HIFU:"Insufficient data availability"

Despite growing popularity, HIFU therapy remains an experimental procedure in localized prostate cancer. Sufficient scientific evidence of its effectiveness is still lacking. Highly focused ultrasound waves are directed into the prostate through a burning glass. At the "focal points", temperatures of around 90 degrees Celsius are generated to destroy the tumor tissue. HIFU (high-intensity focused ultrasound) technology is increasingly in demand for the therapy of localized prostate cancer. However, the method remains controversial among experts.

HIFU is still not an alternative treatment for localized prostate cancer,"said Dr. Pedram Derakhshani of the West German Prostate Center in Cologne, referring to the German S3 guideline on prostate cancer. The Cologne urologist warns that insufficient data does not permit a reliable assessment of the efficacy, safety and cure rates of HIFU therapy. Thereby, thermal ablation can still be classified as an experimental procedure and is not recommended to the patient.

HIFU: Danger of overtherapy

In addition, HIFU is often used for prostate tumors with a very low risk and can also be used for active surveillance according to the recommendations of the current guidelines. The benefits of HIFU thus remain unclear,"says Derakhshani. Rather, there is the danger of an "over-therapy". A further disadvantage: Patients with a larger prostate (over 25 ml) can only be treated with HIFU if the prostate gland has previously been reduced by hormone deprivation or excision. The urologist of the West German Prostate Center admits that HIFU's advantage of being particularly gentle as a minimally invasive procedure is no longer guaranteed.

If there is an urgent need to treat the tumour, well-proven and scientifically evaluated procedures are available to the patient today,"said Derakhshani, referring to gentle methods with low side-effects such as brachytherapy. The great advantage compared to HIFU is that all tumor cells in the prostate are detected during irradiation, which means that prostate cancer of the medium risk group or, in combination with external irradiation, even of the higher risk group can be treated effectively. Long-term data also clearly show that brachytherapy achieves the same healing rates with fewer side effects compared to surgery.

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