How focal HIFU works
High-intensity focused ultrasound uses concentrated sound energy to heat and ablate planned prostate tissue. Focal One is a platform used to plan and deliver HIFU. Focal treatment targets a selected area rather than routinely treating the entire gland.
The aim is to treat the identified cancer while limiting treatment to surrounding tissue. Eligibility depends on more than the visibility of a lesion on MRI.
Assessing suitability
A consultation reviews cancer grade and extent, MRI findings, biopsy mapping, prostate anatomy, urinary function and the feasibility of future surveillance. Additional biopsy may be necessary to understand disease outside the proposed treatment area.
Discuss active surveillance, radical prostatectomy and radiotherapy as appropriate alternatives. Focal treatment is not suitable for every localised cancer.
Evidence and possible trade-offs
Long-term comparative evidence is less established than for radical treatment. Further focal treatment or subsequent surgery or radiotherapy may be needed if significant cancer persists or returns.
Possible problems include urinary retention, infection, scarring and effects on continence or erections. Uncommon serious complications also belong in the consent discussion. A smaller treatment field does not remove these risks.
Surveillance after treatment
Because prostate tissue remains, PSA does not have to become undetectable. PSA alone cannot establish that treatment has been successful. Follow-up may include MRI and repeat biopsy as part of an agreed protocol.
Dr. Sachin’s focal therapy work includes Focal One HIFU. Bring the MRI images, complete biopsy details and PSA history when seeking an assessment.
- What makes this cancer suitable for focal treatment?
- What is known about cancer outside the proposed treatment field?
- When will MRI and biopsy be repeated?
- What are the options if further treatment is needed?
Common questions
Can HIFU replace every prostate cancer operation?
No. It has a selective role and should be discussed alongside suitable established options.
Can a PSA decrease confirm the cancer is gone?
No. PSA is only one part of follow-up after focal treatment.
Does treatment preserve erections and continence in every patient?
No. Functional outcomes vary, and possible side effects must be discussed before treatment.