ABSTRACT
The treatment of prostate cancer with High-Intensity Focused Ultrasound (HIFU) was first reported in 1995 and 1996. Transrectal HIFU continues to be a popular treatment alternative due to it being a minimally invasive treatment for localized disease. Thermal ablation is the predominant mechanism of tissue destruction for the current HIFU devices, but mechanical effects also play a role. Also 50% or more patients in the HIFU and radical prostatectomy population represented more localized clinical stage T1 disease. HIFU has also been used in the past as salvage therapy in cases of advanced disease, even after modalities such as radiation, cryoablation, high-dose brachytherapy, and primary HIFU. Whole-gland HIFU has shown promising long-term function and oncologic outcomes and as imaging and ablative technologies have improved, a new shift toward partial ablation and focal therapy has been seen. Main adverse effects of HIFU and other prostate cancer treatments include urinary incontinence, erectile dysfunction, and potential bowel issues.
