Men with Prostate Cancer May Not Know All Of Their Treatment Options and Risks
by Brian Miles, MD
Houston Methodist Urology Associates
Professor of Urology, Institute for Academic Medicine
Houston Methodist – Weill Cornell Medical College
According to a September 2017 study by BJU International, men who have been diagnosed with localized prostate cancer and have consulted with a urologist often have a poor understanding of their treatment options and the consequences of each one. As a result, they tend to make decisions based on instinct – which does not necessarily result in getting the best treatment.
Typically, men diagnosed with localized prostate cancer — defined as cancer that is not beyond the capsule of the prostate gland and has not reached other parts of the body — are given three options: active surveillance, which can be stressful, radical (whole removal) prostatectomy or radiation therapy which all typically come with the side effects of incontinence and erectile dysfunction.
Often, patients on active surveillance believe they will need radiations in the future, however, only half of the patients watching and waiting require that. While men who are diagnosed don’t need to become experts in prostate cancer to be their own best advocates they should know their treatment options and the associated risks of each:
High Intensity Focused Ultrasound (HIFU)
HIFU, which stands for High Intensity Focused Ultrasound, is a minimally invasive option for prostate tissue ablation through heating with a low occurrence of side effects. Using real-time image guidance — and sometimes paired with additional magnetic resonance imaging (MRI) and/or location of the biopsies in 3D — the doctor directs a focused beam of ultrasound energy at the target area within the prostate through an ultrasound probe inserted into the rectum. No incisions are required to reach the targeted zone and ablate the prostate tissue at the focal point.
HIFU’s precise targeting minimizes damage to the surrounding healthy tissue, and has a low risk of post-procedure impotence and incontinence. Unlike radiation therapy or surgery, it is possible to repeat a HIFU procedure because it does not remove the prostate altogether.