HIFU For Prostate Cancer Frequently Asked Questions
Q. I’m on blood thinners, do I qualify?
Anticoagulants such as Aspirin, Clopidogrel, Warfarin, Apixaban, Eliquis, Fish Oil etc have to be ceased temporarily during HIF treatment, but can be started again soon after treatment.
Q. I’m taking hormone therapy, do I qualify?
Hormonal therapy can be used in conjunction with HIFU.
Q. Is there possibility that cancer can recur at some point even 10 years after treatment?
Recurrence of prostate cancer after HIFU is possible, as it is after any form of treatment. There are no long term studies to compare results of HIFU with surgery or radiation treatments, so the relative risks are unknown. Longterm patient review is therefore very important, so that further treatment can be provided if needed. The published FFS and PCFS rates for HIFU are noted in previous section.
Q. If I am impotent or incontinent after HIFU, is there a chance I may get better?
Mild urinary incontinence after HIFU does improve with pelvic floor exercises. The risk of permanent urinary incontinence is very low, close to zero. Erectile Impotence after HIFU can recover with Viagra or similar drugs, but overall 40% men don’t recover their previous erectile function. This is far less for men having Partial Prostate Ablation compared to Complete Prostate Ablation.
Q. Why do some patients need a repeat HIFU treatment?
HIFU is a minimal invasive treatment relying on focused ultrasound to ablate prostate tissue. If the treatment is incomplete for technical or other reasons, then this will be evident by 3-6 months later, and a repeat HIFU treatment can be performed. A previous HIFU treatment does not exclude a subsequent robotic/radical prostatectomy or external beam radiation treatment.
Q. My Urologist tells me that “HIFU is experimental” ?
HIFU has achieved safety and efficacy standards, allowing its clinical use for prostate ablation in Australia, UK, Europe, Japan, Canada and is FDA approved in USA.
The fact is that Urologists are trained to do surgery, and Radiation Oncologists are trained to do radiation therapy, so this has an influence on professional opinions.
Having said that, surgery and radiation therapy have been extensively studied and have more publications in peer reviewed journals than does HIFU.
Q. How do I know if HIFU has worked?
PSA tests are done at 6 weeks, 3, 6 and 12 months after HIFU. The PSA level should be <1.0 and remain stable over time. If there is doubt about the response to HIFU, then a repeat prostate MRI scan and biopsy is performed to sample the remaining tissue. Longer term monitoring is required, as for any prostate cancer treatment.
Q. What is the cost of HIFU?
HIFU treatment in Australia is currently not covered under Medicare or Private Health Insurance. If you submit a HIFU ENQUIRY via this website, then we can inform you of the cost of HIFU in your specific situation.
The cost of HIFU does include services provided by Cabrini Hospital Operating Theatre and Overnight Bedstay, A/Prof Peter Royce and Urology Nurse, Anaesthesia and HIFU Technician support.