthesia protocol

03.

Intra Operative

Following anesthesia, the duration of planning, contouring, and interpreting images for your personalized treatment will typically take about 30 minutes, depending on the size and shape of your prostate. Subsequently, the treatment itself usually lasts for 1-2 hours.

  • Undergo anesthesia
  • Ensure the rectum is clear of feces
  • Foley catheter will be placed while you are asleep
  • Surgeon will plan, contour and shape the treatment zone
  • Treatment will start
  • Removal of probe

04.

Post Operative

After the procedure, you’ll be transferred to the Post-Anesthetic Care Unit (PACU) for monitoring and recovery from anesthesia. Once approved by the anesthesiologist, you’ll either be cleared to go home or, in case of any complications, may require a hospital stay.
  • Foley catheter will remain in the bladder and urethra
  • Nurses will teach you how to take care of the Foley Catheter
  • After you are cleared you will go home with the Foley Catheter
  • Follow up in the clinic for foley catheter removal or learn how to remove it at home
  • Nothing per rectum for 1 month

05.

Follow Up

After treatment you may have some catheter discomfort this is normal until you get used to it or the foley is removed. Typically we do not give medication as there are more side effects than benefits. 

  • Clinic for foley removal and voiding trial
  • Bloodwork in 3 months
  • Bloodwork in 6 months
  • Bloodwork, MRI and prostate biopsy at 12 months
  • Repeat until shared decision making

F.A.Q.

Roughly 2/3 of patients do well after HIFU and do not need further treatment.

Even following HIFU, individuals may explore salvage options such as repeat HIFU, surgery, or radiation. Opting for HIFU initially does not preclude the possibility of pursuing alternative modalities later, ensuring a flexible approach to prostate cancer management without closing off other potential avenues

The majority of men can return to their usual activities within 1 to 2 days after the procedure, including regular short walks. More vigorous physical activities can be resumed after the removal of the catheter. Notably, there is no need for incision care or stitches removal, streamlining the recovery process.

I conduct a non-opioid procedure. Patients typically experience catheter discomfort, which is effectively managed with over-the-counter pain relievers like Tylenol or Ibuprofen.
Insurance coverage can differ between patients, with some offering coverage while others may not. For personalized assistance and to navigate the unique policies of each insurance provider, I recommend contacting our billing department. In cases where insurance coverage is not available, we offer fair cash payment options.
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