Study shows HIFU noninferior to prostatectomy for localized prostate

Interesting study, but 30 months is not a very long timeframe. It will be important to see what 10, 15, 20 yr data looks like and also how many HIFU patients need subsequent treatment compared RALP over a longer time period.

I agree. It is an interesting option if you "qualify" for the procedure, and it should leave all other options open in case of failure.

T

Another article about this study helped me understand the results.

“Of those patients in the HIFU arm, 10% eventually underwent salvage treatment, 5% underwent second HIFU, and 2% went on active surveillance. In the RP arm, 13% underwent salvage treatment and 2% went on active surveillance.

Regarding safety, complications greater than IIIa were reported in 2.7% and 2.1% of patients after HIFU and RP, respectively.

As for functional results, urinary incontinence and erectile dysfunction "were significantly lower after HIFU," Rischmann reported.

Specifically, at 12 months, 64% of patients who underwent HIFU had a stress incontinence score of 0 (indicating the patient had no or very mild urinary continence symptoms) compared with 48% of patients in the RP group (risk ratio 0.76, 95% CI 0.70-0.83, P< 0.001).

At 30 months, 62% of patients in the HIFU arm had normal to moderately impaired erections compared to 42% of patients in the RP arm. "So there was significantly less degradation for erectile function after HIFU," Rischmann observed.”
https://www.medpagetoday.com/meetingcoverage/aua/109965

"Patients with T1-2 NxM0 disease and a grade group disease of less than 3 were eligible for enrollment on the trial. Other eligibility criteria included having a Gleason score of no higher than 7 and a PSA of less than 15 ng/mL. For patients to be eligible to undergo treatment with HIFU, they needed to be older than 69 years." from the first link

I am 57 and had my HIFU in 2023. I had irregular cells on both sides confirmed by a biopsy in 2017 (Gleason 6). Mayo Rochester detected a small lesion Gleason 7 on one side. HIFU was performed on one side and eliminated all of the irregular cells and the cancer lesion on one side. I still have irregular cells on the other side. I had a catheter for 6 days after the procedure. I have had no continence issues or erection issues since the catheter was removed. My last first PSA after surgery was high for my age, but normal for men in their 60s. My second PSA was normal for my age group. I still have irregular cells or cancer on one side (Gleason 6). I was approved because they had confidence that I would perform the life long follow up that is needed with HIFU

How does this differ from TulsaPro or is it the same thing?

Tulsa Pro uses some of the same ultrasound technology for the ablation, but they are not alike. Tulsa Pro can handle a person with a fair amount of BPH, HIFU can not. HIFU the lesion has limited locations that it can reach so the lesion is best if it is near the rectum, as it is done that way and only reaches a limited area in the prostate. There are other limits some places put on HIFU, and some places put limits on Tulsa too. These are limits the maker of the equipment has not put on using it, as the places doing studies almost always put more limits on who they accept. So bottom line is if you go to a place that is part of a study they may not accept you, where-as private place might.

I was diagnosed in April and was hoping for HIFU. I was ineligible due to the single lesion on the anterior side (can’t get enough energy to that area). I saw TULSA when researching Mayo and it looked like a great option. I am scheduled for July in Rochester. Really like the early data and I am very confident in the rigorous follow up plan.

@jcf58, as you prepare for your trip to Mayo, you might find the discussions in this group helpful:
- Visiting Mayo Clinic Support Group https://connect.mayoclinic.org/group/traveling-to-mayo-clinic/

Loads of suggestions re hotels, things to do, what to expect and more.