What Is HIFU Treatment?
The surgical approach in which ultrasound waves are used to kill the cancer cells in the prostate gland using a higher intensity is known as the high intensity ultrasound treatment HIFU. Ultrasound or sound waves are generally used for the diagnostic purposes, but the high intensity sound waves directed at a particular target can kill cancer cells with the generation of heat. It is the choice of treatment in the early stages of cancer.
Causes of Prostate Cancer:
The exact element that leads to an over production of cells in the prostate gland remains unknown. A lot of factors may contribute to the development of cancer such as:
- Genetic history: If the cancer runs in the males in the same family, an extended one or a distant family, chances of the off springs getting cancer is increased.
- Excessive smoking and alcohol consumption can also act as a stimulus for prostate cancer
- Obesity may also trigger prostate gland cancer
Signs and Symptoms of Prostate Cancer:
- A frequent urge to urinate
- Painful urination
- Blood in urine
- Erectile dysfunction
- Blood in semen
- Difficulty in producing semen
- Pain and discomfort in the lower abdominal region
Diagnosis of Prostate Cancer:
- Digital rectal examination DRE: In this examination, the urologist or the andrologist inserts index finger into the anal canal of the patient. The prostate gland which lies adjacent to the rectum can be palpated with the help of indexed finger. Any sign of tenderness, inflammation, bleeding if present is recorded and further tests are run. DRE is the basic diagnostic examination which can also be used to screen men for cancer of the prostate.
- Prostate specific antigen test PSA: A prostate specific antigen is always present in the blood stream in small amounts, produced by the prostate gland itself. If this levels shoots up in the blood stream on examination of blood samples, it can be co-related with infections or cancer of the prostate gland. However, it not a confirmatory test for cancer and further tests are required to confirm the cancer.
- Ultrasound: USG of the pelvic region would help in the location of the prostate gland along with the cancer growth it is carrying. An ill defined radiolucent area or areas of cancer can be detected with the help of USG. The adjacent lymph nodes affected with the cancer may or may not be well appreciated with the USG.
- Magnetic resonance imaging MRI: A magnetic resonance imaging focuses on the soft tissues in the pelvic region. The major areas of interest are the prostate gland and the lymph nodes. It also needs to seen whether the cancer has become aggressive and affected the urinary bladder, penis tissues, liver or lungs.
- Computerized imaging technique CT scan: For prostate cancers that have become aggressive and invaded the adjacent bone and other soft tissues, a CT scan becomes mandatory to be diagnosed. The lumbar and sacral vertebrae may become involved in the cancer leading to damage to the nerves. This can manifest in the form of nerve compressions or tingling sensations in the extremities. Cancer may also spread to parts of the pelvic bone.
- Positron emission tomography PET: This is a highly advanced diagnostic procedure in which a radioactive marker or dye in injected into the pelvic region close to the gland. X rays are then taken into succession of the pelvic region. The cancer cells have a tendency to absorb the dye and thus appear well on the radiographic film. In this manner, the exact location of the cancer, number of cancer masses, edges of the cancer mass or masses can be defined.
- Biopsy: A small mass of the prostate gland is excised surgically and studies in the labs to understand the nature and type of cancer cells. This helps in choosing the appropriate treatment plan for the cancer.
Types of Prostate Cancer:
Getting into the histology of the prostate gland, it is majorly composed of basal and luminal cells. Thus cancer of the prostate can be of either basal type or that affecting the luminal cells.
A general classification of cancer of the prostate can also be as follows:
- Acinar adenocarcinoma: This is the most common type of cancer of the prostate. It occurs in the lining of the gland
- Ductal adenocarcinoma: This occurs in the lining epithelium of the ducts in the gland
- Transitional cell carcinoma: This occurs in the cells that line the tube carrying urine to the urethra.
- Squamous cell cancer: These develop in the luminal parts of the gland
- Small cell prostate cancer: This is neuroendocrine in nature
The HIFU Treatment Procedure:
The high intensity focused ultrasound treatment, as the name suggests is the variant of the standard ultrasound technology which is used to treat cancers of the prostate. It is done in the following steps as follows:
- All the diagnostic methods are carried out on the patient in order to confirm cancer of the prostate. A decision regarding the HIFU is taken only when the cancer is localized in nature which means it is well within the boundaries of the prostate gland.
- Secondly, the entire procedure is explained to the patient and the family members and consent from them is taken.
- The procedure is performed under general anesthesia, spinal or epidural anesthesia is administered.
- The entire procedure takes about 2 to 3 hours.
- A rectal ultrasound probe is inserted through the rectum and with the help of this probe, sound waves are targeted towards the prostate gland.
- As a result of this, heat is produced in the cells at which sound waves are being targeted ultimately resulting in their death and disintegration of the cancer mass.
- The heat generated can have a temperature from 98 to 100 degree Celsius.
- The cells can get expelled from the body as per the system’s need to bring them out.
- Complications And Risk Factors Associated With HIFU:
- Ejaculation problems occur in almost 50 percent of cases treated with HIFU
- There may be a chance the ultrasound probe damages the rectal wall
- Painful urination, burning sensation while urinating
- Increased frequency of urination with little volume of urine passing out
Am I Good Candidate For HIFU Treatment?
If at all you happen to satisfy any of the below symptoms pertaining to prostate cancer, you can surely be an ideal candidate for HIFU. These symptoms include:
- Diagnosis show you have a cancer that is small, confined to the prostate gland only
- You are in the earliest stages of cancer, with minimal to no signs of cancer and wish to eliminate the growth and a need for subsequent treatment in future.
The patient recovers in about one week to ten days, can be discharged after three days of the surgical intervention. However, a timely and continuous monitoring of the prostate gland and symptoms of cancer in it need to be done.
The procedure is known to be successful in 93 percent of cases. A small percent of cases may require a second treatment protocol to be followed if the cancer relapses and the symptoms appear again.
Benefits of HIFU Treatment:
HIFU has the following benefits:
- 93 percent success in all cases
- It eradicates the cancer mass completely in one go
- Prevents further invasion of the cancer into the adjacent tissues
- Does not requires extensive incision making and suturing and thus infections and scarring is avoided
Cost Comparisons for HIFU:
Since the procedure is extensively practiced in India, we bring to you the price at which the HIFU is done. In the range of 5,00,000 to 5,50,000 INR is the entire procedure completed, along with the surgical intervention, hospital stay and medications used. It is practiced in the metro cities including Mumbai, Delhi, Bangalore, and Kolkata. Places like Pune, Ahmedabad, Nagpur also have hospitals where this procedure is being followed.
Why Choose India:
The Food and Drug Administration FDA in the US has still not recognized HIFU and approved of it, it seems to be under clinical trials in the guinea pigs in the labs. India however has shown successful human HIFU treatments at the most affordable costs and best outcomes. Team MedcureIndia being an Indian platform for medical tourism, strongly recommends this procedure to be carried out on the Indian land.