HIFU Ablation Is Not a Proven Standard Treatment for Localized Prostate Cancer (Point-Counterpoint) (High-Intensity Focused Ultrasound) (Report‪)‬

Author(s): Alan I. So, MD, FRCSC Optimal management of clinically significant localized prostate cancer centres on the achievement of the prostate cancer "trifecta" : (1) cure of malignancy; (2) preservation of erectile function; and (3) maintenance of voiding function and continence.[sup.1] Although in use since the mid-1990s, high-intensity focused ultrasound (HIFU) as an ablative source to treat prostate cancer has not been clearly demonstrated to be advantageous in any of these parameters compared to already established therapies, including surgical (radical prostatectomy) and radiation (brachytherapy) options. Interestingly, the lack of robust clinical evidence showing a benefit, or even equivalence, of HIFU in comparison to standard therapies is the primary reason why the European Association of Urology,[sup.2] the American Urologic Association,[sup.3] National Comprehensive Cancer Network,[sup.4] the UK National Health Service based National Institute for Health and Clinical Excellence Prostate Cancer guidelines[sup.5] and the US Federal Drug Administration do not currently recommend HIFU as a standard option for the initial management of clinically localized prostate cancer.