High-intensity focused ultrasound (HIFU) can control prostate cancer with fewer side effects

In recent years, a new treatment strategy known as focal therapy (partial gland ablation) has emerged for prostate cancer considered to be “intermediate risk” — mostly, small tumors confined to one area of the prostate. At Memorial Sloan Kettering Cancer Center (MSK), researchers have been working closely with an advanced focal therapy approach known as high-intensity focused ultrasound (HIFU), guided by magnetic resonance imaging (MRI).

Now a landmark clinical trial has demonstrated this less-invasive method works well for many patients. The phase 2 trial, led by MSK urologic cancer surgeon Behfar Ehdaie, looked at a particular type of HIFU treatment, also called MR-guided focused ultrasound (MRgFUS), in men with intermediate-risk cancer. The novel approach effectively controlled the disease in patients and greatly reduced adverse side effects of treatment. This suggests many men with intermediate-risk prostate cancer can avoid surgery, chemotherapy, and radiation.

“We believe this novel treatment strategy will improve the lives of many prostate cancer patients,” Dr. Ehdaie says. “To draw a parallel with how breast cancer treatment changed 30 years ago, you could think of focal therapy as a ‘male lumpectomy.’ Instead of removing all the tissue in a breast or prostate, we have learned that it is safe and effective to treat specific areas and greatly reduce the burden on patients.”

Results from the clinical trial, published June 14, 2022, in Lancet Oncology, represent a major step toward having the new HIFU approach become part of widespread prostate cancer treatment.

When the cancer is confined to the prostate gland, the main treatment options have traditionally included active surveillance (close monitoring), surgery, and radiation. But men who needed surgery or radiation often had persistent side effects, such as urinary and sexual problems, that could reduce quality of life.

“Advancements in prostate cancer over the past two decades have been headlined by successes that have benefited all patients, and now focal therapy provides another exciting area that can move the needle in prostate cancer management,” Dr. Ehdaie says.

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