For the estimated 220,000 men who will be diagnosed with prostate cancer this year, deciding on a method of treatment can be a challenge. Some with early-stage cancer pursue active surveillance, while others with more severe cancer immediately pursue surgery, including prostatectomy. Others fall somewhere in the middle. For those men, a new minimally invasive therapy might be an optimal treatment approach.
High-intensity–focused ultrasound, or focal therapy, is a new concept for treating prostate cancer pioneered by clinician-scientists at NYU Langone Medical Center. The goal is simple: destroy only the clinically significant cancer within the prostate, while sparing adjacent structures and minimizing side effects, such as erectile dysfunction and urinary incontinence.
“This technology provides important treatment for a niche group of men with prostate cancer who otherwise have limited options for care,” said Herbert Lepor, MD, the Martin Spatz Chair and Professor of Urology at NYU Langone.
In January 2016, Dr. Lepor and colleagues at NYU Langone were the first in the Northeast to utilize Sonablate, a new focal therapy device, to treat patients with intermediate-risk prostate cancer. Manufactured by SonaCare Medical, Sonablate uses focused ultrasound energy to destroy prostate tissue at the focal point without harming the tissue around the lesion.
How It Works
During the high-intensity–focused ultrasound procedure, a diagnostic and therapeutic ultrasound probe is inserted into the rectum under general anesthesia. The surgeons direct the focused ultrasound energy precisely to the cancer under real-time ultrasound guidance, which is coregistered to the original magnetic resonance image that was used to plan the extent of the tissue ablation. The innovative coregistration fusion software allows the surgeon to ablate the targeted cancerous tissue and a rim of normal tissue, minimizing damage to untargeted tissue.
“Building upon our pioneering work in prostate imaging and targeted biopsy, this technology adds an innovative, minimally invasive treatment option to the array of modern treatment choices we can offer our patients,” said James Wysock, MD, Assistant Professor of Urology and a Urologic Oncologist at NYU Langone certified in high-intensity–focused ultrasound ablation. “We will continue to study this therapy and identify better ways to screen, detect, and treat the disease.”
The U.S. Food and Drug Administration approved high-intensity–focused ultrasound therapy for ablation of prostate tissue in the fall of 2015. The procedure is currently not covered by insurance or Medicare. ■
Disclosure: Dr. Lepor owns stock in SonaCare Medical. Dr. Wysock has no disclosure of any commercial interest or financial support from SonaCare Medical.