Transcript HIFU AND CRYOSURGERY

HIFU AND CRYOSURGERY
David Spellberg M.D., FACS
HIFU with the Sonablate® 500
The Sonablate® 500 is a medical
device that uses HIFU to thermally
ablate the prostate.
What is HIFU?
HIFU stands for
High Intensity Focused Ultrasound
• Non-Invasive therapy that focuses sound
waves to create heat
• Similar to light traveling
through a magnifying
glass to create heat
• Raises the temperature of the target tissue
to almost 195 degrees Fahrenheit (90
degrees Celsius)
• Destroys the targeted tissues where sound
waves cross
2000
W/cm2
Transducer
Focal
Point
Status of HIFU in the US
• The Sonablate® 500 is being studied in clinical
trials for use in the treatment of prostate cancer
in the United States and is not approved for use
by the U.S. Food and Drug Administration.
• HIFU with the Sonablate® 500 is authorized for
use for the treatment of prostate cancer in
Canada, Argentina and the Dominican Republic.
It is also available in the Bahamas and Mexico.
Brief History of HIFU
• HIFU research began in the 1950s in
Indianapolis, IN.
• Over the years HIFU has evolved to the
applications we have today which include
treating various types of cancer and diseases.
• In 2004, the first International HIFU Centers
opened in the Americas.
The Sonablate® HIFU Procedure
• 1-4 hour outpatient procedure,
depending on size of prostate
• Spinal/epidural anesthesia with
light sedative
• Therapy is delivered through a
transrectal probe after patient is
numbed from the waist down
• 1-2 hour recovery at HIFU
treatment facility
• After procedure, most patients
resume normal lifestyle within
a few days
In most cases, HIFU is a one time
procedure. It is non-surgical,
radiation free and has minimal blood
loss.
Recovery & Follow Up
• Patients have a catheter that is removed 1421 days after HIFU. Office visit with doctor
required for removal.
• Check PSA at 3, 6, 9 and 12 months then
yearly thereafter.
Side Effects & Complications
• HIFU results from a study done in Japan show low
rates of both
– Impotence (<2%)
– Incontinence (<0.6%)
• Minimal Complications
– Discomfort associated with catheter
– Tissue passing
– Most are temporary and mild
MRI Pre and Post HIFU
MRI Image of prostate Pre-HIFU
MRI Image of prostate 2 weeks
Post-HIFU
USHIFU Results & Data
•
•
•
Physicians have treated more than 3000 patients
in Mexico, the Dominican Republic and Canada.
According to a Japanese study, the disease free
rate after 6 years is 97% for low risk patients
(PSA < 10; Gleason < 6)
Another small study from the UK showed that
92% of men had Nadir PSA of 0.2 ng/ml or
lower after 3 months.
Cryosurgery
• Treats localized prostate cancer by freezing
and destroying prostate cancer cells13
• A probe filled with liquid nitrogen is guided
through a skin incision into the cancer tissue
using transrectal ultrasound (TRUS), which
allows the physician to monitor the freezing
process13
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