High Intensity Focused Ultrasound (HIFU)
This page has information on a new type of cancer treatment called “High Intensity Focused Ultrasound or ‘HIFU’. There is information about
High intensity focused ultrasound or HIFU is a new type of cancer treatment. The treatment is given using a machine that gives off high frequency sound waves. These waves deliver a strong beam to a specific part of a cancer. Some cells die when this high intensity ultrasound beam is focused directly onto them.
Doctors have been interested in this type of treatment for nearly 50 years. But it is only in the past few years that they have been seriously investigating its use in treating different types of cancer. One advantage of this type of treatment is that because it only uses sound waves to kill the cancer cells, it doesn’t have as many side effects as other types of cancer treatments already in use.
Doctors hope to use HIFU to kill cancer cells without damaging healthy cells. Chinese researchers were the first to lead the way using this treatment. They have done trials treating nearly 5,000 people with many different types of cancers. Researchers in Europe are now doing trials to find out if HIFU could be used for people unable to have surgery to remove their cancer. But they are not sure how well this will work as yet.
HIFU is only useful to treat a single tumour or part of a large tumour. It doesn’t treat tumours that are more widespread. This means that HIFU is not suitable for people with cancer that has spread to more than one place in their body. HIFU doesn’t pass through either solid bone or air. This means that it is not suitable to treat every type of cancer.
HIFU is only available in the UK as part of a clinical trial. These trials are only for certain types of cancer. If you take part in a trial it may mean that you will have HIFU treatment and then have surgery to remove your cancer soon after that. This is so doctors can look at the area treated with HIFU and the areas that were not. They will compare the two so they can see how good HIFU is at killing cancer cells. There is information on the HIFU trials going on in the UK further down this page.
Below is a list of several types of cancers that HIFU has been tested on. If you click on the links it will take you to more information on HIFU treatment and these cancers.
HIFU is not a suitable treatment for
- Brain tumours
- Lung cancer and cancers in the pelvic area
- Cancer that has spread to the lymph nodes
- Skin cancers
- Head and neck cancers
Prostate cancerBecause the prostate is situated deep within the pelvis, you have HIFU for prostate cancer by putting an ultrasound probe into your back passage (rectum). From that position, the ultrasound can direct beams more accurately at the prostate. Doctors call these ‘transrectal probes’. Results from trials so far show that HIFU may be as successful in treating prostate cancer as treatment with radical prostatectomy or radiotherapy. But we also have to be sure that the long term results will be as good as surgery or radiotherapy. The treatment hasn't been around long enough for us to know that yet.
In 2008, NICE (National Institute for Health and Clinical Excellence) issued guidelines for the treatment of prostate cancer. You can download these guidelines from the NICE website. These said that HIFU should only be used as part of a clinical trial. You could be offered HIFU instead of surgery or radiotherapy for localised prostate cancer. Doctors have used it for cancer that has just been diagnosed, or for cancer that has come back in the prostate after earlier treatment.
If you are invited to go on a trial of HIFU for prostate cancer, your doctors need to make sure you know
- What is involved in having the treatment
- That we don't know everything about side effects yet
- That we don't fully understand how long term effects of HIFU compare to other treatments
- What other treatment options they have
Doctors must also monitor all the patients who have HIFU so that we can learn more about side effects and long term benefits or drawbacks. You will sign a consent form to say that all these things have been explained to you before you have the treatment. NICE say HIFU can be used for early prostate cancer or for prostate cancer that has come back in the prostate after other treatment (this is sometimes called salvage treatment).
There is a trial looking at HIFU for newly diagnosed prostate cancer that is contained in just one half of the prostate gland. There is another trial for men with prostate cancer that is contained within the gland, but has started to grow again following radiotherapy. The men on these trials only have HIFU to the area that contains the cancer. There is information about these trials on our clinical trials database. To find the information, click the blue clinical trials button to the left of your screen and select 'prostate' from the drop down menu of cancer types.
Kidney cancer There have been 2 recent trials going on in the UK using HIFU for renal cell (kidney) cancer. In one trial patients had HIFU and a week or two later they had an operation to remove their cancer. The doctors will look at the cancer cells they removed to see what effect the HIFU had. The other trial recruited patients with more advanced cancer that could not be removed with an operation. The aim of of this trial is to find out how well HIFU works for kidney cancer, and what the side effects are.
Both these trials finished recruiting patients at the end of 2007 and we are now waiting for the results.
Primary and secondary liver cancer
There have been two trials in the UK using HIFU to see how it affects liver cancer cells. One trial was for cancer that started in the liver - primary liver cancer. The other was for cancer that had spread to the liver from a cancer in another part of the body - secondary liver cancer.
In the first trial, patients had HIFU and a week or two later had an operation to remove their cancer. The researchers will be looking at the cancer to see what effect the HIFU had. In the other trial, patients with cancer spread to the liver that couldn't be removed with an operation had HIFU treatment. This trial is to see how well HIFU works for secondary liver cancer, and to find out more about the side effects. These trials have now finished recruiting patients and we are waiting for the results
Pancreatic cancer
Doctors in China have used HIFU to help relieve pain and other symptoms in people with advanced pancreatic cancer. It is not being used to cure pancreatic cancer. Both in the UK and China, surgery is still the first choice of treatment for people with pancreatic cancer that has not spread to other parts of the body. If you are not fit enough to have surgery to cure your cancer, then HIFU treatment would not cure your cancer either.
Bladder cancer
Doctors in China have used HIFU to treat people with bladder cancer. But if the cancer comes back in the bladder then doctors in china will use surgery as the standard treatment with regular follow up.
People who have been treated with HIFU so far have had very few side effects. It may cause some pain for 3 to 4 days afterwards. And it may cause sore skin in the area treated, but this is unusual.
There are HIFU trials going on in the UK for prostate cancer. While these trials are recruiting, there will be information about them on our clinical trials database. Follow this link and then pick prostate cancer from the drop down menu. Or type 'hifu' into the free text search box on the clinical trials page.
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