There are many different treatments for prostate cancer, with some that are more common than others. Two prostate cancer treatments that are often confused are HIFU and radiation treatment.
However, there are some key differences between them, particularly when it comes to side effects.
With any medical treatment, it’s important to make an informed decision. Here’s what you need to know about HIFU vs radiation for prostate cancer so that you can choose which treatment will be right for you.
What is HIFU treatment?
HIFU stands for High-Intensity Focused Ultrasound — a popular focal therapy for prostate cancer that uses high-energy beams to heat and destroy cancer cells so that they can be metabolised by the body.
It isn’t currently available on the NHS, except in clinical trials.
What is radiation treatment?
Radiation treatment, or radiotherapy, is a common cancer treatment that uses high-energy waves that are similar to x-rays to destroy cancer cells. It is used to treat lots of types of cancer, including prostate cancer.
Unlike HIFU treatment, radiation treatment is less focused which means that it generally targets a wider area of the body.
Comparing HIFU vs radiation treatment
On the surface, HIFU and radiation treatment sound extremely similar. Nevertheless, there are some key differences between them that could impact your decision about which you would prefer to have to treat your prostate cancer.
Side effects
All treatments come with side effects, and prostate cancer treatments are no exception. However, it’s important to note that type and severity of side effects can vary between patients, and that every experience is different.
Side effects of HIFU
One of the main reasons why many patients with prostate cancer choose HIFU treatment is because, compared to conventional NHS treatments, the focal nature of HIFU means it has far fewer long-term side effects. You will need to wear a catheter for a few days, but after this is removed, you shouldn’t experience any long-term effects.
Side effects of HIFU are typically mild and short-term, and may include:
- Temporary urinary issues
- Risk of contracting a urinary tract infection (while the catheter is in)
- Blood and seminal fluid in your urine in the days and weeks after surgery, which is a sign that the cancer cells are breaking down and being processed out of your body
- Risk of infertility due to decreased/absent ejaculatory fluid
Nevertheless, our evidence shows that with HIFU, 100% of men had no urinary problems within two weeks of treatment, and 95% of men enjoyed normal erectile function at six weeks post-treatment.
Side effects of radiation therapy
There are both short-term and longer-term side effects associated with radiation therapy. Initially, patients can expect to experience skin redness and soreness in the area being targeted.
Other side effects tend to start around two weeks after the start of a course of radiotherapy. These include:
- Tiredness and weakness
- Loss of pubic hair
- Problems passing urine, including burning pain when peeing, weak flow and urinary incontinence
- Loose bowels/diarrhoea
- Soreness around your rectum
There are also many longer-term consequences associated with radiation therapy. These can start during treatment, or even months or years later.
These side effects are rarely given enough attention, but we feel it’s important for patients to be aware so that they can make an informed decision about their prostate cancer treatment. They include, but aren’t limited to:
- Urinary incontinence. Almost 50% of men who have radiotherapy for prostate cancer will have some problem with leaking urine after six years. It’s also rare, but not impossible, for men to need a full-time catheter as they aren’t able to control their urine at all.
- Bowel problems. Although diarrhoea is a common side effect during the treatment itself, some patients go on to experience longer-term bowel problems including ongoing loose stools, urge incontinence and inflammation of the rectum.
- Sexual dysfunction. Erectile problems are something of a taboo at any time. Unfortunately, they are also more likely after radiotherapy for prostate cancer. This is because radiotherapy can damage the nerves that control getting an erection. Studies suggest that erectile dysfunction affects up to 70% of men following radiotherapy, with many men needing to use medication to achieve an erection in the months and years following their treatment.
Length of treatment
The length of the treatment is another key difference between HIFU and radiation therapy.
HIFU is generally a single, one-off treatment that takes between one to three hours, depending on the size of the area to be treated.
Before the treatment, you’ll need an enema to empty your bowels, which makes it simpler for your doctor to see the prostate and administer the treatment. HIFU is performed under general anaesthetic, meaning you’ll be asleep for the procedure. A probe will be placed inside your back passage which will emit the high-intensity ultrasound energy used to break down the cancer cells, as well as feed back ultrasound images of the area.
Since the beam of light is about the size of a grain of rice, the probe will need to be moved around to treat all areas of the prostate where the cancer is. However, the procedure is performed as a day case and you’ll be able to go home the same day.
Radiation therapy is also performed as an outpatient treatment (or day case).
However, radiotherapy requires multiple sessions. Most people with localised prostate cancer will have a course of radiotherapy that involves around 20 sessions carried out over a period of four weeks. Exactly how your treatment plan looks will depend on your individual circumstances.
Radiation therapy is performed externally, and each session usually lasts around 10 minutes depending on the size of the area being targeted. There is virtually zero preparation time and you can go home immediately after your treatment.
Success rates
When it comes to the success of both treatments, it’s fair to say that the results are comparable.
Radiation therapy has long been considered to be a very effective treatment technique for many types of cancers, including prostate cancer. Men with localised prostate cancer who are treated with radiation therapy have a cure rate of 95.5% for intermediate-risk prostate cancer, and 91.3% for high-risk prostate cancer. This equates to an overall five-year survival rate of 98.8%.
Nevertheless, HIFU has very positive clinically-proven outcomes too. Following a decade-long clinical trial conducted between 2006 and 2016, results showed a 100% cancer-specific survival rate, with 74% of patients needing no further treatment after their initial focal therapy treatment.
However, some of the most impressive study results came when looking at the side effects of HIFU. 98% of men had no issue with urinary incontinence after the treatment, while just 2% needed to use incontinence pads for just a couple of weeks.
Meanwhile, 75% of men had no issues with sexual dysfunction at all, with 20% using over-the-counter medication (but given their age, may have been using this before HIFU treatment).
When it comes to HIFU vs radiation for prostate cancer, there are some key differences between these treatments. Focal therapies such as HIFU are an effective way of treating early to moderate-stage prostate cancer while minimising the risk of experiencing long-term side effects.
Find out more about HIFU by contacting our experienced and knowledgeable team today.
Sources
- https://www.targetingcancer.com.au/2015/02/radiation-therapy-95-effective-prostate-cancer/
- https://www.cancerresearchuk.org/about-cancer/prostate-cancer/treatment/radiotherapy/external-radiotherapy/long-term-side-effects-external-radiotherapy
- https://tau.amegroups.com/article/view/6049/html
- https://www.thefocaltherapyclinic.com/focal-therapy-precision-prostate-cancer-treatment/
