Experimental Treatments for Prostate Cancer


Email Raji.Kooner@svha.org.au or call 02 8382 6980 for a confidential appointment.

Well there are really two experimental or emerging treatments for prostate cancer and the first is High Intensity Focused Ultrasound or HIFU and the second is Cryotherapy. 

There are two HIFU machines, the Ablatherm and the Sonablate.

The Ablatherm has been used fairly extensively in Europe with the Sonablate mainly used in Japan.1
I was fortunate to go to Japan and learn from the world leader regarding the Sonablate.


Although there’s been a lot of cases done worldwide there are some concerns about the long term results of these treatments and we’re still awaiting 10 to 15 year data on the success of HIFU in the management of prostate cancer.2

So essentially what is involved with HIFU treatment is we have a probe in the back passage, we scan the prostate, you have soundwaves that go through and treat the prostate and heat the prostate so the cancer cells die.3

The advantage of this treatment is that it is repeatable2, you can do it again, it’s usually an outpatient treatment or an overnight treatment.

Sometimes we compile it with a prostate resection to allow patients to pass urine better.

There is a fairly high erectile dysfunction rate with it4 and the concern is that we don’t have long term data on it but it’s a treatment that can be offered to patients particularly if they’re not suitable for surgery or radiotherapy.5

The second type of emerging treatment or experimental treatment which is cryotherapy which is freezing the prostate.

This is only really done in about three centres in the United States.

Its main use maybe in patients that have radiotherapy and failed treatment.6

There’s a significant erectile dysfunction rate6 and we are, we do have concerns about cure, the cure rate with cryotherapy.

So really it’s really not used very much in Australia and could be classified as experimental treatment at this stage but I think within a clinic trial, both the HIFU and cryotherapy is reasonable to consider.

References

1. The clinical applications of high intensity focused ultrasound in the prostate - Rowland Illing and Alexander Chapman - International Journal of Hyperthermia, 23(2), 183–191. https://doi.org/10.1080/02656730601173037 2. High-intensity focused ultrasound with visually directed power adjustment for focal treatment of localized prostate cancer: systematic review and meta-analysis - Samuel J. Peretsman, Mark Emberton, Neil Fleshner, et al. - World J Urol 42, 175 (2024) - https://doi.org/10.1007/s00345-024-04840-6
3. What is HIFU - Cancer Research UK - https://www.cancerresearchuk.org/about-cancer/prostate-cancer/treatment/high-intensity-focal-ultrasound-hifu
4. Risk Factors for Severe Erectile Dysfunction after Focal Therapy with High-Intensity Focused Ultrasound for Prostate Cancer - Sunao Shoji, Satoshi Kuroda, Kohei Uemura, et al. - Biomedicines. 2022 Nov; 10(11): 2876 - doi: 10.3390/biomedicines10112876 - https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9687416/
5. High-Intensity Focused Ultrasound (HIFU) in Localized Prostate Cancer Treatment - Mohammed Alkhorayef, Mustafa Z. Mahmoud, Khalid S. Alzimami, et al - Pol J Radiol. 2015; 80: 131–141 - doi: 10.12659/PJR.892341
6. Cryotherapy for Primary Treatment of Prostate Cancer: Intermediate Term Results of a Prospective Study from a Single Institution - S. Alvarez Rodríguez, F. Arias Fúnez, C. Bueno Bravo, et al. - Prostate Cancer. 2014; 2014: 571576 - doi: 10.1155/2014/571576 - https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3945790/