Sonoblate provides the best HIFU focal treatment for prostate cancer
I have been actively treating patients using Sonablate HIFU for 17 years.
I still follow patients that I treated as far back as 2008, and they are doing well with no evidence of persistent or recurrent prostate cancer. Overall, I have been involved in the management of 500 patients treated with Sonablate, including several hundred for which I am personally responsible.
The Tissue Change Monitoring feature that is only available with Sonablate HIFU has helped me to improve the efficacy of this procedure over the years. I have also been able to decrease the actual procedure time by downsizing the size of the prostate before I operate; consequently, this has reduced the post-HIFU need for urethral catheterization dramatically. In my practice, the usual post-HIFU period of urethral catheterization has dropped to 2-3 days, and the patient is prepared to resume his usual activities within 3 to 5 days without any decrease in the efficacy or post treatment side effects.
Using Sonablate HIFU, there is an ability to perform either partial prostate ablation or ablation of the entire gland. Patient selection is most important. One must be sure that there has been no extra prostatic spread of the tumor.
I believe and have demonstrated in my own practice that any genuine candidate for radical prostatectomy–absence of extra prostatic cancer; demonstrated absence of extra prostatic PSMA positivity; and prostatic height of 3.7 centimeters or less–is a likely candidate for Sonablate treatment in lieu of radical prostatectomy or radiotherapy. The usual long-term side effects of prostate cancer treatment (incontinence and or sexual dysfunction) are immediately avoided. In the rare instance that intraprostatic prostate cancer recurs, further Sonablate treatment may be used to safely treat recurrence.
The advent of PSA testing, and the improved understanding of patients at risk of prostate cancer, has helped urologists like me to identify patients earlier in their disease progression. I have identified numerous patients who had prostate cancer with PSA levels as low as 2.0 ng/mL, and I have successfully treated a number of these individuals with Sonablate therapy, with preservation of continence and sexual function.
For patients who have been previously treated with radiation and who experience intraprostatic recurrence in the absence of extra prostatic recurrence, salvage HIFU therapy has been demonstrated to be the treatment of choice in efficacy with a low occurrence of complications. This was demonstrated in a double-blind, multi-institutional published study.
In summary, Sonablate HIFU therapy occupies a prominent role for me in the management of intracapsular prostate cancer, and I feel this is the best platform to use when possible.
Please note the following for the UK. Note by Marcus Clark
In the UK the following protocol for focal treatment is used:
- For posterior lesions (the back of the prostate) HIFU
- For large anterior lesions (the front of the prostate) Cryotherapy
- For smaller anterior lesions IRE (Nanoknife)
There are two different suppliers of HIFU systems to treat posterior lesions, Sonoblate HIFU and Focal 1 HIFU.
On the list of clinicians offering HIFU, you can assume that the system used is Sonoblate HIFU unless specifically stated.
There have different performance characteristics that you need to be aware of as illustrated below.
To date Sonoblate HIFU has superior outcomes when compared to Focal 1
Be aware, some hospitals which are participants in the PART trial research, which compares focal treatment outcomes to robotic prostatectomy, use Focal 1 HIFU.
Remember, in England you can always be referred to an NHS Clinician of your choice using the ebooking system or ask for a second opinion from a Clinician who uses Sonoblate HIFU.
