UT GANGE

24 HEALTHY UTAH MARCH 2010 25 UTHealth.com
wellness [ men’s health ]
One in 6 men in the U.S. will be diagnosed
with prostate cancer in their lifetime, and
most will have no symptoms at the time of
diagnosis. PSA (prostate specific antigen)
blood testing (available since the early 1990s)
combined with examination of the prostate
have improved early diagnosis rates. When
discovered early enough prostate cancer can
be cured. The problem men face as they make
a treatment decision is that the side-effects
of the most common treatments (radical
surgery and radiation) are significant and life
altering. Many men feel as though they are
between a rock and a hard place in making
that decision, and that the treatment seems
worse than the disease.
The development of a less invasive treatment
option called HIFU (High-Intensity Focused Ultrasound)
offers men with early prostate cancer
an exciting and potentially safer alternative.
Specifically this cancer treatment looks comparable
to traditional therapies, but with significantly
limited impact on sexual function
and causing almost no urinary incontinence.
HIFU is a therapy that destroys tissue with
rapid heating; this heating is achieved by
focusing sound waves to a very specific location
or “target”, and repeating the process
throughout the organ to attempt to completely
eradicate the tumor. Focused ultrasound
waves raise the temperature at the
tiny target area to over 90 degrees Celsius in
a matter of a few seconds, while the tissue
O outside the target area is virtually unaffected.
When performed for prostate cancer, a probe is
inserted in the rectum under anesthesia, which
both allows for precise focusing of energy to
the target and simultaneous avoidance of areas
of normal tissue, without making an incision
of any kind in the body and without the use of
ionizing radiation. A typical prostate treatment
lasts several hours and is performed on an outpatient
procedure. Patients experience little if
any post-operative pain, but may have trouble
urinating for up to a few weeks, so a small tube
is placed in the lower abdomen to drain the
urine for that time period.
HIFU was developed in the 1950s here in the
U.S., and has been used for treatment of various
tumors. It has already been FDA-approved
for use in uterine fibroids, and studies are
underway that will be presented for FDA
approval for treatment of prostate cancer soon.
Meanwhile, HIFU for prostate cancer has been
performed on nearly 10,000 men worldwide
and has been extensively studied in Japan and
Europe; studies from other countries suggest
this treatment is comparably as effective as
other treatment options but with reports of
fewer urinary and sexual side effects, making
this treatment option appealing to physicians
and patients alike.
Currently for a man from the US to receive HIFU
he must either enrolled in a clinical trial or travel
outside the US. International HIFU uses the
Sonablate® 500 overseas, and specially trained
American Urologists and a team of nurses
and engineers travel with patients for these
treatments. Most patients travel to Canada, the
Bahamas, or Mexico for their treatment, typically
arriving the day before the outpatient treatment,
and returning home the day after.
Regionally, only the doctors at Western Urological
Clinic have begun using HIFU for prostate
cancer (see www.westernhifu.com for details).
More information, including the opportunity
to speak with someone who has had HIFU
therapy, is also available at 1-888-874-4384.
About the doctor:
Dr Gange is a UCLA medical school
graduate and has practiced with
Western Urological Clinic since
1996, with particular expertise in
all stages of prostate cancer management,
emphasizing minimally
invasive procedures (including
HIFU since April 2009) and compassionate
care. He is also President of
the Utah Healthy Living Foundation,
founded in 2001 and dedicated
to improving quality of life through health
education and screenings. He is on the board
of IVUmed, an organization that trains third
world doctors to provide skilled urology care.
He has held numerous other leadership positions
including President of the Utah Urological
Society and Chief of Surgery at
St. Mark’s Hospital. He regularly
lectures to physicians and lay
groups on all aspects of urology
and was instrumental in the
creation of the Urology section
of WebMD. Dr. Gange is also
the medical director of Healthy
Utah magazine
“Heart disease is
at least six times
more likely to kill a woman
than breast cancer...”
HIFU for Prostate Cancer
w r i t t e n b y S t e v e n N . G a n g e , M D , F A C S
In spite of advances in early diagnosis, an American man dies of prostate cancer
every 15 minutes. If detected early enough it can be cured but often at a high cost of
debilitating side effects. Emerging treatments like HIFU may help change all that.