HIFU & The Sonablate® 500
There are a number of different options for how prostate cancer can be treated, each has its own risks and benefits. Primarily patients chose between watchful waiting (also referred to as expectant management), surgery (radical prostatectomy, open or robotic)), different types of radiation therapy( IMRT, Seed implant, or Proton) or Cryotherapy (freezing) New emerging prostate cancer therapies such as HIFU are becoming increasingly popular because they are non invasive, repeatable, and preserve patient quality of life. Please take the time to learn about all of the options.
2. What is the history of HIFU and how long has it been done?
Research on HIFU actually began in the 1950s at Indiana University. In 1994, the first human prostate cancer study was done by Dr. Marberger and Madersbacher at the Univ. of Vienna in Austria using the now Sonablate® 200 treating 29 human prostates in vivo shortly before performing a radical prostatectomy. The goal was to see if the energy delivered was enough to destroy the prostate tissue. Study found that treatment could be performed safely and could be repeated. In 1995, a study done at Indiana University showed that the whole prostate could be treated without damaging the prostate capsule or the rectal wall. In 1999, Dr. Toyaki Uchida began treating patients using the Sonablate® 200. In 2001, the Sonablate® 500 received the CE mark from Europe and the first patient in the study was treated at Indiana University by Dr. M. Koch. In 2004, USHIFU was created and has placed machines in Canada, Mexico, Costa Rica, South Africa and the Caribbean. Currently there are nearly 100 Sonablate® 500 HIFU centers worldwide on six continents. There are over 150 physicians using the Sonablate® 500 worldwide and over 6,000 total procedures have been completed with the Sonablate®.
To read clinical papers, abstracts and data visit our clinical data section where you can download the latest published data and reports. Learn more about the Benefits of HIFU with the Sonablate® 500.
4. Does HIFU only target the cancerous cells or does it ablate the entire prostate?
HIFU destroys the entire prostate by targeting tissue in six overlapping zones. The tissue is heated rapidly in small lesions until eventually the entire prostate is ablated. By destroying the entire prostate gland, the chance for recurrence, or the cancer coming back is minimized. All the organs and tissue outside of the prostate remain unaffected during HIFU.
5. If the entire prostate is tablated, does that include the urethra? What happens to the urethra? is it damaged?
The urethra consists of different anatomical segments. From the tip of the penis to the base of the bladder: the fossa navicularis (or meatal opening), the pendulous urethra, the membranous urethra and the prostatic urethra. During HIFU, the entire prostate is destroyed, including the prostatic urethra, as it can have cancerous cells in it. In doing so, the end result is an empty cavity that acts like a conduit during normal urination. However, the urethra is derived from a different type of tissue (derived from the bladder squamous type epithelium) vs. prostatic tissue (glandular, fibrotic and muscular) and regenerates or re-epithelializes with time. The externalsphincter and bladder neck are the vital structures with respect to maintenance of urinary function NOT the urethra. These vital structures are not affected or harmed during HIFU.
Traveling for the HIFU Procedure
1. Where can I have HIFU?
The procedure is approved by the United States FDA for investigational purposes only, meaning as part of a clinical trial. However, the Sonablate® 500 is treating patients worldwide in Canada, Mexico, Europe, Central America, Asia and the Caribbean.
2. How do I schedule a HIFU procedure in an approved country?
If you would like to schedule HIFU in one of the countries where HIFU is already approved call the HIFU CARE Center at Coastal Carolina Urology at 1-866-422-2284. HIFU CARE Center will be able to give you the schedule and reserve your spot for HIFU therapy. HIFU CARE Center , working with USHIFU, can provide you with payment instructions and a number to call to assist you in making travel arrangements.
3. Is the procedure covered by insurance or Medicare?
Since the procedure is not yet approved by the FDA and is preformed out of the United States, US-based insurance companies and Medicare does not normally provide coverage for HIFU. However, several patients have been able to receive full reimbursement from their insurance company. People have been successful by filing a claim through an independent claims filing service. Patients are given a detailed receipt after the procedure to assist in filing and for tax purposes.. You may be able to deduct HIFU as a medical expense on your taxes; For more information on deducting medical expenses visit http://www.irs.gov or consult with your accountant.
In addition, patients may finance all or a portion of the cost of the procedure for up to 60 months through a division of GE Consumer Finance, called Care Credit. For more information visit http://www.carecredit.com.
4. What information do you need from me prior to HIFU?
When you make arrangements for HIFU and schedule a date the HIFU medical team will send you information about how to prepare for the procedure and what they need from you before you travel. To find out if you qualify for HIFU, Click here.
5. When can I schedule a HIFU procedure?
For a list of the upcoming dates available for scheduling HIFU and the location please call our office at 1-866-422-2284, or you can visit our calendar.
6. When I travel for the HIFU procedure, how long do I have to be out of town?
HIFU CARE CENTER recommends that you arrive one day prior to your scheduled procedure day in order to get settled and have time to rest and meet with the medical team once you arrive. Patients are usually comfortable to travel home the day following HIFU. For example if you are scheduled for HIFU on a Saturday, you should arrive on Friday to the hotel. Most likely you will be able to travel home on Sunday. Some patients prefer to arrive several days earlier in order to be comfortable and well rested in the location before the procedure. Others stay additional days after having the HIFU; travel preferences depend entirely on the individual and vary from patient to patient.
7. May I speak with Dr Scionti or other patients about the procedure and their experience?
Certainly. In fact, we encourage it. Call our free prostate cancer treatment hotline at 1-866-422-2284 to arrange a consultation with Dr Scionti or if you would like to speak with someone who has already had HIFU.