Excellent review of HIFU in contemporary urology

HIFU for prostate cancer – For more than a decade, HIFU has been investigated as a less invasive alternative to surgical treatment in men with localized prostate cancer. A growing and maturing body of research suggests that HIFU is a safe and efficacious option for several subgroups of patients. – Contemporary Urology

HIFU for prostate cancer
For more than a decade, HIFU has been investigated as a less invasive alternative to surgical treatment in men with localized prostate cancer. A growing and maturing body of research suggests that HIFU is a safe and efficacious option for several subgroups of patients.


I am still skeptical of long term cancer cures of HIFU for prostate cancer, but I expect it to be in the USA in the next 2-3 years. Reading the article shows that there have been advances since I was involved with HIFU research 6 years ago at Indiana University.
This was a good review of the current technology and side effects and early outcomes.
Important negatives that the article point out are the difficulty in treating large prostates. They recommend treating the prostate before HIFU hormones (which have side effects of hot flashes, mood swings, etc.), a TURP (which can be very bloody in large prostates, or treatment with 2 rounds of HIFU. This last option is most attractive in my opinion if you have a large prostate and elect to have HIFU.
The other negative is the use of a foley catheter (2-7 days) which is similar to my catheter length after dvP. Patients also need a suprapubic catheter which is not needed with dvP.
My last issue is the suggestion that a negative biopsy is similar to a cure. A biopsy will only sample a small part of the prostate and longer followup will be needed to see how many cancer cells will not be destroyed and lead to clinical failures.