April 17, 2019
In His Own Words: Dr. Frank Simoncini, D.O., Cancer Survivor
What is HIFU? High Intensity Focused Ultrasound. For many years, thousands of men suffering from prostate cancer have benefited from prostate cancer treatment with robotic-assisted radical prostatectomy, radiation therapy, and HIFU. HIFU has been cleared for use in the USA for the ablative treatment of prostate cancer since 2015.
My personal belief, as a physician, surgeon and cancer survivor is that prostate cancer treatment in the United States is very good. Most likely the best the world has to offer is in the United States. I do not believe in a ‘one size fits all’ approach to prostate cancer.
All that being said, patients, at times, have a reluctance to having prostate cancer treatment. The reason is there are risks and benefits to any treatment. With prostate cancer surgery, the patient’s worry is mainly incontinence and impotence. ‘My prostate cancer is gone but I am wearing diapers and cannot get an erection.’ Those are very real concerns for patients. ‘I had radiation therapy but what if it recurs?’ That is a real concern as well. Let me tell you a couple of things about being a cancer survivor. I hear patients say this very often ‘well if I get ten years, I’ll be happy with that!’ I can just tell you two things from my experience as a cancer survivor. First, ten years go by in a blink of an eye. Second, surviving ten years might sound reasonable until about year nine. Year nine comes around very fast. All that being said, the majority of patients do not have major long-term complications with surgery or radiation therapy. Most of those problems resolve over time. Nonetheless, patients do have real concerns about potential complications and are always looking for an alternative approach to treatment.
So, will HIFU change the prostate cancer treatment paradigm? HIFU has only recently been approved in the United States, however; has been in practice worldwide for the last twenty years. The studies show good cancer control, comparable to traditional prostate cancer treatments. The results of cancer control with HIFU have significantly improved over the years as the technology has improved. I believe we will need to study HIFU more extensively in the future before we have all of the answers, however; the initial studies are favorable.
What makes HIFU very attractive to patients is that it offers good cancer control with very minimal side effects when compared to more traditional prostate cancer treatments. There are no incisions, no scars, no early or late side effects of radiation therapy. HIFU is performed in outpatient surgical facilities currently (whether surgery center or hospital) there is little to no pain postoperatively, very minimal chance of urinary incontinence, much better outcomes with preservation of erectile function postoperatively, and you are back to work and normal activities very soon after your procedure. It is possible with MRI Fusion biopsy to isolate cancer lesions and treat half of the prostate or even just the lesion itself which have even less side effects than traditional full gland HIFU. It is a treatment that can be repeated safely if a patient does have a recurrence of his prostate cancer.
In very general terms, HIFU offers an alternative to traditional prostate cancer treatment. Studies initially have shown good cancer control, very minimal side effects and can be done as an outpatient procedure. If you have a recurrence down the road the treatment can be repeated, hence the attraction to HIFU.
To see Dr. Frank Simoncini’s full blog and a step-by-step look at HIFU treatment, CLICK HERE.