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A man diagnosed with prostate cancer currently has a wide spectrum of treatment choices ranging from proton beam and intensity-modulated radiation therapy to robotic-assisted radical prostatectomy and active surveillance.1 The latest medical device, high-intensity focused ultrasound (HIFU), has some appealing features for patients and urologists. Technically, it is relatively straightforward to insert a transrectal HIFU probe that generates ultrasound waves that thermally ablate prostate tissue. HIFU may be used for focal therapy or for partial or total prostate gland ablation. Partial gland ablation is used to treat biopsy-positive areas, suspicious areas on multiparametric magnetic resonance imaging (mp-MRI), or both. However, HIFU failed to gain US Food and Drug Administration (FDA) approval twice in the past 3 years for prostate cancer indication because of the inability of HIFU to demonstrate efficacy or direct patient benefit.
Hu JC, Laviana A, Sedrakyan A. High-Intensity Focused Ultrasound for Prostate CancerNovelty or Innovation?. JAMA. 2016;315(24):2659-2660. doi:10.1001/jama.2016.5002